Sadaak et al (2024) Effect of aquatic versus conventional physical therapy program on ankle sprain grade III in elite athletes – randomized controlled trial

Grade III ankle sprains, common in high-performance athletes, cause severe pain, instability, and significant downtime from sports. This randomized controlled trial compared the efficacy of aquatic therapy versus conventional land-based physiotherapy in 30 elite athletes aged 18–30 with acute ankle sprains.

The results demonstrated that athletes receiving aquatic therapy showed superior improvements in pain reduction, dynamic balance, and athletic performance. Pain scores, measured on the Visual Analog Scale, decreased significantly faster in the aquatic therapy group. Performance tests, including hop tests and agility evaluations, revealed marked gains in muscle power, proprioception, and functional mobility. Most importantly, the aquatic therapy group returned to sports approximately three weeks earlier than those undergoing conventional rehabilitation.

Aquatic therapy leveraged the buoyancy and hydrostatic pressure of water, reducing joint stress and enabling effective movement. The therapy protocol included progressive exercises such as water walking, squats, lunges, and proprioceptive tasks. In contrast, the conventional physiotherapy group received standard land-based rehabilitation involving resistance training and manual therapy.

The study concludes that aquatic therapy is highly effective for early rehabilitation of Grade III ankle sprains in elite athletes. Its benefits in reducing pain, enhancing performance, and accelerating return-to-sport timelines make it a recommended approach for this population.