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A 21-year-old woman complained of lateral left ankle pain
after experiencing a grade 2 ankle inversion sprain during walking one week
prior to treatment. She had been diagnosed with left ankle inversion sprain
2 years prior, for which she had received manual physical therapy for 3 weeks.
However, she continued to experience occasional ankle sprain. She complained of
painful ankle inversion and instability when descending stairs, ascending an
oblique surface, and standing on unstable ground and severe pain during
running, jumping, and squatting. Full weight bearing on the sprained leg was
especially difficult.
Ankle
inversion sprain often occurs during sports-related activity, landing on an
inverted and plantar flexed foot after jumping, and running on uneven surfaces.
Approximately 85% of ankle sprain injuries are related to the lateral ligament.
It involves pain, lateral ligamentous injury, excessive ankle inversion,
swelling, and limitations in ankle range of motion. Some patients with ankle
inversion sprain experience continuous pain and ankle instability at long-term follow-up.
Additionally, the re-injury rate of ankle inversion sprain may be as high as 80 per cent. Therefore, utilizing the most effective intervention for ankle
inversion sprain is important. Here, we report the
effects of repeated application of ankle eversion taping (AET) using
kinesiology tape in a patient with ankle inversion sprain.
A young lady with grade 2 ankle inversion sprain had significant improvement in functional dynamic balance, ankle instability and pain after using ankle eversion taping for four weeks.
She had a history of left ankle inversion sprain two years
prior, for which she had received manual physical therapy for three weeks.
In the initial assessment,
the Numeric Pain Rating Scale (NPRS) score of the lateral ankle at rest was 4
and that on application of 3 kg pressure on the most tender area of the lateral
ankle using an algometer was 7. Her left ankle score on the Cumberland Ankle
Instability Tool (CAIT) questionnaire was 2/30. The Y-Balance test was used to
assess functional dynamic balance with ankle instability. The maximal reach
distances of the opposite leg in 3 directions (anterior, posteromedial, and
posterolateral) while in a sprained left leg stance were 35 cm, 55 cm, and
54 cm, respectively. The lunge test was used to assess ankle flexibility. The
initial distance of the left toe was 5 cm.
Followed by detailed diagnosis, patient was treated with
ankle eversion taping (AET) using kinesiology tape daily to the left ankle for
4 weeks (average, 15 h/day). Firstly, an I-shaped tape was applied from the
talus to the calcaneus in a mild dorsiflexion position for posterior talar
glide. Secondly, an I-shaped tape was applied from 5 cm above the lateral
malleolus, over the medial calcaneus, to the inside of the instep of the foot
in an eversion position to prevent painful inversion. Thirdly, an I-shaped tape
was applied using the same method as that used for the second tape to reinforce
prevention of painful inversion and allow ankle eversion. Fourthly, an I-shaped
tape was applied using the same method as that used for the first tape to
reinforce posterior talar glide and provide ankle support. We applied AET to
the sprained left ankle daily after removal of the AET applied the previous
day, even though the patient did not complain of itchiness. Additionally, the start and end points of the tape
(approximately 2–3 cm) were applied without stretching to prevent skin
problems. No other treatment intervention for ankle inversion sprain was used.
This case study showed that repeated AET application for 4
weeks reduced lateral ankle pain and improved ankle flexibility and functional
dynamic balance. Painful plantar flexion and inversion of the sprained ankle
were prevented through a more everted ankle with AET application. In addition,
the sprained ankle was protected from re-injury through the mechanical effects
of AET application. Previous studies have reported that kinesiology tape
application to an ankle with instability and
eversion sprain reduced pain and improved
stability. Therefore, healing of ankle inversion sprain was possible.
Repeated ankle eversion taping is an effective treatment
intervention for ankle inversion sprain as in this case. Ankle instability and
pain were reduced and functional dynamic balance was improved after ankle
eversion taping for 4 weeks. Kinesiology
tape may provide support to the joint structure
and improve joint position sense. However, future studies on the clinical
effects of AET in a larger number of patients with ankle inversion sprain are
required.
J Phys Ther Sci. 2016 Feb; 28(2): 708–710.
A case of effects of ankle eversion taping using kinesiology tape in a patient with ankle inversion sprain.
Sun-Min Lee et al.
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