The use and abuse of ankle supports in sports injuries

The use of ankle bracing, taping, and wrapping for athletic injuries is both overused and underused. The overuse occurs in patients who don't need ankle support at all, or who don't need it anymore. Underuse occurs in patients who could potentially return to activity sooner with the extra support.It is now well established and accepted that prolonged immobilization of a body part brings with it a number of deleterious effects. Immobilized animals have been shown to have decreased strength of muscles, bones, tendons, and ligaments.1-3 Immobility adversely affects the healing process and has been shown to decrease ligamentous tissue, DNA, and collagen synthesis, and to decrease tensile strength compared to ligaments in mobilized rats.4 Similar effects are seen in humans. Proprioception is felt to be impaired after immobilization of the ankle,5-8 and persistent atrophy of the muscles may ensue.9 Weak muscles and poor proprioception predispose the athlete to further injury. Thus, it is clear that immobilizing joints as a part of treatment brings with it morbidity of its own. That is not to say that it is never necessary and useful. Certainly an unstable joint needs to be stabilized, but in recent years the emphasis has shifted from complete immobilization to providing support in only the unstable planes, allowing functional activity to occur in the stable planes. Bracing, taping, and wrapping are increasingly used to provide such support.