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Ankle pump exercises do not produce clinically meaningful benefits in oedema, pain, functionality or mobility after acute ankle sprain: a randomised controlled trial

Journal
Brazilian journal of physical therapy (Q1)
Published
10 September 2026
Study design
Randomized controlled trial
Evidence level
Level 1, High (CEBM 1b)
Authors
Guilherme S Nunes, Bruna Batista Da Cas, Andreza Evaldt de Lima, Gabriela Beck Aliano, Lucas Dos Santos Costa, Brenda Dutra Guterres
PMID
42721828
DOI
10.1016/j.bjpt.2026.101656

Why clinicians should know about it

  • Picked for Rehabilitation (top studies of the week, 13 September 2026): Ankle pump after sprain, acute injury

Abstract

BACKGROUND: Inadequate resolution of inflammation following ankle sprain may contribute to persistent pain and chronic instability. However, the effectiveness of active interventions, such as ankle pump exercises, during the acute phase remains uncertain. OBJECTIVE: To investigate whether ankle pump exercises provide additional benefit when added to usual care in the management of acute ankle sprain. METHODS: This randomised controlled trial included 88 individuals with acute ankle sprain. Both groups received usual care based on the protection, optimal load, ice, compression, and elevation protocol. Participants in the experimental group additionally performed ankle pump exercises. Primary outcomes were oedema, assessed using the figure-of-eight ankle perimetry method; pain, assessed using a visual analog scale; and function, assessed using the Foot and Ankle Ability Measure (daily living and sports subscales). Outcomes were assessed at baseline, 5 days post-intervention, and 15 days post-intervention. RESULTS: After 5 days of intervention, the experimental group demonstrated a greater reduction in ankle oedema than the control group (mean difference -1.2 cm, 95% CI -2.2; -0.2). This between-group difference was not evident at 15-day follow-up (mean difference -0.9 cm, 95% CI -1.9; 0.1). No between-group differences were observed for pain, ankle range of motion, or function at any time point. CONCLUSION: Our findings indicate that adding ankle pump exercises to usual care produced a statistically significant but small short-term reduction in oedema compared to usual care alone, unlikely to be clinically meaningful. No benefits were observed in pain, mobility, or function, and no between-group differences were observed at the 15-day follow-up.

Abstract as published, via PubMed.

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For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.