Struck down by your Achilles heel?

Make sure you read below for tips on how to manage Achilles tendon pain!

Achilles tendon problems can be very painful and frustrating conditions. If you’ve had the pain for quite some time it can start to impact how much you exercise and especially limit how much running you can do. They usually present as pain and stiffness at the back of the heel running up towards the calf muscle. Often they are painful in the morning and upon commencing exercise, but tend to improve once warmed up but may again deteriorate over the course of an exercise session or day. Additionally, they can be very painful the day after a lot of exercise.

The Achilles tendon is an important component for generating power and propulsion during fast paced activities such as running and jumping. Often sub optimal loading of the area can result in pain and irritation. Tendons are generally very robust structures, however they do not respond well to large changes in loading – for example someone increasing their running distance in one week from 10km to 50km (total km’s over the week). 

"Have you recently increased how much activity you are doing?"

Fortunately, if your pain is recent it can be managed fairly quickly with some active rest and proper loading of the area. On the other hand, if your pain has persisted for a long time you will need a highly structured, detailed and personalised rehabilitation plan. This may include:

•           A structured individualised exercise loading program
•           Assessing your biomechanics
•           strength training
•           use of orthoses
•           strapping to assist in deloading the tendon
•           avoidance of  particular aggravating activities

In summary, load management is the most important aspect in both keeping your tendon healthy and rehabilitating your tendon from injury. 

Avoid large spikes in running, walking and your exercise activities and ensure the appropriate amount of rest between sessions.

Some common mistakes we see include:

•          excessive stretching of the tendon
•          aggressive massage over the tendon
•          pushing through the pain

If any of the above applies to you or you are experiencing any of the symptoms outlined, whether recently or for a long period of time, come in to the clinic for a personalised rehabilitation plan to get you back doing the things you love.

How's your Goose's Foot?

How’s your goose’s foot?

If you get pain just below your knee, it may well be your goose’s foot!

We’ve been seeing quite a few people with issues with their goose’s feet lately and thought you should know about yours.

Just below the knee on the inside of the leg there is a structure called pes anserinus, which literally means goose’s foot! As 3 tendons come together at this point, it resembles the appearance of a goose’s foot.

There are usually underlying biomechanical issues, which means that excessive strain is being placed on the tendons and attachment area of the goose’s foot.

Pes anserinus injury is highly painful and usually results in having to cease running or walking and even causes a limp.

The good news is that alleviating the pain can be achieved by:

• using anti-inflammatory measures
• taking the strain off the injured tendons (e.g. taping)
• limiting activity levels
• soft tissue techniques

Whilst getting rid of the pain is all well and good, the most important thing for those with pes anserinus issues is to address the biomechanical issues underlying the condition and allow return to physical activity.

This requires a thorough assessment with an experienced physiotherapist with a sound understanding of lower limb biomechanics. Altered biomechanics can be addressed in a number of ways including:

• specific strengthening exercises
• targeted stretching
• changes in footwear or orthotics

If you think you may may be having issues with your goose’s foot, we can help you get out of pain, get back exercising and improve your biomechanics. To make an appointment with one of our experienced physios phone 8850 7770 or click here.

Do you ever shake your hands to rid pain or regain sensation in your hands?

• Do you find yourself waking at night with hand pain or numbness?
• Are you frequently shaking your hands due to lack of sensation?
• Do you get shooting pain up the forearm?

If so, you may have Carpal Tunnel Syndrome.

Carpal Tunnel Syndrome is more common than you think and we've been seeing it (to varying extents) in a large proportion of our patients. It can also be a highly debilitating condition impacting many aspects of daily life.

What is Carpal Tunnel Syndrome?

Carpal Tunnel Syndrome is damage or irritation to the median nerve as it passes through the carpal tunnel (a ring of bones in the wrist). The result of damage to the nerve is commonly pains, pins & needles or numbness in the hand (typically the palm side of the hand, including the thumb, index and middle fingers). These symptoms can occur at any time, although they are often worse at night with people frequently waking with a dead hand sensation as well as having severely disrupted sleep.

