Ultrasound and Balance Training for Ankle Sprains: A Case Study on Pain and Stability

Abstract

Ankle sprains are among the most prevalent musculoskeletal injuries and frequently progress to Chronic Ankle Instability (CAI) when not managed comprehensively. Persistent pain, proprioceptive deficits, and impaired neuromuscular control contribute to recurrent injury risk and decreased athletic performance. Therefore, integrative physiotherapy strategies targeting both tissue healing and dynamic stability are essential. This case study aimed to evaluate the clinical effectiveness of combining therapeutic Ultrasound and Balance Training in reducing pain and improving functional ankle stability in an athlete with ankle sprain. A single-subject case study design with a pre-test–post-test approach was conducted on a 22-year-old male professional football goalkeeper diagnosed with ankle sprain. The intervention consisted of 12 therapy sessions over four weeks at Fisiohands Physiotherapy Clinic. The program included Ultrasound therapy (3 MHz, 1.5 W/cm², 5 minutes) to stimulate ligament healing and progressive Balance Training using a Bosu Ball and Wobble Board to enhance neuromuscular control. Pain was assessed using the Numeric Rating Scale (NRS), and functional stability was measured using the Cumberland Ankle Instability Tool (CAIT). Post-intervention findings showed significant clinical improvement. Resting pain decreased from 5 to 0, tenderness from 7 to 1, and motion pain from 8 to 1. The CAIT score improved from 9 to 22 points, reflecting a 13-point increase in functional stability. The integration of Ultrasound and Balance Training effectively reduced pain and substantially improved ankle joint stability, supporting its role as a comprehensive physiotherapy strategy to facilitate safe return to sport and minimize reinjury risk.