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Are Ankle Braces Part of the Uniform or for Injury Prevention?

Trainers and therapists, as well as doctors, have long debated the pros and cons of ankle braces. It is important to know that regular ankle strengthening and balance exercises are crucial. Whether you are recovering from a past ankle sprain or injury or looking to prevent future ankle injuries, this is very important.

If ankle sprains are not properly treated or recovered fully, it can lead to chronic ankle instability and repeated sprains. This when it may be a good idea to look into ankle bracing.

Volleyball players, in particular, have embraced the use of prophylactic ankle braces, with some coaches making ankle bracing mandatory for their players. With sprain rates so high, who wouldn’t want to protect their ankles? Are braces really effective in reducing the risk of ankle sprains? Here are a few frequently asked questions about ankle braces, based on the most current literature available.

Do ankle braces prevent re-injury?

It does appear that braces are effective for ankles that have been sprained before, especially within the first year after injury. Ankle sprain rates double in the 1-2 years following a sprain. Furthermore, 30-50% of people who sprain their ankle develop chronic instability. Prevention of reinjury following a sprain is therefore vital, and several studies have shown that bracing does reduce the risk of reinjury. A combination of bracing with specific ankle exercises is likely the best course of action in preventing re-injury.

Does the type of brace matter?

Ankle braces may vary in the type of support they offer. For example, lace-up braces, such as the Breg “Wraptor” add stability both on the sides and in the front and back, while stirrup type braces (such as Active Ankle) only support the ankle on the sides. This won’t make a difference in most people– as the majority of ankle sprains are inversion/lateral sprains– but if you have anterior/posterior instability it may make a difference. The second-way braces work is by increasing proprioception and feedback to your sensory and musculoskeletal systems. Proprioception is your brain/body’s unconscious awareness of a joint’s location in space. Increased proprioception helps your muscles react faster and stronger when they are needed to support your ankle against a potentially injuring force.

Most volleyball players have a ‘dominant ankle’, the ankle opposite their hitting arm. This ankle is more likely to be injured because they land on it more often. Setters may be at risk for more ankle sprains on the right because that is the ankle closest to the net, increasing risk for under the net contact after jump sets.

Altering natural ankle mechanics may cause injury at other joints, such as the knee. The ankle has a range of motion built-in that is necessary to help absorb awkward landings. If the ankle cannot move, it becomes akin to landing on a peg-leg, which, if off-balance, means the knee can be the next joint to collapse at an unnatural (and injurious) angle.

Do I Need a Brace?

Bracing is very much an individual choice. However, quite a lot of teams, especially at higher levels do require that braces are worn by everyone during games and training, as they simply don’t want to lose players. When factoring in your decision to wear a brace or not, please remember that you aren’t going to detrain your ankles, just help prevent a serious injury. Also when wearing bracing prophylactically, be sure to alternate during practice and games, to help train those muscles and mechanoreceptors.

How Can We Help?

At the Arthritis and Injury Care Centre, we strive to help patients on their journey and provide them with the education and support they need. If you or a loved one would like more information on how we can help, please contact us for an opportunity to meet with one of our staff.

Verhagen EA, Bay K. Optimising ankle sprain prevention: a critical review and practical appraisal of the literature. Br J Sports Med. 2010 Dec;44(15):1082-8.

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