Using the Mulligan Mobilization with Movement and Fibular Repositioning to Treat High School Patients with Grade One Lateral Ankle Sprain

Abstract

Ankle injuries are common among high school athletics with the highest incidence rates in boys and girls basketball and boys football. Novel treatment paradigms like the Mulligan Mobilization with Movement (MWM) in conjunction with fibular repositioning tape have shown promising results in reducing pain, disability and time lost due to lateral ankle sprains. However, research focusing on the Mulligan treatment strategies and ankle swelling following a lateral ankle sprain is limited. Therefore, the purpose of this case series was to evaluate the combined effects of the MWM and fibular repositioning taping on swelling, function, and pain in high school patients with an acute grade 1 LAS. A convenience sample of seven (4 females, 3 males, 5 right ankle, 2 left ankle injuries) consecutive high school patients (15.9± 1.4 years of age; range = 14-18 years) were evaluated following an acute lateral ankle sprain and treated with the Mulligan MWM and fibular repositioning tape. Subjective evaluation of pain, self-report function and disability were assessed throughout the treatment process utilizing PROMs. Specifically, the Numeric Pain Rating Scale, Disablement in the Physically Active scale, Foot and Ankle Ability Measure and the Foot and Ankle Ability Measure Sport Subscale were included throughout the treatment protocol along with the figure-of-eight ankle girth measurement to assess the amount of swelling following each treatment session. All seven patients returned to unrestricted participation following an average of 2.9±0.8 treatments (range 2-4 treatments) and presented an average decrease in ankle girth of 24.7±13.7mm from baseline to return to participation. Overall, the Mulligan MWM and  fibular repositioning tape produce an immediate change in pain, disability, function and swelling following an acute grade 1 LAS.