Detailed Guide to Ankle Strapping

Ankle strapping is commonly used as a preventative measure against sustaining ankle injuries and in the rehabilitation and return to activity following ankle injuries.

This detailed guide provides a step-by-step account (including photos) as to how to strap an ankle for the most common ankle injuries.

Happy taping!

Please note that the taping described is a generic ankle taping and that you are advised to consult with your health care professional to see if this form of strapping is appropriate for your individual circumstances.

Please also be aware that a small percentage of the population can have an allergic reaction to tape. If you are aware that you may have a reaction, you should not apply tape to yourself as per these guidelines. If you do experience an allergic reaction, you are advised to seek medical attention immediately.

Fast Physio Facts #3

1. The difference between running and walking is that running involves a period of time whereby neither foot is in contact with the ground. This period of time is know as the flight phase.
2. The cause of pain isn't always in the area where you feel the pain.
3. Breaks and fractures are actually the same thing when referring to bones.
4. When a joint is sprained, it never completely returns to its pre-injury state.
5. Some people can have an extra rib coming of their neck vertebrae!

Horses for Courses!

Did you know that particular injuries are more likely to occur when participating in certain sports?

You should be aware of the injuries that are most likely to occur in your chosen sport(s)!

Below is a non-inclusive list of some of the common injuries in certain sports:

Running: Patellofemoral (knee) pain, calf/hamstring strains, iliotibial band syndrome, tibial stress conditions (shin splints), heel/foot overuse injuries, low back injuries.

Swimming: Shoulder impingement injuries, back injuries, neck injuries, knee ligament/tendon injuries (particularly breaststroke).

Cycling: Patellofemoral (knee) pain, low back injuries, hip joint injuries, wrist and elbow nerve injuries (road bikes).

Netball: Ankle sprains, knee ligament injuries, finger sprains/dislocations, shoulder injuries.

Rowing: Rib stress fractures, wrist tendon/muscle/joint injuries, back injuries.

Cricket: Shoulder joint injuries, back injuries (including fractures), hamstring strains, muscular trunk injuries.

Soccer: Hamstring strains, adductor (groin) strains, pelvic bone injuries, ankle and knee ligament sprains.

AFL: Hamstring strains, shoulder dislocations, finger injuries, ankle and knee ligament sprains, low back injuries.

Rugby Union / Rugby League: Contact related injuries, AC (shoulder) joint injuries, back injuries, thumb injuries.

Hockey: Low back injuries, hamstring injuries, ankle sprains, ball contact injuries.

Basketball: Knee and ankle tendon injuries,ankle sprains, calf strains, finger injuries.

Golf: Back injuries, shoulder overuse type injuries, elbow overuse/technique related injuries, wrist injuries.

Tennis: Shoulder injuries, elbow tendon/joint injuries, upper and lower back injuries, knee ligament/tendon injuries, ankle ligament/tendon injuries. 

Dancing: Foot/ankle tendon injuries, foot stress fractures, back injuries.

If you would like to know more about injuries in your sport, contact your health professional, send us an email or comment below.

FIFA 11+ Injury Prevention Program

Have you heard of the FIFA 11+ Injury Prevention Program? If you play football (or soccer as it is predominantly known in Australia) you should make yourself familiar with it! 

Some of the best sports medicine practitioners in the world have collaborated to develop a simple set of exercises, which have been shown to decrease the likelihood of injury in footballers.

The best part of these exercises is that they are based on best practise evidence; such that you can be confident that what your warm-up is first class and exactly what the professionals should be doing too!

In a country like Australia, where we have multiple football codes, these same exercises are also appropriate for use in AFL, rugby union and rugby league.

So what are they?

There are 15 exercises in total which are expected to take a total of 20 minutes. The 15 exercises consist of 9 running exercises and 6 exercises which work on strength, balance and plyometrics. Each of the 6 strength, balance and plyometric exercises have 3 levels of difficulty and it is expected that you only complete one of each during each warm-up. Check out the exercises in more detail.

When should I do them?

The exercises should be completed at the beginning of all training sessions and prior to all games.

Are the exercises appropriate for children?

Absolutely! I would suggest that for the strength, balance and plyometric exercises, that children use the basic exercises with a focus on technique rather than attempting the more challenging exercises.

