PDFQ: Should one use ankle supports or taping after an ankle injury?
Male sports player, 22, UK
A: Principles which guide me in relation to ankle supports:
1. If you limit normal movement in a normal joint, you will create stresses elsewhere. One vivid example was the gymnast who jumped down from the high bar and collapsed in a heap: his heavily taped ankles (American-style) prevented his legs from giving normally as he landed, so all the pressure was taken up to his back, which gave a loud and painful "crack". By limiting movement, you reduce muscle work. If all the lower leg muscles are relatively de-activated, those round the knee and into the thigh have to work harder, while proprioception in the foot and ankle gets progressively undermined. Proprioception is a joint’s internal awareness of position, which depends on finely tuned nerves inside the joint.
2. If you use a sock-type support, you restrict the circulation, and that causes reduced efficiency in neuromuscular activity, ie progressive weakening and muscle wasting.
3. There have seen papers identifying that ankle taping does not prevent ankle injury.
4. Post-injury, or in cases of recurrent ankle sprains, the ankle may need support to prevent abnormal twisting (especially inversion). In the very early stages of a severe sprain, there is a case for taping the ankle or immobilizing it in a walking cast.
During the recovery phase, the most effective support for preventing unwanted movements is the stirrup type, which consists of two rigid bands on either side of the ankle and lower leg, attached with velcro straps. It may look cumbersome, but in fact is light and comfortable enough for sports like squash or football. For someone with weak ankles which tend to get sprained a lot, the stirrup support can be used routinely for sports as a protective measure.
5. In all cases, protective exercises for the ankles have to be done. These are not only strengthening and mobilizing exercises, but also proprioceptive training, which consists of special exercises to re-train the nerve systems which control the ankles. Ankle exercises should be a daily routine, and kept up indefinitely.
1. If you limit normal movement in a normal joint, you will create stresses elsewhere. One vivid example was the gymnast who jumped down from the high bar and collapsed in a heap: his heavily taped ankles (American-style) prevented his legs from giving normally as he landed, so all the pressure was taken up to his back, which gave a loud and painful "crack". By limiting movement, you reduce muscle work. If all the lower leg muscles are relatively de-activated, those round the knee and into the thigh have to work harder, while proprioception in the foot and ankle gets progressively undermined. Proprioception is a joint’s internal awareness of position, which depends on finely tuned nerves inside the joint.
2. If you use a sock-type support, you restrict the circulation, and that causes reduced efficiency in neuromuscular activity, ie progressive weakening and muscle wasting.
3. There have seen papers identifying that ankle taping does not prevent ankle injury.
4. Post-injury, or in cases of recurrent ankle sprains, the ankle may need support to prevent abnormal twisting (especially inversion). In the very early stages of a severe sprain, there is a case for taping the ankle or immobilizing it in a walking cast.
During the recovery phase, the most effective support for preventing unwanted movements is the stirrup type, which consists of two rigid bands on either side of the ankle and lower leg, attached with velcro straps. It may look cumbersome, but in fact is light and comfortable enough for sports like squash or football. For someone with weak ankles which tend to get sprained a lot, the stirrup support can be used routinely for sports as a protective measure.
5. In all cases, protective exercises for the ankles have to be done. These are not only strengthening and mobilizing exercises, but also proprioceptive training, which consists of special exercises to re-train the nerve systems which control the ankles. Ankle exercises should be a daily routine, and kept up indefinitely.
