1 – Prevent or Eliminate Soft Tissue Swelling Focal and
generalized compression. To appreciate why focal compression
around both malleoli in the early stages plays such an important
role in the management of uncomplicated lateral ankle sprains,
one must recognize that the anatomy of the ankle consists of
peaks and valleys—with the lateral and medial malleoli being the
peaks and the areas anteroinferior and posterior to the malleoli
being the valleys. As a result of soft tissue trauma, swelling
accumulates in the “areas of least resistance”—the lateral and
medial valleys. Emphasis must be placed on filling these valleys
as soon as possible with focal compression to prevent swelling
or eliminate swelling that has already occurred (Figure 1).
Compression devices. For years, felt horseshoe pads, secured in
position with an elastic wrap, have been the gold standard for
focal and generalized compression in the athletic trainer
community (Figure 2). However, horseshoe pads can be fabricated
from other materials that