Efficacy of deep transverse friction massage in treatment of chronic ankle sprain

Ankle sprains of lateral ligaments are extremely common injuries in athletic and physically active population and recurrence remains a common problem accounting for as high as 80% with ankle instability. Neuromuscular and proprioceptive deficits are thought to be related to chronic ankle instability, including functional and mechanical insufficiencies. Physical therapy is a treatment modality for patients who have suffered moderate to severe ankle sprains, especially persons who have chronic instability and recurring symptoms. Deep Transverse Friction Massage (DTFM) is a special type of connective tissue massage used after an injury or mechanical overuse in muscles, tendons and ligaments is evaluated as a method of treatment in Ankle sprains.

Aims & objectives

To evaluate and compare the short term therapeutic effects of Pulsed Ultrasound and Deep Friction Massage with Strengthening in Treatment of Recurrent Ankle Sprain

Hospital based, single blind, Randomized Controlled Equivalence Trial

The study population were patients clinically and radio logically diagnosed by Consultant Orthopaedic surgeon in Orthopaedic OPD as recurrent ankle sprain and referred to physiotherapy for treatment. The

Patients >15 years age, of both genders with ankle sprain with previous history of minimum two episodes of ankle sprain in the same foot and who had suffered from last ankle sprain within two months.

Acute inflammation and swelling(less than 48 hours),Ankle fractures and unstable ankles, Neurological disorders like neuropathy, Musculoskeletal condition of the lower limbs like limb shortening, foot deformities (Congenital or acquired) A total of 30 patients who were fulfilling the inclusion criteria were enrolled in this study.

A blinded observer recorded pain scores on rest and on movements before treatment, than on 3^rd, 7th, and 10^th day after completion of therapy using visual analog scale (VAS). Range of movement at ankle namely Dorsi flexion, Plantar flexion, Eversion, Inversion at ankle joint was measured by Goniometer and. Foot and ankle disability scale score was recorded pretreatment and post treatment.

Of 30 patients, 19 were females (63.33%) suggesting female preponderance. The mean age of the patient was 24.63 years. Twenty One patients had right side ankle involvement. Two groups were comparable for age, gender and side of sprain. On comparing the results of two therapies there was no statistically significant difference noted in relief parameters suggesting that the two studies were giving equivalent short term relief to patients of chronic ankle sprains. Overall analysis of Ankle disability score recorded pre-treatment and post treatment in both modalities showed statistically significant improvements in Ankle disability scores.

DTFM is an efficacious tool for short term treatment of chronic ankle sprains. Its efficacy is equivalent to standard ultrasound therapy.