Taping, bracing and exercise can all help prevent ankle sprains

This FastFact showcases a clinical guideline which explores the diagnosis, prevention and treatment of lateral ankle sprains. It was created by a multi-disciplinary team of experts and is evidence-based1.

Ankle sprains are among the most common injuries in football. They can have significant morbidity and can be associated with recurring instability. One of the stated objectives of this clinical guideline was to review the evidence regarding prevention and to provide evidence-based recommendations for clinicians. While there are a number of important themes in the paper this FastFact focuses on prevention.

There is level one evidence showing that the use of an ankle brace or taping can reduce the risk of both recurrent and first-time lateral ankle sprains. There does not appear to be any difference in efficacy between different types of tape and/or braces and as a result a player should chose the option that best suits his needs. Kinesiotape, which is currently very fashionable, may also have a preventive effect in patients who have already sustained an ankle sprain. Comfort and cost are important considerations when choosing or prescribing this treatment. There do not appear to be any meaningful negative effects with this approach.

Exercise therapy, including ankle strengthening exercises (especially the peronei), coordination and balance training are important preventative strategies. This is especially important when the player has had recurring sprains. Rehabilitation should be started as soon as possible after the initial sprain to prevent recurrent lateral ankle sprain (LAS). When possible it should be included in regular training activities and combined with home-based exercise. The preventive effect of exercise therapy for first-time ankle sprains has not been proven.

There is a current trend for players to wear high top boots (with a built in sock). Some of the marketing for these products has suggested that wearing them may help prevent injury. This is in contrast to the data however as there is currently no evidence that shows that footwear type impacts the risk of injury (three RCTs, n=3410).

It is always important to recognise that the absence of evidence does not mean that a treatment does not work. Taking a pragmatic approach to the prevention of ankle sprains it would appear that strengthening and balance training are key, that ankle taping or bracing is important and that players should chose footwear that they find comfortable.

To find out more about ankle injuries please complete the ankle module in the FIFA Diploma in Football Medicine.

Reference
1Vuurberg G Hoorntje A, Wink L M et al. Diagnosis, treatment and prevention of ankle sprains: update of an evidence-based clinical guideline. Br J Sports Med 2018;52:956. doi:10.1136/bjsports-2017-098106

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Mark FulcherDr Shahnawaz GaziBenidektus Adi Priantoahmed mustafaFIFA-Medical Recent comment authors
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Dr Shahnawaz Gazi
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Dr Shahnawaz Gazi

I think instead of depending on taping and bracing, we should rather focus on perturbated propioception Training.

marcomlages@gmail.com
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It all works but surely the key element of treatment and prevention for further injuries is Proprioception Training

Mark Fulcher
Member

The evidence would suggest that a combination of all of these factors is important to prevent re-injury. My impression is that it is easier to study things like taping or bracing – and harder to prove that neuromuscular training is effective. That is why the data is more compelling for these interventions.

Nwachukwu Adaku
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Nwachukwu Adaku

i totally agree on the taping, bracing method and of course the ultimate is strengthening exercises and proprioception exs too.

sasha
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sasha

Hello all. I have a question. Hope you can help me. It’s for part of my assignment for my master’s.

I just want to know, for football, is there a document where I can find what medical devices are allowed onto the field of play? Eg if taping, orthoses, braces are allowed etc

And also if there are any mandatory safety equipment? ( I guess shinguards and gloves for goalies)

Just looking for an official document from FIFA with it

Thanks!

Sasha.

Dr Shahnawaz Gazi
Member
Dr Shahnawaz Gazi

Pl text your mail I’d

Mark Fulcher
Member

Hey Sasha. Sorry for the delayed reply. This is all covered in the ‘Rules of the Game”. I have attached a link to this document. “All players are required to wear a jersey, shorts, shin guards, socks and boots. The socks must cover the shin guards entirely. If the referee deems a player’s equipment unsatisfactory, the player can be sent off until the issue is remedied. The referee is the authority on the field, and their word is law.” Goalkeeper gloves are optional (and not mandatory). In some cases soft or thermoplastic splints are okay. Heavy casts are generally not.… Read more »

ahmed mustafa
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ahmed mustafa

Taping is a very important method to give ankle stability and increasing muscle endurance and proprioception .. Good article 👍👍

Benidektus Adi Prianto
Member

proprioception and stabilization really important