Ankle Support: An Effective Way to Prevent Ankle Sprains
Ankle sprains usually occur as a result of a twisted motion caused by missed timed steps, awkward landings, or tackles during the movement. This injury can cause damage to the soft tissue around the ankle, which is sometimes associated with bone and/or cartilage damage. The most common type of ankle sprain I've seen at my physics training in Sydney is a lateral ankle ligament injury. A lateral ankle ligament sprain is where the outer (lateral) ligaments of the ankle are stretched or torn, usually when the ankle is in a slightly pointed position and then forced inward. The biggest risk factor for an ankle sprain is a previous ankle sprain, which means that if you've injured your ankle before, you're more likely to injure it again in the future. In addition to the acute treatment of an ankle sprain, much of the physical therapist's approach when rehabilitating an ankle sprain is an effort to restore the individual's balance control to prevent re-injury. However, often individual training/sports requires a return to activity before full recovery, which means that precautions such as ankle braces are recommended for an early return to play.
How Ankle Brace Works
Wearing a brace can help support your ankle and prevent sprains. Ankle braces have been shown to be an effective way to prevent ankle sprains. The mechanism of injury in an ankle sprain is usually due to a twisted condition where the muscles that support the ankle are not ready for the injured movement and respond slowly or not enough to prevent the twist. As mentioned above, some common situations that can lead to an ankle sprain are being knocked down while landing from a jump or landing on an uneven surface or someone's foot. When jumping or cutting or changing direction on uneven surfaces, being knocked or bumped before the foot is implanted is a common cause. In these cases, the brace can protect the ankle because the muscles don't have the time or strength to slow or prevent twisting motion. After an ankle sprain, often the injured ankle ligaments heal, but the ability to maintain ankle stability is reduced and the ankle ligaments relax. This can happen if the ankle ligaments are completely torn or the healing process sees the ligaments "stretch" a bit. In situations where the ligament itself has less structural support, a ligature or ankle brace can serve as a temporary "surrogate" for the ligament's lack of stability. After an ankle sprain, often the injured ankle ligaments heal, but the ability to maintain ankle stability is reduced and the ankle ligaments relax. This can happen if the ankle ligaments are completely torn or the healing process sees the ligaments "stretch" a bit. In situations where the ligament itself has less structural support, a ligature or ankle brace can serve as a temporary "surrogate" for the ligament's lack of stability. After an ankle sprain, often the injured ankle ligaments heal, but the ability to maintain ankle stability is reduced and the ankle ligaments relax. This can happen if the ankle ligaments are completely torn or the healing process sees the ligaments "stretch" a bit. In situations where the ligament itself has less structural support, a ligature or ankle brace can serve as a temporary "surrogate" for the ligament's lack of stability.
Ankle Bracing: Early Prevention After Acute Injury
Ankle braces are often used in physical therapy to immobilize and prevent further injury early after an acute sprain. In moderate-to-severe graded injuries, ankle braces are recommended to protect healing ligaments so they don't re-injure or elongate during the healing process.
Use of some form of ankle support is appropriate for athletes who have previously suffered a sprained ankle injury and are returning to high-risk activities, such as contact sports or sports that involve jumping and landing, cutting and changing directions, or sports on uneven surfaces . It should be mentioned here that the use of ankle braces should not be viewed as a substitute for proper rehabilitation, but only as part of the rehabilitation process. Optimal outcomes after an eventual sprained ankle are usually combined with a comprehensive rehabilitation program focused on restoring range of motion, strength and balance control, and timely ankle banding or bracing. This approach will give the athlete the best chance of getting back on the field sooner and help avoid re-injury.
Will any ankle brace work?
Ankle braces don't have to cost a fortune, and the basic braces I often recommend are so-called combo braces. This is an ankle brace that has a lace-up function on the front of the brace with overlapping stirrups, which is generally inexpensive and pleasant, and in my experience is very effective at preventing lateral and rotational movement of the ankle. There are several brands that make these types of braces, and usually they'll only set you back around $50, making them well worth the investment. Personally, I haven't seen anyone re-injuring their ankle while wearing this proper brace. I'm not saying it's impossible to injure your ankle wearing this type of ankle brace, sadly it won't make you bulletproof, but it will certainly protect your ankle from re-injury for a long time.
How long should an ankle brace last after an injury?
I usually recommend braces or tape for most of my patients with severe ankle sprains for around 6 months (or even up to a year after the injury). If the sprain is minor and the ankle maintains ligamentous stability and the athlete regains control of homeostasis, then long-term bracing or banding may not be necessary, and they can begin to stop using the bracing point of view until then.
Does training require ankle support too, or is it just game day?
It is recommended that you engage in high-risk activities at all times, such as exercising on uneven surfaces, contact sports, or sports that involve jumping, cutting, and changing direction, for bracing or strapping to stabilize after injury. In the above situations, whether or not "just training with teammates", the risk of injury remains high. Therefore, if some form of ankle support is deemed necessary on game day, then training is also necessary.
Ankle brace verse taping, which is better?
This decision comes down to a few factors, research comparing ankle bracing and taping show that they have nearly the same level of effectiveness. So, one of the things to consider around deciding between an ankle support and taping is $$$. Typically taping in the long run is going to work out more expensive, taping is not a one of purchase like a brace is so taping for training and game days for an extended period is going to add up. Taping is generally more time consuming and the effectiveness of ankle strapping relies heavily on the skill of the individual applying the tape. Seems like an open and shut case for bracing, however in certain sports bracing may negatively influence performance. Braces are clearly more cumbersome than ankle taping and in a sport such as soccer a brace can affect the athletes playing ability. A brace can impact the “feel” of kicking the ball and affect the player's “touch”. In situations where footwear is required to be particularly sung or the feel of a ball against the foot and ankle is desirable then I would suggest taping may be a better option over the more bulk ankle brace counterpart. In these situations, people may opt for the use of an ankle brace for training days where a “good touch” isn't 't as crucial and then taping for the game day, when performance is key. Obviously if you are unsure if the use of some sort of ankle support is relevant for you and if so what the best option is given your specific circumstances then approach your physiotherapist and ask their opinion, a physiotherapist will be able to easily point you in the right direction.