Background Ankle sprains are the most common musculoskeletal injuries that occur in athletes. The importance of finding ways to prevent these injuries is therefore of paramount importance to athletes, their teams and the medical system as a whole.

Objective To review the published evidence on the effectiveness of various methods in the prevention of ankle sprains in the athletic population.

Design A literature search was conducted using multiple databases and only included prospective, level 1 and 2, randomised and quasi-randomised controlled trials (RCTs) published between 1980 and August 2010. Keywords used in the search were prevention in combination with ankle sprains.

Results Overall, 19 RCTs were reviewed consisting of a total of 12 233 participants. The studies showed a significant reduction in the number of ankle sprains in individuals allocated to an external ankle support group. This reduction was greater for those with a previous history of ankle sprains. Braces seemed to be more effective in preventing ankle sprains than tape. Appropriately applied braces, tape or orthoses, do not adversely affect performance. Proprioceptive training reduced the incidence of ankle sprains in athletes with recurrent ankle sprains to the same level as subjects without any history of ankle sprains.

Conclusion Semi–rigid orthoses or aircasts are more effective than taping to reduce the incidence of sprains. Sensori-motor control can seemingly be improved in previously injured ankles, such that the risk equals that of healthy ankles. Rules must be changed to limit contact between players and possibly harsher penalties introduced. When the above interventions are utilised effectively, ankle sprains can be significantly prevented.