Grade III lateral ankle sprains are common in sports like basketball and volleyball and can derail an athlete’s season.
Traditional land-based rehab is effective, but aquatic therapy may offer a faster, less painful route to recovery.
This study aimed to test whether aquatic therapy accelerates return to play and improves performance better than conventional rehab.
Can early aquatic therapy outperform conventional land-based rehab in speeding up return to sport after a Grade III ankle sprain?
What Did the Researchers Do?
- Subjects: 30 elite athletes (18–30 yrs), mostly in basketball, volleyball, football, or rugby, all with MRI-confirmed Grade III lateral ankle sprains within 1–7 days.
- Randomized into two groups:
- Control Group (n=15): Traditional rehab with land-based therapeutic exercises, manual therapy, and external support.
- Aquatic Group (n=15): A 4-week underwater rehab protocol, progressing from walking and stretching to resistance-based proprioceptive training.
- Outcomes Measured:
- Pain (VAS)
- Dynamic balance (Star Excursion Balance Test)
- Performance (Hop Tests, Agility T-Test, Illinois Agility Test)
- Muscle power (Single Leg Press)
- Return-to-sport time
What Were the Results?
- Pain: Aquatic group had greater pain reduction by Week 4 and Week 6 (VAS Week 6: 0.55 vs 2.01, p < 0.001).
- Hop Tests: Significant improvement in all (Single, Triple, Cross-over) except 6-m Hop.
- Agility Tests: T-Test and Illinois Agility improved significantly more in the aquatic group by Week 4 (p < 0.001).
- Balance: Aquatic group had better scores in all directions of the SEBT (e.g., average: 93.5 vs 88.6).
- Muscle Power: Higher strength gains in the aquatic group at Week 4 and 6 (p < 0.001).
Return to Sport: On average, the Aquatic group returned in ~4.7 weeks, while the control group returned in ~7.7 weeks, a difference of 3 weeks.
What Does This Mean?
Aquatic therapy led to:
- Faster reductions in pain
- Greater improvements in functional performance and dynamic balance
- Quicker return to sport without sacrificing quality of recovery
Early water-based rehab may enhance confidence and reduce reinjury risk by facilitating movement without joint overload.
Coach’s Takeaway
- Use Aquatic Therapy Early ⮕ Start rehab in water within 7 days post-injury for elite ankle sprains.
- Better Performance, Sooner ⮕ Aquatic athletes returned nearly 3 weeks faster while showing stronger test results.
- Don’t Over-Rely on Immobilization ⮕ Aquatic movement can reduce pain and swelling more effectively than rest alone.
I hope this helps,
Ramsey
