In today’s sports arenas, it’s common to see athletes wearing ankle braces during a game, in practice or even in the halls at school. But why are ankle braces necessary for young athletes? We checked in with Dennis Coonan, athletic trainer and Program Manager of the Sports Medicine Center, to learn more.

Why do athletes need ankle braces?

First and foremost, not all athletes need an ankle brace. But those that do usually need external ankle support for a new or a reoccurring injury. Most commonly, a lateral ankle sprain is the culprit. That can happen when an athlete steps wrong and rolls their ankle outward, makes a sudden change of direction or jumps and lands on an uneven surface.

"There are certainly other ankle and foot related injuries we see but they don't make up the bulk of the injuries especially in the pediatric population,” Coonan says.

Most importantly, if a young athlete sprains their ankle once, and the ligaments are stretched, there’s a high rate of recurrence. Wearing braces can help prevent further time spent on the bench. However, braces alone don’t prevent ankle injuries.

What is proprioceptive training?

Proprioception is the body’s sixth sense, a superpower that helps you know where your arms, legs and other body parts are even when you can’t see them. It’s the reason athletes can run without looking at their feet. Receptors around the body tell the brain about the body’s state, so you always know where you are and how you’re moving. Coonan notes that proprioceptive exercises are vital to prevent and improve common ankle injuries.

“Research points to the most effective way to prevent ankle sprains is a really strong proprioceptive training routine,” Coonan says. “We push programs to incorporate one as it’s an easy thing to add to warmups. That includes exercises like single leg hopping and balancing with your eyes open and eyes closed.”

This type of training can often go hand in hand with physical therapy to improve body awareness, motor function and balance. It’s important to get guidance from a medical professional before starting an exercises if you’re recently injured, but some common proprioceptive exercises for ankle sprains include:

• Single leg stance: Stand on the injured leg for 30 to 60 seconds at a time. This can be done on a stable or unstable surface, such as a balance board, as the injury heals.
• Catch and toss while balancing: Toss a ball against a wall or to a partner while standing on one foot.
• Mini squats on one leg: Balancing on one leg, with the other leg extended in front, bend the balancing leg into a mini squat.
• Agility ladder or cone drills

Does a sport or surface influence ankle injuries?

While there’s a risk of injury with every sport, certain sports pose more risk for ankle sprains than others. Soccer players, for example, often get ankle sprains due to uneven grass, quick direction changes and being tackled at the feet. Basketball, volleyball and football competitors are also at risk with quick movements and jumping. And while the playing surface can play a part, it isn’t what usually causes an injury.

“Anytime anybody is playing on natural grass versus turf or a basketball court, there's an increased risk that they could step in a little ditch or divot,” Coonan says. “But it really has more to do with the sport and what you're being asked to do.”

Is ankle taping or bracing more effective?

Many athletes tape their ankles before games to provide support, especially if they’ve had an ankle injury in the past. And while it may seem like an efficient treatment used by athletic trainers, taping is effective for only about 45 minutes after application. That means by the time athletes get through warmups, the ankle tape is already ineffective. Braces on the other hand keep their promise to protect and support the ankle.

“As much as people push ankle taping, it really isn’t the best practice,” Coonan says. “Ankle braces are the way to go. They are significantly more effective, and if an ankle brace loosens a bit, you can reach down, tighten it up and keep going. Ankle tape doesn’t do that.”

How do ankle braces affect performance in young athletes?

A big concern for athletes is whether ankle braces limit performance or change the way of moving that could harm other joints. However, research around braces shows that they do not significantly affect speed, jump height or agility tests in young athletes. While there may be some time for adjustment directly after injury, braces are a proven, low-risk way to prevent recurrent sprains.

It’s important to note that relying too heavily on braces instead of balance training and incorporating proprioceptive exercises into a training regimen can reduce ankle stability over time. As with any injury, combining multiple treatments and therapies is best to keep playing over time.

Guidelines for ankle brace use

While there are many types of braces on the market, Coonan suggests an ASO ankle brace that laces up with velcro straps that go around the heel and over top of the foot. Not only does he consider this type of brace the gold standard but finds it’s the most effective to use as it’s adjustable for injury.

These tips can be helpful when wearing and caring for a brace:

• The brace should be comfortable, not cutting off circulation or causing cramps, but also restrictive enough to protect the ankle.
• Swelling can affect what size of brace an athlete chooses post injury. It’s important that when the ankle is healed to evaluate if a different size may be better for play.
• There’s a large difference between an ankle sleeve and ankle brace. A sleeve is like a tight sock that helps with compression for swelling to help the ankle feel better but does not actively support the ankle. Ankle sleeves shouldn’t be used instead of braces during athletic activity.
• If a brace is worn daily, it should be washed several times a week to combat smell and sweat.
• Braces should be replaced every sports season. For example, a soccer player who participates in the fall and spring season and uses an ankle brace every day for practice and games should get a new one for each start.