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Treating injured ankles is old hat to seasoned
practitioners of sports medicine.
Many people envision a busy training room with dozens of
athletes getting their ankles taped prior to practice or a game
when they think of sports medicine or athletic training.
In fact, the treatment and prevention of ankle injuries
is central to any sports medicine practice.
This column has focused on the recognition, treatment
and therapy for sprained ankles several times before.
Today, the emphasis will be on the functional
stabilization of the ankle joint in order to protect the ankle
and/or to prevent injury.
As mentioned above athletic trainers have long been
skilled in the art of the ankle tape job.
This method of ankle stabilization has served many
generations of athletes very well and remains the gold standard
in settings with experienced athletic trainers.
However, ankle strapping and taping is definitely an art
and is not applied with similar efficacy by all who attempt a
tape job.
The purpose of a tape job is usually one of two
things. One
possible reason to tape an ankle is to prevent an ankle injury.
Since most injuries occur due to an inversion (turning in
of the ankle) most prophylactic ankle tape jobs are applied so
that they limit the inversion motion.
Preventative tape jobs are useful in situations of ankle
weakness secondary to a remote injury or when the likelihood of
suffering an ankle injury is high due to the practice or game
conditions.
One theorized disadvantage to preventative ankle
taping is that it may weaken the body’s natural protective
mechanisms. Ligaments
are the body’s primary structural support and what a tape job
tries to augment. However,
there are secondary supports such as muscles, tendons, joint
capsules, etc. that naturally augment and supplement the
ligaments support. Many
believe that regular use of a prophylactic tape job will cause
the secondary supports to become weaker and less effective, so
that if the tape job fails or the athlete plays without it,
injury is more likely.
A second reason to tape an ankle is to protect a
recent injury. After
an ankle sprain, the ligaments and secondary restraints are weak
and injured. In
order to resume practice and play safely and swiftly, ankle tape
jobs are often applied to protect the injury.
Again, since most injuries are due to an inversion
mechanism, these tape jobs often center around preventing
inversion. But
since an injury has likely been evaluated by a doctor prior to
return to play and the mechanism has been sorted out, the tape
job can be modified to protect against the exact mechanism of
injury in most situations.
One of the main problems with ankle tape jobs is that
learning to tape follows a fairly shallow curve. In other words, one must complete many tape jobs to become
efficient.
Another potential problem is that there is a great
deal of variability between tape jobs applied by different
people. A veteran
trainer once commented that there are as many different ways to
tape the ankle as there are people taping.
An alternative to ankle taping is ankle bracing.
Most sports medicine practitioners fall into one camp or
the other with some advocating taping and others bracing.
In reality, there are probably uses for both.
There are a wide variety of ankle braces available on
the market. Some
are designed for an athletic population and others are not.
But they all have in common that their primary function
is, like a well applied tape job, to prevent inversion.
One of the more popular and time tested braces is the
lace up brace. Many
different companies make lace up braces and some even come with
other features like metal supports or horse shoe cushions.
These are generally fine for prevention and stabilization
following a minor ankle injury, but should be used with caution
following a moderate or severe ankle injury.
Additionally, they should be worn fairly snugly and
re-laced frequently during practice or play.
Stirrup braces are another popular style of ankle
brace. Aircast and
gelcast are two of the more popular versions of the stirrup
brace. While these braces do effectively prevent inversion,
they are quite bulky and may interfere with athletic performance
more than some other brands.
Rocket-soc is another ankle brace that many consider
to be one of the more “top-of-the-line” braces. It is a neoprene sleeve that has several straps that secure
the ankle from different angles and effectively reduce
inversion. They
also allow for relatively full ranges of motions in other ways
and minimally effect performance when worn properly.
For those interested in learning more about ankle
injuries, taping, strapping, and bracing techniques there will
be a basic sports medicine course dealing with the lower body
tomorrow (26 August 2000).
The course is offered free of charge to anyone who is
interested and will be presented at the Regional Orthopaedic and
Sports Medicine Center in Waxahachie. The course begins at 9:00 am and will conclude between 3:00
and 4:00. Lunch
will be provided. Please
call (972) 937-8900 if you have any questions.
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