Ankle Injuries: To brace or to tape?

During every sport season and in virtually all sports, coaches and athletic trainers are faced with athletes who have a history of “weak” ankles, which can lead to ankle injury. The traditional approach has been to tape these players to give them additional protection from injury or re-injury.  Unfortunately, this has been proven to be a poor choice, both from an economic and protection standpoint.

The scene: It’s the second game of the new basketball season. Your starting shooting guard is driving through the lane, as he is planting to go up for the reverse lay-up, his plant foot lands on the outside of an opponent’s foot. As your star player loses the ball, landing in a heap on the floor, clutching his ankle and screaming in pain, the crowd goes silent.

 This scene is played out numerous times at schools all over the area and in various sports every season. What is your reaction to the above scenario? Well, it may differ depending on if you’re the player who was injured or the coach of the team. The initial reaction of all involved is to hope that there is no fracture present. A high percentage of the time when an injury occurs as described above, (landing on the outside of the foot and “rolling” it over) the injury is a first, second, or third degree tear or stretching of the lateral ankle ligaments. After the initial treatment of RICE (Rest, Ice, Compression, & Elevation) have been completed and X-rays have ruled out bony problems, next comes rehabilitation of the injured joint and questions about when the athlete can return to play. A secondary question often overlooked is how to prevent this injury from happening again.

During every sport season and in virtually all sports, coaches and athletic trainers are faced with athletes who have a history of “weak” ankles which can lead to ankle injury. The traditional approach has been to tape these players to give them additional protection from injury or re-injury. Unfortunately, this has been proven to be a poor choice, both from an economic and protection standpoint.

From a protection standpoint:
There have been dozens of studies done on this topic over the last 20 years. A recent study done during the 2009-10 high school basketball season right here in Wisconsin revealed that high school basketball players who wore stabilizing lace-up ankle braces had 68% fewer injuries than athletes who did not wear braces.  The study enrolled 1,450 athletes at 46 different high schools. Half of the athletes wore braces and half did not. Athletic Trainers at those schools kept track of the injuries. Another study done at Wake Forest University involving 300 football players in the late 80s-early 90s compared the use of a brace vs. tape in injured ankles. There were 158 total injuries; 115 injuries occurred with taped ankles while only 43 occurred with the braced ankles, a difference of 73%. The study concluded that the performance difference was attributed to loss of support resulting from the tape loosening. Other studies have mentioned 40-60% of tape effectiveness being lost after only 10-20 minutes. This does not even cover the warm-up session, when athletes may be performing at less than 100% exertion.

From an economic standpoint:
Compare the cost of one lace-up ankle brace to the cost of taping one ankle over the course of a full basketball season. The average price of a good lace-up brace with brand names such as Mueller, ASO, McDavid, or Swede-O are $30-45.00 and can be purchased at some sporting good stores. Also, a well cared for brace will last 1-2 years through multiple sport seasons which reduces the price even more. The average roll of 1.5” athletic tape nowadays costs about $3.00. An acceptable ankle taping will require at least three quarters of a roll of tape, or $2.25. Multiply that over the course of a full season that runs from middle of November to the end of February (about 75 practices and/or game days – excluding Saturdays and Sundays), and you arrive at an approximate cost of $169.00 – roughly 3-4 times as much as a brace! Spending that much money to tape one ankle over the course of a season (which loses its effectiveness after 10-15 minutes) seems unreasonable. And that expense doesn’t take into account cost of pre-wrap or heel & lace pads that help reduce blistering while taping.

To “wrap” this up, so to speak:
As a former athlete and athletic trainer, I heartily recommend braces for athletes returning to competition after ankle injuries or with weak ankles. Numerous studies have been done that prove beyond a shadow of a doubt that bracing is more effective than tape, and that information should be enough to convince coaches and athletes of this. When looking at the economics of using tape, where it costs at least three times as much or more than a brace, the choice is easy – especially in this day and age when most schools are struggling to meet the demands of increased budgetary concerns.

For more information about bracing, or to purchase a brace, contact a Licensed Athletic Trainer (LAT) at Fort HealthCare Therapy & Sport, 920-563-9357.