ReviewA systematic review on the effectiveness of external ankle supports in the prevention of inversion ankle sprains among elite and recreational players
Introduction
As prevention of injury becomes an increasingly important part of practice today, researchers strive to understand and identify what can optimally reduce the incidence of ankle injury and re-injury. Individuals who participate in athletic activities are particularly susceptible to ankle injuries.1, 2, 3 Of these injuries, approximately 86% are sprains.4 Ankle sprains have often been reported as one of the most common types of injuries occurring during recreational and full time sporting activities.1, 4 Several epidemiological studies have also shown that about 10–28% of all sports injuries are ankle sprains and as much as 73% of competitive and recreational athletes had recurrent ankle sprain2, 5, 6 leading to the longest absence from athletic activity compared to other types of sports injuries.2 Because of this, different interventions such as exercises, ankle taping techniques, ankles braces and orthoses have been identified to reduce the incidence and recurrence of ankle sprains. In the review by Handoll et al.7 various methods of prevention are commonly used for active people and these include taping, the use of ankle supports, shoes and coordination training using ankle disks.7
Prospective epidemiological studies have shown a decrease in the incidence of ankle injury with external ankle support use.8 The effectiveness of this was dependent upon the material properties and application method of the tape or brace, and on the athlete's status of ankle stability or previous injury.8
Another study conducted laboratory investigations and some clinical trials to evaluate the effectiveness of external ankle support.9 It concluded that external ankle supports are generally accepted preventive practice for ankle sprains. Two of the most common supports used especially by athletes in the prevention of lateral ankle sprains are taping and bracing.9 One possible rationale is that the use of ankle tape or a brace increases the kinesthetic awareness of ankle positioning and increases support to the ankle joint by limiting hindfoot motion, specifically inversion.10
Hume and Gerrard8 examined the literature regarding the effectiveness of external bracing in reducing ankle sprains. They reported that little information was available delineating the precise mechanisms through which ankle supports reduce ankle injury.8 Conventionally, it has been presumed that the ability of a brace to restrict ankle motion has been the predominant mechanism of action. Other mechanisms of effect were postulated for taping such as enhancing the proprioceptive function of the injured ankle8.
This review, aimed to focus on the effectiveness of external ankle supports such as ankle braces and ankle taping in preventing the occurrence and recurrence of ankle sprains among elite and recreational players. It has been noted that in some situations, external supports impair performance and involve risk of possible knee injuries among athletes. The objective of this review was to identify which type of external ankle support is most effective in the prevention of ankle sprain.
Section snippets
Methods
Criteria for considering studies for this review.
To determine the evidence of effectiveness of external ankle supports in preventing ankle sprains, randomised controlled trials (RCT) were the study design of choice. However, due to the limited number of RCTs available, other forms of experimental studies, such as non-randomised controlled and quasi experimental trials were considered.
This review included studies involving adolescent and adult elite or recreational players.
Participants may have
Results
A total of fifty four articles were retrieved from the initial search strategy. Forty one articles were excluded because of the type of intervention (exercise, proprioceptive program and other preventive interventions) and the outcome measures (pain, range of motion, performance measures). Thirteen articles were then considered for this review. From the 13, a further 7 articles were excluded because of the type of study. Finally, six experimental articles were included in this review: four
Discussion
Ankle braces and ankle taping have been commonly used in the field of sports to prevent and manage ankle sprains. This study focused on the use of such techniques in the preventive aspect. The studies included in this review were all clinical trials. It is important to note that there were limited published trials investigating the effects of using external ankle supports in the prevention of ankle sprains. In this context, it was not possible to conduct comparisons and analyses for different
Conclusion
This review provides good evidence for the use either ankle taping or ankle braces to prevent lateral ankle sprains among previously injured players. However, for those without previous ankle injuries this still needs to be proven. There is no evidence on which external ankle support is better than the other. Each has its own advantages and disadvantages. Reports on the incidence of other joint injuries with the use of ankle braces also have no sufficient evidence base.
There have been reports
Disclosures
No external financial support.
Acknowledgments
The authors would like to acknowledge Prof. Karen Grimmer-Somers, Dr. Saravana Kumar and Ms. Anthea Worley from the Centre for Allied Health Evidence, and the Joanna Briggs Institute, for their assistance in completing this review.
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2022, Journal of Science and Medicine in SportCitation Excerpt :As it has been discussed, this review provides some evidence that ankle taping can restrict ankle plantarflexion angle when landing from a height, but there was no change in GRF. It has previously been suggested that the use of external ankle supports is linked to larger vertical GRF when landing40,50 or at initial contact during a cutting task.31,40,41 This review provides evidence that ankle supports do not change GRF.