Technique Highlight: Functional Mobilization for Ankle Inversion Sprains

This is a great technique for inversions sprains, from acute prior to swelling and chronic lateral ankle pain.

If inversion stress test is positive, or patient has limited functional WB activities, try this technique! Mulligan postulated that some inversion sprains that test painful and lax are as a result of the lateral malleolus getting pulled anteriorly by the ATF.

Patient:

• supine
• foot in resting position to start

PT:

• test inversion stress, if limited ROM and/or painful
• mobilizing hand grasps anterior lateral malleolus with thenar eminence to apply glide
• fingertips of the mob hand are grasping posteriorly
• other hand on lateral anterior forefoot to apply inversion stress or assist patient with AROM inversion and apply overpressure

Technique:

• apply a constant posterior glide and retest inversion stress test
• if pain free, apply 2-3 sets of 10 reps, ending in overpressure - has to be 100% pain free other than stretch
• note, if acute, may be tender to touch at lateral malleolus, as long as it does not remain increased when done
• if not 100% pain free, try more force, less force, or changing to posterior superior glide or posterior inferior glide
• if effective, not only will the inversion stress test be improved, but functional ADLs should be as well!

I've even used this on myself immediately s/p an acute inversion sprain, it made it so that I could walk and WB the rest of the evening and most likely reduced the healing time.