Ankle Bracing Scores Big In High School Athletics

Nothing New?

Ankle injuries in high school sports such as football and basketball may be nothing new, but they remain a concern for athletes, coaches, athletic trainers and parents alike. Ankle sprains and strains are common among these young, growing athletes who leap, pivot, pounce and push themselves—but what can be done?

The expertise of athletic trainers—and the technology available to them—has come a long way since traditional taping and R.I.C.E. (rest, ice, compression and elevation.) While those tools remain important components of prevention, protection and recovery, the options available for today’s adolescent athletes have advanced significantly in recent years.

Bracing for Football¹

In one study, researchers wanted to know if lace-up ankle braces reduce the incidence and severity of lower extremity injuries sustained by high school football players.

They randomly assigned 2,081 players from 50 high schools to a braced or control group for the 2010 football season. Athletic trainers recorded brace compliance, athlete-exposures and injuries. The brace selected for the study was the DonJoy Ankle Stabilizing Brace.

The result? “Players who used lace-up ankle braces had a lower incidence of acute ankle injuries but no difference in the incidence of acute knee or other lower extremity injuries. Braces did not reduce the severity of ankle, knee, or other lower extremity injuries.”

The acute ankle injury rate was 0.48 in the braced players versus 1.12 in the control group, while the severity of injuries was the same.

Bracing for Basketball²

In another study of high school basketball players, researchers wanted to measure the impact of ankle brace use, over a season, on dynamic postural control and functional tests.

The study looked at 21 healthy high school basketball players (13 girls, 8 boys) who underwent multiple tests in random order, including:

• Star Excursion Balance Test for posteromedial, medial and anteromedial directions.
• Three functional tests of single-leg crossover hop, single-leg vertical jump and single-leg 6-m hop for time.

After being pretested without the brace, the athletes wore the brace on both limbs for the 16-week competitive season, with follow-up evaluations at mid- and post-competition season. Researchers found that wearing the ankle brace during sports significantly improved dynamic postural control and functional performance for the athletes.

Preventing Injury & Reinjury^3,4

In a third study, a trial was undertaken to determine if lace-up ankle braces reduce the incidence and severity of acute first-time and recurrent ankle injuries in high school basketball players.

Researchers randomly assigned 1,460 male and female basketball players from 46 high schools to a braced or control group for the season. Athletic trainers recorded compliance, athlete exposures and injuries.

Researchers found: “Use of lace-up ankle braces reduced the incidence but not the severity of acute ankle injuries in male and female high school basketball athletes both with and without a previous history of an ankle injury.”

Acute ankle injury was 0.47 in the braced group versus 1.41 in the control group. Severity of ankle injuries was similar in both groups, but for players with a previous ankle injury, the incidence of acute ankle injury was 0.83 in the braced group versus 1.79 in the control group. For players who did not report a previous ankle injury, the incidence of acute ankle injury was 0.40 in the braced group and 1.35 in the control group.

For a published report, researchers posed the clinical question: “Do prophylactic ankle braces reduce the incidence of acute ankle injuries in adolescent athletes?”

The clinical scenario was that a large number of injuries sustained by high school athletes are ankle injuries. They wanted to determine if ankle bracing might be an effective and efficient method to reduce those injuries. The clinical takeaway? “There is moderate evidence to support the use of prophylactic ankle braces in adolescent athletes, particularly those who participate in football and basketball, to reduce the incidence of acute ankle injuries.”

The Bottom Line⁶

Finally, while some may argue that taping is just as effective as bracing, one study evaluated the overall cost of taping versus purchase of an ankle brace, and found that prophylactic bracing can actually save money for an athletic program, while also protecting the athletes from ankle injury.

“The time required to tape an athlete averaged 67 seconds per ankle, resulting in a total of 97 minutes per ankle during an entire season, and the average cost to tape each ankle during an entire season was greater than the cost of the commercially available brace. The projected cost savings for an athletic program using prophylactic bracing could be substantial when compared with the use of prophylactic taping of the ankle.”

While there was a monetary savings in bracing versus taping, there was no statistically significant difference in the incidence of ankle sprains between the two groups.

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