Get yourself a copy of the exercises either as a poster or as a manual. For more information on the FIFA 11+ Injury Prevention Program visit the website.

Don't forget to show your coach too!

Enjoy the new exercises and let us know how you find them!

Fast Physio Facts #2

1. There are 206 bones in the adult body.
2. Children have even more bones than this. These bones fuse to become mature adult bones in time.
3. A third of those who sprain their ankle will re-sprain their ankle within 3 years.
4. Touching a painful area can reduce the amount of pain experienced. This is why you see people grab an injured area when they hurt themselves. Try it next time you hurt yourself!
5. Excessive abdominal muscle strength training can lead to sexual dysfunction in males!

Should I Ice or Should I Heat?

This is a question that is asked very frequently by people regarding their injury.

VS 

Any acute injury (new injury or flare-up of an existing injury) as a result of trauma, over exertion or overuse should have ICE applied over the first 48 hours as per the RICE guidelines. Heat should NEVER be applied to an acute injury!

Any chronic (long-term) injury or injury that flares up due to static postures would benefit most from the application of HEAT to the area. However, if you know from experience though that you gain relief from ice with your chronic injury, then this is perfectly fine to use.

Of course, things aren't always as simple as this and there are always exceptions to the rules. If you are unsure, consult your health professional.

What does RICE mean?

So you injure yourself and you're told to RICE. But what does this actually mean? Rice stands for REST, ICE, COMPRESSION & ELEVATION.

REST refers to ceasing the activity leading to injury and then limiting ANY activity involving that body part as much as possible.

ICE refers to placing an ice pack, frozen peas or any other cold item directly over the site of injury. This should be done for 20 minutes in every 2 hour period in the first 48 hours following injury.

COMPRESSION refers to placing a bandage, elastic sleeving or compressive sportswear over the injured area in an effort to limit the swelling at the site of injury which can be detrimental to heeling. This is VERY IMPORTANT and often overlooked.

ELEVATION refers to raising the injured body part again in an effort to minimise the damaging effect of excess swelling. For example, if you injure your ankle, you should ensure that your ankle is resting higher than your knee which in turn is higher than your hip. This same principle applies for all other body parts. 

The length of time that RICE should be utilised for varies depending on the nature of the injury. As a guide, this should be conducted for 48 hours following an injury. To determine the extent of injury and to receive appropriate treatment, you should consult with your health professional.

Why do People Use Frozen Peas to “Ice” Their Injuries?

Have you ever put thought to why people choose frozen peas over anything else in the freezer to apply to their injuries?

I thought I would share a few reasons why this may be so.

Firstly, frozen peas received a very good wrap in 2000 when a study¹ showed that a packet of frozen peas decreased skin temperature more than what a flexible ice pack did in 20 minutes!

Other reasons probably include their relative low cost, ability to conform to any body shape and the fact that frozen peas reside in so many household freezers.

Something to think about anyway. Share your thoughts about frozen peas!

Should I be using frozen peas on my injury???

Despite mentioning above the good light that frozen peas are seen in, there is no clear information that any form of frozen object is better than another to use on an injury. Make sure that whatever you choose to use (ice bag, flexible ice pack, frozen peas or anything else) is able to conform to the body part to give an even cooling effect and ensure that you place a tea towel (or similar) around the frozen object to ensure that you avoid ice burn to your skin.

1. Chesterton, L.S., Ross, L. & Foster, N. (2000). A comparative study of skin surface temperature responses to the application of a flexible frozen gel pack and a packet of frozen peas over 20 minutes. Physiotherapy 86(1) 35.

Fast Physio Facts #1

1. The pedestrian crossing signals at traffic lights in Australia require you to be able to walk at a speed greater than 1.2 metres per second (or 4.32 km per hour).
2. If you strap 2 of your fingers together, after 20 minutes your brain will recognise these 2 fingers as only 1 finger.
3. The shoulder joint is the most unstable joint in the body.
4. Some people cannot feel pain at all. This is known as congenital analgesia.
5. Ice can burn your skin if placed in direct contact with your skin, left in contact with your skin for lengthy periods of time or if too cold.

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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