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Year : 2020  |  Volume : 20  |  Issue : 2  |  Page : 36-39

The influence of athletic taping and bracing on ankle sprain: A literature review

1 Department of Physical Therapy, Prince Sultan Bin Abdulaziz Hospital, Urayra, Eastern Province, Kingdom of Saudi Arabia
2 Department of Physical Therapy, Medical Rehabilitation Center, Qatif Central Hospital, Qatif, Kingdom of Saudi Arabia

Date of Submission24-Jul-2020
Date of Decision12-Aug-2020
Date of Acceptance18-Sep-2020
Date of Web Publication20-Jan-2021

Correspondence Address:
Dr. Majed A Alabbad
Department of Physical Therapy, Medical Rehabilitation Center, Qatif Central Hospital, Qatif
Kingdom of Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjsm.sjsm_15_20

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Ankle sprain is a common injury in sports, and it is considered one of the most body parts injured in athletes. An inversion ankle sprain is the most common type of ankle sprains injuries and constitutes 45% of sports injuries with a high recurrence level that could approximately affect 73% of athletes. This literature review is aimed to highlight the influence of the athletic taping and bracing on the athletic ankle sprains. Literature search was carried out using PubMed, SIMMON, Cochrane Library, and Google Scholar. Athletic taping and bracing have been used for athletes with the purpose of injury prevention and as treatment during sporting activities. However, some studies showed ankle sprain injury reduction significantly up to half of the injury rate while using athletic tape. Furthermore, wearing the brace significantly lowers the injury rate of 1.6 sprains/1000 exposure comparing to 5.2 sprains/1000 exposure to those who did not wear the brace. Finally, athletic taping and bracing are common modalities used in practice. There is a lot of confounding factors and doubt in the literature regarding the influence of these modalities on the incidence and severity of injurers.

Keywords: Ankle sprain, athletic tape, bracing, taping

How to cite this article:
Altaweel A, Alabbad MA. The influence of athletic taping and bracing on ankle sprain: A literature review. Saudi J Sports Med 2020;20:36-9

How to cite this URL:
Altaweel A, Alabbad MA. The influence of athletic taping and bracing on ankle sprain: A literature review. Saudi J Sports Med [serial online] 2020 [cited 2023 Dec 8];20:36-9. Available from: https://www.sjosm.org/text.asp?2020/20/2/36/307518

  Introduction Top

Ankle sprain is one of the most common injuries occur in sports. The injury may affect athletes in all ages and different kind of sport activities. For instance, in the USA, an estimated of 28,000 ankle injuries occur everyday, which is very high number of injuries.[1] In Saudi Arabia, a study conducted in Jeddah showed that 40% of the sports-related injuries were ankle injuries, which lead to loss of athletes for 1–4 weeks from training and match period.[2] Furthermore, a study conducted in Tabuk Clubs on 400 soccer athletes showed that ankle sprain injury constitutes 63.8% of the lower limb injuries.[3] Almalki et al. conducted a similar study among high school students regarding the prevalence of ankle injuries.[4] A total of 399 students participated in the study. Approximately of 35% of the students had ankle injuries during the high school times.[4] Inversion ankle sprains is the most common ankle sprain, and the most common ligament injuries are the anterior talofibular ligament followed by calcaneofibular ligament.[5] Ankle sprain injuries may represent around 45% of sports injuries.[6] People who had a history of ankle sprain are at high risk to get a recurrent of ankle sprain five times than those who do not have history of ankle sprain, and the recurrence of ankle sprains occurs in around 73% of athletics.[7] The ankle sprain injury incidence rate is very high in many sporting activities, Fong et al.[8] reported that the injury incidence rate in hockey is the highest followed by other kind of sports such as volleyball, soccer, and basketball. The physiotherapist uses many ways of techniques and modalities to manage the ankle sprain consequences such as pain, loss of range of motion,[9] and loss of the joint functions. One of these modalities is athletic taping and bracing. While watching the sports media, we notice a lot of professional players in different kind of sports who have tapped their ankles during competitions or training with different type of tape such as athletics tape and elastic therapeutic tapes. The purpose of this paper is to review some of the literatures to find out the influence of the athletic taping and bracing on the athletic ankle sprains.

