Ankle braces are often prescribed as part of the treatment for ankle sprains. Athletes with healthy ankles are also often advised to wear these braces to prevent sprains. In this post we set out to answer the question “do ankle braces work?”. We review the results of 3 key studies to examine the important sports medicine question of whether these braces have been shown to work to prevent or treat ankle sprains.
Ankle sprains are a common injury among US college athletes, with the incidence of sprains among basketball players coming in the highest. These are the conclusions of a 2017 study by K.G. Roos et. al titled “The Epidemiology of Lateral Ligament Complex Ankle Sprains in National Collegiate Athletic Association Sports”.
Lateral sprains involve rolling the ankle joint either outward or inward, as shown in the diagram to the right. These rolls cause the lateral or medial ankle ligaments to be stretched or torn. The result is pain, swelling and inflammation of the ankle. The patient will also experience lost range of motion and strength of the ankle for a few weeks at least.
Ankle sprains can also happen during pursuance of non sporting activities, although this is less common.
Do Ankle Braces Work To Prevent Ankle Sprains?
As mentioned above, many athletes wear ankle braces as a prophylactic measure to prevent ankle sprains. Let’s examine the evidence to support this practice.
2011 Study Of High School Basketball Players
The results of the study were that wearing lace up braces resulted in a rate of acute ankle injury of 0.47 per 1000 exposures. The corresponding rate was 1.41 in a control group not wearing any form of ankle braces.
Further, for those athletes who did get injured, the median severity of the injury was similar between the braced and control groups.
The authors also examined the rates of ankle injury between the sub groups of athletes who reported a previous injury and those who did not.
For those athletes who reported having previously experienced ankle injuries, the incidence of a recurrent acute injury was 0.83 among the group wearing braces. It was 1.79 in the control (unbraced) group.
For athletes with no previous history of ankle injuries, the results also showed a higher degree of protection for those wearing ankle braces. For these athletes, the incidence of acute injury was 0.4 among those wearing braces and 1.35 among those who were not.
In conclusion, wearing lace up ankle braces appears to reduce the risk of experiencing severe ankle injuries. This is true both of athletes who had experienced previous severe ankle injuries (or at least those who reported having done so) and those who had not.
Interestingly, however, the data do not indicate any statistically significant difference in the median severity of the injuries actually suffered by athletes in the two groups.
2012 Study Of High School Football Players
A second study of the effectiveness of lace up braces among high school football players was conducted in 2012 by the same researchers.
The results were similar to those of the first study mentioned above. Rates of acute ankle injury were 0.48 per 1000 exposures in the braced group compared to 1.12 in the control (unbraced) group.
The median severity of the injury suffered (measured by the days of lost activity) was the same among the two groups (5 days).
Based on these studies, we can tentatively state the following conclusions, at least as far as lace up ankle brace designs are concerned:
- Wearing a lace up brace therefore appears to reduce the risk of experiencing an ankle injury, whether or not the athlete has previously experienced such an injury.
- However, if the athlete is unfortunate enough to experience an injury, wearing a brace does not appear to make a difference in the severity of the injury.
These studies did not, however, address the question of whether the type of ankle brace played a role in the effectiveness of wearing a brace. In addition to lace up braces, there are also ankle sleeves, ankle braces with straps and stirrup braces. The last two are sometimes collectively referred to as semi rigid braces.
A more complete study is needed that includes athletes wearing ankle sleeves and semi rigid braces in order to answer the question more comprehensively.
Another interesting question would be how the effectiveness of wearing an ankle brace compared to that of having the ankle taped to prevent a sprain. This would be a pivotal question for athletic trainers looking to safeguard the long term ankle health of the athletes in their care.
Do Ankle Braces Work To Treat Ankle Sprains?
The second major application of ankle braces is to help in the rehabilitation of ankle sprains among athletes who are trying to recover from this injury.
2010 Study Comparing Treatments With Functional Supports vs. Immobilization
A 2010 study into evidence-based treatment for ankle injuries found backing for the use of “functional support” over immobilization in the treatment of ankle sprains.
For the purpose of the study, a functional support is a removable device that offers variable immobilization. These supports therefore allow for exercise as an integral component of the treatment. They include ankle braces, as well as elastic bandages, tapes and wraps.
“Immobilization” typically refers to the use of a below knee cast together with a tubular bandage. This is the standard alternative treatment to the use of a functional support such as an ankle brace.
The study showed a higher percentage of people returning to sports activity and a shorter return time to work. Other differences were less persistent swelling and greater range of motion at various stages of the treatment.
Having said this, the study noted a lack of evidence supporting lower rates of ankle instability or in the risk of sprain recurrence in the use of a functional support vs. immobilization.
Based on the above study, we can tentatively conclude that:
- Ankle braces offer a more effective ankle sprain treatment option than the use of a cast where time to recovery and the probability of recovery are concerned;
- There is no conclusive evidence at this time that ankle braces offer a lower incidence of ankle instability or of injury recurrence, compared to immobilization with a cast.
We can conclude that lace up ankle braces reduce the risk of injury recurrence among athletes. However, they do not appear to reduce the severity of the injuries that actually occur. They also do not address the questions of whether an ankle brace can reduce swelling or ease ankle pain after experiencing a sprain.
We should also note that ankle braces should fit comfortably if they are to be effective. A brace that is too tight or otherwise uncomfortable will not be worn as often as one that is pleasant to wear. As a result, a less comfortable brace will be less effective over the long term.
Where treatment is concerned, ankle bracing (together with other forms of functional support) offers better chances of recovery and shorter recovery periods. There is no evidence at the moment that there are additional benefits to using an ankle brace for treatment of sprains.