Netball: To brace or to tape ankles?

With the netball season almost upon us, I thought I would give my thoughts regarding whether netballers should be taping or bracing their ankles (or doing neither) prior to training or competing.

Ankle sprains are one of the most common injuries sustained playing netball. Some ankle sprains are minor requiring minimal (if any) time away from the sport and others can be major requiring months away from netball, significant rehabilitation and occasionally surgery. One thing is common to all ankle sprains, no matter how much rehabilitation you do or how well you look after your ankle, it will never return to being 100% compared to how it was prior to the injury. Another important thing to be aware of is that 1/3 of all people who sprain their ankles will re-sprain their ankle within 3 years! (scary stuff!).

So what can you do to prevent it?

Unfortunately, you can never eliminate the risk of spraining your ankle playing netball completely. However, there are 2 things that that you can do to markedly reduce you risk of spraining your ankle.

• The first is working on and improving your proprioception. What this means is incorporating specific training methods to improve your body's awareness of what your leg (particularly your ankle) is doing. (I will elaborate on this in coming posts.)

• The second thing that you can do is to tape or brace your ankle, which provides external support to your ankle in effort to prevent it from rolling underneath you. Taping and bracing both have their pros and cons which you need to balance up to see what is right for you. In the end it really comes down to personal preference and what is going to work for you.

Taping

Taping can be very effective although does need to be applied correctly in order to provide adequate support, still allow normal movement, restrict excessive movement leading to ankle sprains and still be comfortable. The application of tape can take some time and practise to master. Every ankle is slightly different and instruction should be sought from a physiotherapist or other suitably qualified individual as to how to correctly tape your ankle. Taping should be applied using a 38 or 50mm sports tape depending on personal preference.

The cons of taping include:

• the time taken to correctly apply the tape (which may be significant if training and playing several times a week), 
• some people are allergic to the zinc oxide adhesive in many sports tapes and hence taping may not be appropriate or they may have to use a hypoallergenic tape underneath the sports tape (e.g. fixamull),
• the cost of sports tape should be approx. $12 a roll. You should anticipate being able to strap 3-4 ankles per roll of tape. Over the course of a season, this can add up to a significant amount of money.

Bracing

Bracing can similarly be effective as taping. There are a large number of braces on the market. An appropriate brace is a semi-rigid brace similar to the ASO brace pictured below. Elasticised braces will not provide enough support to prevent ankle sprains and completely rigid braces will impede ankle function and performance. It may be wise to seek advice from a physiotherapist or other suitably qualified individual as to the most appropriate brace for your ankle. Appropriate ankle braces should cost between $70 and $110. 

The advantages of braces are the ease of application and the one-off cost. 

The major disadvantage of ankle braces is that they need to be the correct size; a brace that is either too big or too small will not offer optimal support to the ankle to prevent injury. This definitely needs to be considered with growing bodies!

Do I really need to be taping or bracing?

• If you have had a previous ankle sprain or injury then most definitely you should be taping or bracing your ankles to play netball.
• If you have never had an ankle injury, why wait until you do! Taping or bracing your ankles is still advised.
• If you find that taping or bracing your ankles impedes your performance, then this is something that you need to weigh up in your decision. If you choose not to tape or brace, then you may be at increased risk of sustaining an ankle injury.
• Younger, growing children who have not sustained a previous ankle injury may not need additional ankle support with taping or bracing. If children have sustained a previous ankle injury, are hypermobile (often referred to as "double jointed" or being overly flexible), are "clumsy" or have "weak" ankles, taping or bracing is advised.

When should I be taping or bracing?

Taping or bracing should be applied for all trainings and games. Many teams have policies in place regarding this matter already.

Can taping and bracing create other problems?

No evidence exists to support that correctly applied ankle taping or correctly fitted ankle braces can create injury to other parts of the body by transferring the forces up the knee, hip or back or lead to a weakening of the ankles.

Some netballers report taping or bracing to restrict their ankle motion and leads to a decrease in performance. Correctly applied taping and appropriate braces should not impede ankle motion.

Conclusion

All netballers need to aware that they are at risk of sustaining an ankle injury by participating in their chosen sport. Taping and bracing are the recommended measures to reduce the risk of sustaining these injuries. Each individual needs to weigh up the pros and cons of each to determine what is going to work best for them. If taping is used, it must be applied correctly to provide appropriate support. If bracing is used, it must correctly fit the ankle to provide appropriate support. If you are unsure what is correct for your circumstances, consult with your physiotherapist.

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