Three athletic trainers walk into a bar… and then one sprains their ankle. All three athletic trainers present have very strong opinions about their ankle treatment protocols, so a discussion ensues about whose methodology is best. Perhaps you’ve worked with one of these individuals and/or share their philosophies – but when presented with an ankle injury which method do you typically go with?

Ankle Taping is the Only Way

Old school Bob swears his ankle tape job is the best tape job around, so much so that he never uses ankle braces on his athletes. Bob is the master of the roll of tape and applying that basket weave with figure eights and a special twist at the end gives him confidence the ankle is locked and ready for action. Bob’s tape job is necessary when returning from an ankle injury, but does it have to be the only treatment method used?

Ideally, ankle taping should be used in conjunction with a hinged or hinged-cuff ankle brace that can provide much longer lasting ankle support than tape alone. Once the ankle is healthy, the (flawlessly executed) tape job can be skipped and the athlete can continue using the hinged-cuff brace so their range of motion isn’t limited.

No Bracing Without Lacing

Lace-up Larry is sold on lace-up ankle braces for treating all ankle conditions, even acute ankle injuries. Larry loves the tightness of the lace-up and those figure 8 straps really lock that heel in place. But even with all that ankle restriction, Larry finds he has trouble with any athlete having an acute ankle injury with weight bearing pain. What Larry doesn’t know is that lace-ups cannot “unload” the ankle, which reduces weight bearing pain and allows players to recover and return to activity more quickly. Only braces with a semi-rigid U-shaped design with full heel section can unload the ankle and reduce weight bearing pain.

As for preventative ankle bracing, Lace-up Larry also recommends the lace-up brace despite research findings that lace-up braces “negatively affected ankle joint motion and muscle function by significantly decreasing plantar flexion-dorsiflexion ROM.” Larry wastes many minutes of his life watching his athletes lace-up their braces and has learned to turn off his sense of smell every time he has a sweaty, smelly, lace-up stuck in his face. While these braces are relatively inexpensive and readily available, there are also cons to lace-up braces that need to be considered as newer brace technology is developed and being utilized.

Strong Ankles Don’t Need Support

Rehab Rita says as long as the ankle is properly rehabilitated and strengthened no ankle brace is ever needed, especially prophylactically. While I think every athletic trainer would agree that a comprehensive rehabilitation program is necessary, when a basketball player comes down from a rebound and lands on another player’s foot an ankle injury will occur no matter how strong the ankle is. That movement happens in a split second and unless the athlete is wearing an ankle brace they are going to suffer an ankle injury. As we all know, braces cannot prevent all injuries but they can lessen the severity when an injury does occur.

Ankle rehabilitation is a must post-ankle injury because now the athlete’s ligaments are stretched out and another ankle injury can easily occur. An ankle brace designed to provide long-lasting ankle protection combined with a comprehensive rehabilitation program is the best bet for helping to prevent more ankle injuries down the road.

So, What is the Best Ankle Treatment Method?

While Bob, Larry, and Rita are all strong in their ankle injury treatment protocols, they are also each correct in their own way. As for treating an ankle injury, it is best for the athletic trainer to take into consideration each of the ankle treatment methods mentioned above as well as stay on top of emerging technologies to continue improving their treatment plans and staying on top of their games.  Athletic trainers can continue to excel at their craft and provide the best treatment options by learning about new products and research findings and then integrating those with their tried and true methods listed above.

As for the three athletic trainers in the bar evaluating how to treat an ankle injury – what would you recommend to them? Tell us your preferred ankle treatment methods below in the comments – we’d love to hear them!

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