  Injury Prevention Top

One of the major purpose of taping and bracing is the prevention of sports injuries.[10],[11] It is used to prevent 1st time ankle sprain and to prevent the recurrence of ankle sprain.[1] Despite the most effective one, both taping and bracing have a positive influence in reducing the incidence of injury rate.[12] Many studies done on taping and bracing have shown a positive influence. A randomized controlled trial by Garrick and Requa[13] investigated 2562 basketball players for 2 years and the participants were allocated randomly to two groups. One group received Gibney basket-weave taping with heel-lock and the second group received no tape. The result showed there was a significant ankle sprain injury reduction in the taped group compared to the no taped group when the injury rate was 14.7 sprains/1000 player games and 32.8 sprains/1000, respectively. Almost the injury rate reduced to the half with the influence of using the athletic taping. Sitler et al.[14] in a randomized controlled trial study investigated the effect of semi-rigid ankle stabilizer among 1601 basketball players from United States Military students in reducing the injury rate. A group wore an Aircast Sport Stirrup brace, while the other group did not wear. The injury rate was significantly reduced in the group who wore the semi rigid (Aircast Sport Stirrup) ankle brace. Another study was done to evaluate the effect of using the lace-up ankle brace in reducing the injury rate and severity of 1st time or recurrent ankle sprain injury among youth basketball players. In a study by McGuine et al.,[15] around 1460 male and female basketball player who participated were allocated randomly to a lace-up ankle brace group and a control group. The injury rate for those who have previous ankle sprain in the braced and control group was 0.83/1000 exposure and 1.79/1000 exposure, respectively. The severity of acute ankle sprain in both groups was similar, 6–7 days in the braced group and the control group. The study concluded that lace-up ankle brace reduced the incidence of the ankle sprain injury. At the same time the wearing of brace did not influence the severity of injury. Many studies have been done focusing on the positive effect of using the taping and bracing, and the outcome of reducing the injury rate, however, these studies did not focus on how the taping and bracing may reduce the severity of the injury.

Both taping and bracing have a positive influence and both are effective in preventing and reducing the ankle sprain injury. It is debatable in terms of the effectiveness. Having a look at the studies been conducted, there were different results. Some researchers claimed that both taping and bracing have similar effect. Kemler et al.[16] conducted a randomized controlled trial study comparing the effect of taping and bracing in the recurrence of ankle sprain: 157 participants were allocated randomly to two groups and each group received 4-week treatment. The first group was braced and the second group was taped. The study reported that the injury recurrence in the braced group was 17% and the taped group was 14%. It is clear that the result show a similarity in the reduction of injury incidence rate in both groups. Although the study might have a better outcome, it has a high number of dropouts, in which approximately 52% continued the study. Only 81 participants of 157 participants continued their 4-week bracing and taping and 76 participants could not continue, and the main reason was the skin irritation. In another study by Mickel et al.,[12] the incidence of ankle sprains using taping and semi-rigid ankle orthosis was compared in 83 high school football players during a season. There were a total of 6 injuries of ankle sprains: 3 injuries occurred in each group. The study concluded that taping and bracing are equal to each other because there was no difference in the incidence of ankle sprain in both groups. However, the study had some limitation due to the lower number of participants in the study and the need to bigger number, which may result of differ between two groups. On the other hand, some researchers reported that the bracing is more benefitable in prevention injury than taping. Sharpe et al.[17] evaluated the effect of bracing and taping after the occurrence of the ankle sprain. Participants were allocated to four groups: bracing group, taping group, taping, and bracing group and no intervention group. The study concluded the significant reduction in the recurrence ankle sprain on the bracing group when compared to other groups. It is still controversial which one is more preferable to be used for prophylactic purpose, but McGuine et al.'s[15] study concluded that bracing is cost-effective and beneficial more than taping. Most of the athletes prefer to use taping rather than bracing because they feel that the brace is heavy and limits their ability to move fast, so they feel tape is more comfortable to them.[18]

  Biomechanics Influence Top

Taping and bracing could be used for different purposes such as using them for injury prevention by restricting the ankle joint excessive motion. The most common injury in the lateral ankle sprain is inversion mechanism.[19] Taping and bracing are used to provide mechanical support ligaments in order to reduce the excessive inversion range of motion by restricting the rotation of talar and subtalar joint. According to Wilkerson,[18] the lateral subtalar sling taping technique might reduce the strain on the antero talofibular ligament during the subtalar inversion. When the strain is reduced, the load on the antero talofibular ligament will decrease that may prevent the injury. A meta-analysis examined the uses of athletic taping, lace-up brace, and semi-rigid brace on the range of motion before and after activities.[20] The study concluded both brace and the tape reduces the ROM, but the semi-rigid brace provided the higher restriction on inversion whereas the tape provided higher restriction in dorsiflexion.[9]

Another bio-mechanical influence of ankle taping and bracing is that it may cause an increased loading on other joints. Santos et al.[21] Due to the restriction effect of taping or bracing in ankle ROM, the knee joint could be under a higher risk of injury when the restriction on the ankle may reduce the trunk axial rotation and increase the axial rotation load in the knee joint that may end up with a knee injury.

As discussed before, the tape and brace has an influence on decreasing the excessive joint motion and thus increase the stability of the joint. The strength of tape may reduce after some period following application. Both taping and bracing evaluated. For the bracing a study showed that after performing 10–15 min of sports activities the efficacy of brace inversion resistance my decrease 50%.[22] Same thing could happen to the taping, Bauer[23] founded that the taping lost its effectiveness of the ankle restriction around 84% after 30 min of the application. Also, Myburgh et al.[24] founded that after 1 h of the application the restriction loosen of the ROM was around 90%.

