Supervised physiotherapy for mild or moderate ankle sprain

Lateral ankle sprains are the most common musculoskeletal injuries in physically active populations.1 Incidence rates in the general population are also high, at an estimated five to seven injuries per 1000 people per year.2 3 More than 40% of patients fail to recover because of persistent pain, recurrent injury, and instability.4 These symptoms, which are characteristic of chronic ankle instability, result in long term constraints to levels of physical activity and could be a key mediator for post-traumatic osteoarthritis.4 Despite this, many patients regard ankle sprains as being innocuous with fewer than half seeking formal medical care.5 This generally occurs in an emergency care facility and is based on advice for self management. While supervised rehabilitation represents a more comprehensive approach, there is ongoing controversy around its cost benefit ratio.

The randomised controlled study by Brison and colleagues (doi:10.1136/bmj.i5650) is one of the largest to …