Consensus Statement: Diagnosis, treatment and prevention of ankle sprains: an evidence-based clinical guideline.Kerkhoffs GM, van den Bekerom M, Elders LAM, van Beek PA, Hullegie WAM, Bloemers G, de Heus EM, Loogman M, Rosenbrand K, Kuipers T, Hoogstraten J, Dekker R, ten Duis H, van Dijk CN, van Tulder MW, van der Wees PJ, and de Bie RA. Br J Sports Med. 2012; doi:10.1136/bjsports-2011-090490.
https://bjsm.bmj.com/content/early/2012/04/19/bjsports-2011-090490
“A multidisciplinary clinical practice guideline was developed with the aim to prevent further health impairment of patients with acute lateral ankle ligament injuries by giving recommendations with respect to improved diagnostic and therapeutic opportunities. The recommendations are based on evidence from published scientific research, which was extensively discussed by the guideline committee. This clinical guideline is helpful for healthcare providers who are involved in the management of patients with ankle injuries.”
This article mentions that using tape or a brace is effective in preventing ankle sprains, but it also says that it is recommended to phase out the use of tape/bracing over time. I've found that athletes seem to think braces are a cure-all for ankle injuries and that they can just wear them and not do anything else, however we all know that braces are not a substitute for good training. How do you deal with athletes who use their tape/brace as a crutch? Do you ever manage to get them to phase out of wearing them? Do you think it's even an issue, or should we just let them wear what they want and not worry about it?
Response via Facebook:
Mike Hopper: I typically tape them if they want it. It just depends on the injury and sport. I normally give them the option of brace, tape, or nothing once we're beyond the acute phase.
I work primarily with women's basketball and feel that controlled mobility (and strength) is more important than limited confinement. I'd rather have them work on ROM, strength and movement than be taped or braced at all. I'll mechanically restrict their ROM for all activities if they have a chronic issue that calls for it but in most cases I only have to tape them for a relatively short period of time. If they suffer an acute lateral ankle sprain then I'll tape them once they are ready to return to the court, go over proper movement patterns once again and then slowly wean them off of the tape by taping lighter and lighter over time. However, I never fully "lock" their ankle up with a typical closed basket-weave type technique with all non-elastic athletic tape. I feel that if they require that then they are probably not quite ready to get back on the floor. I initially evaluate their ROM, balance and strength of their flexor hallucis longus as well as tib anterior. We’ll go through a typical ankle rehab program but ensure that they also work great toe flexion and short foot exercises. On the court, we focus on proper technique and full body awareness (knees above the foot, “core” stiffness etc). In the 14 years I’ve been doing this I’ve only had (knock on wood) 3 lateral ankle sprains that I would consider “significant” and out of those 3, 2 were back without issue within 3 days the last person took 3 weeks but I don’t think all the tape and bracing in the world could have prevented her injury. I understand the idea of taping/bracing everyone all the time. Some coaches require it. However, at this time of my career I don’t see the need. I personally believe that monitoring their level of training, CNS recovery and making sure they tie their shoes correctly is more important. Anyway, for now those are my personal thoughts on the matter for what it’s worth.They my change in the future.