  Proprioception Influence Top

Application of tape or brace can also influence proprioceptive input of the joints. The defect of the proprioception may lead to poor ankle position awareness that may lead to re-injury again. It is believed that the taping and bracing enhance the proprioception and improve the sense of the joint.[18] Heit et al.[25] examined the effect of taping and bracing on the joint position sense. He concluded the joint proprioception has increased. The plantarflexion movement was improved by worn the ankle brace as well as the plantarflexion and inversion were improved by enhancement of using the taping. On the other hands,[26] a meta-analysis compare the proprioception of ankle with tape and brace and no tape or brace. The study concluded that the use of prophylactic taping and bracing have no effect in improving the proprioception and joint sense and it may be worse the inversion and eversion movement.

  Performance Influence Top

Most of the studies were talking about the effect of taping and bracing in reducing the injury incidence rate but fewer studies focused on the influence of the athletic performance.[27] As the uses of the tape and brace to limit the excessive ROM as prevention purpose,[28] it seems logical that the tape and brace might negatively influence the athletic performance. Barkoukis et al.[29] studied the influence of taping and bracing while preforming a balance task. Thirty students participated in the study. The participants did a balance task in order to assess the right and left deviation of the ankle joint. They performed the task in four different conditions as follow: With tape, with Swede-O brace, with Aircast and without stabilizer. The study concluded there was no different was found on the four groups. The findings indicated that no effect of taping and bracing in the athletic performance.

  The Placebo Effect Top

The idea came from the patient thoughts and expectation that he could have a positive effect of improvement from the placebo intervention.[30] Sawkins et al.[31] studied if the ankle tape has a placebo effect on ankle instability patients. There were 30 participants who had ankle instability. All participants were blinded to the purpose of the study. The participant notified that the study only would study the method of the taping either mechanical (real) or proprioceptive (placebo). Participants did hopping tests and star excursion balance test. Both tests provided in three different conditions, real tape, placebo tape and no tape. The study concluded that the was no difference in the performance in the three groups. Participant's confidents and stability during performance were improved in both real and placebo groups. More research is needed to give more information and to explain the role of placebo effect of athletic taping as it might influence the sports participants' performance. Although,[31] Clinicians should focus more of increasing the sports participants beliefs of the taping and bracing believes as the taping and bracing applications improve the sports participants confidence and stability during performance. Also, the taping and bracing may playing a role in preventing injury.

  Conclusion Top

Taping and bracing for ankle sprains have been used for long time ago in the sport arena. The purpose of the uses is varied such as preventing injuries, reducing the incidence injury rate, treatment purposes, and influencing the performance during competition and training. It is commonly used and the debate is still available in the preferences of using the taping or the bracing during sporting activities or for prevention and reducing the incidence and severity of injurers. More researches are needed to be done to answer the controversial questions in the mechanism of the prevention injuries, and the enhancement of the taping and bracing in the proprioception of the ankle, and the influence of the taping and bracing on the different kind of sports activities. Also, researches on the placebo effect are needed.

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  References Top

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Almalki MA, Alowaime NA, Alanazi AM, Alanazi AK, Alamri NN, Alaqil MA, et al. Prevalence of ankle injuries in physical education and sports classes among saudi high school male students in Riyadh, Saudi Arabia. Journal of Musculoskeletal Surgery and Research 2018;2:16.  Back to cited text no. 4
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Sitler M, Ryan J, Wheeler B, McBride J, Arciero R, Anderson J, et al. The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball. A randomized clinical study at West Point. Am J Sports Med 1994;22:454-61.  Back to cited text no. 14
McGuine TA, Brooks A, Hetzel S. The effect of lace-up ankle braces on injury rates in high school basketball players. Am J Sports Med 2011;39:1840-8.  Back to cited text no. 15
Kemler E, van de Port I, Schmikli S, Huisstede B, Hoes A, Backx F. Effects of soft bracing or taping on a lateral ankle sprain: A non-randomised controlled trial evaluating recurrence rates and residual symptoms at one year. J Foot Ankle Res 2015;8:13.  Back to cited text no. 16
Sharpe SR, Knapik J, Jones B. Ankle braces effectively reduce recurrence of ankle sprains in female soccer players. J Athl Train 1997;32:21-4.  Back to cited text no. 17
Wilkerson GB. Biomechanical and Neuromuscular Effects of Ankle Taping and Bracing. J Athl Train 2002;37:436-45.  Back to cited text no. 18
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Raymond J, Nicholson LL, Hiller CE, Refshauge KM. The effect of ankle taping or bracing on proprioception in functional ankle instability: A systematic review and meta-analysis. J Sci Med Sport 2012;15:386-92.  Back to cited text no. 26
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