If Carpal Tunnel Syndrome is left untreated, it can result in:

• Persistent pain, tingling and/or numbness in the hand,
• Weakness in the hand, which may lead to functional impairments (including reduced grip strength and hand dexterity).
• Additional nerve damage further up the arm and even in the neck,
• Permanent damage to the median nerve.

Those with Carpal Tunnel Syndrome will tell you that they will do anything to get rid of it. Why wouldn't you want a pain-free, fully functioning hand with normal sensation? Or perhaps an uninterrupted night of sleep, the ability to open jars again or not having to shake your hand to "wake it up"?

Tailored physiotherapy programs can treat the symptoms of Carpal Tunnel Syndrome that you may have. Physiotherapy treatments for Carpal Tunnel Syndrome include:

• Splinting, which involves wearing an appropriate brace to ease the strain and reduce the irritation on the median nerve.
• Nerve gliding exercises, which are specific exercises to get your median nerve moving well through the carpal tunnel as it often get "stuck" when it is irritated.
• Wrist and forearm stretching and strengthening exercises.
• Addressing postural concerns and neck issues which can be associated with Carpal Tunnel Syndrome.

Our physiotherapists are well-versed in identifying and assessing for Carpal Tunnel Syndrome, as well as differentiating this from other similar conditions.

If you are waking in the night with hand pain or think you may be experiencing Carpal Tunnel Syndrome, a consultation with one of our physios will help put a plan together to put an end to it. Phone 02 8850 7770 or click here and we'll help you get on top of it ASAP.

Ouch! My foot hurts after running/walking...What's going on?

Foot pain can be extremely debilitating, not to mention extremely inconvenient given the amount of time we all spend on our feet during the day.

Lately, with the warm weather and people spending plenty of time out and about being active, we’ve seen an increase in foot complaints and in particular, a high number of stress fracture injuries.

A stress fracture is a nasty injury; however, it is important to note that it differs from a regular fracture in many ways.

So here’s the big question:  How do you know when you have a stress fracture or are at risk of developing one?

As professional physiotherapists, we see a lot of nasty foot injuries and have extensive experience in picking the difference between stress fractures and standard fractures (as well as numerous other foot complaints).

A stress fracture is the result of repetitive stress imparted on a particular segment of bone, and is therefore classified as an overuse injury. It is not the result of acute trauma. Typical activities that can result in foot stress fractures include dancing, running and jumping activities. We have even seen foot stress fractures recently from excessive walking!

The single greatest contributing factor to a stress fracture is load – that is the volume of activity that you are doing and therefore the cumulative stress that you are putting on the bones in your feet.

Other factors that contribute to developing foot stress fractures include decreased strength and flexibility (especially in your calf and toe flexor muscles), reduced balance, poor biomechanics (including feet rolling in), foot anatomical variances including having a 2^nd toe longer than the 1^st (known as a Morton’s foot!) and inappropriate footwear. Believe it or not the surface on which you are exercising (too hard) can play a role as can low bone density, poor nutrition and even menstrual irregularities in females.

Combine any number of these risk factors together with a high load of running, walking, dancing or jumping activities and you place yourself at high risk of developing a stress fracture and spending a lengthy period of time away from these activities.

The reality is that stress fractures can occur in any of your bones in your body with repeated stress applied to them and they do! Due to the complicated biomechanics of the foot, and the fact that we spend large portions of the day on our feet transmitting our body weight through these tiny bones, it should come as no surprise to know that stress fractures are particularly common in the feet.

The most important role that we can play as physios is in the prevention of a foot stress fracture. This is achieved through noting the early signs of bone stress which include foot pain after activity (which may not be severe initially) which progressively worsens with activity and focal pain on palpation.

In most cases identifying what needs to be done to avoid a stress fracture of the foot is as simple as having a thorough discussion with the patient to ascertain activity load (and recent changes to this) and conducting an assessment of the lower limb biomechanics. This allows us to identify activity overload or biomechanical issues in the area, as these are the main contributors to injury and their identification is key to prevention.

Once it has been determined that you are at risk, our physios will take a number of steps in order to help you recover and prevent further injury. This will typically include:

• Altering activity load as appropriate,
• Gait/running/jumping analysis and intervening to make appropriate changes as required,
• Assessment and recommendation of appropriate footwear ,
• Personalised stretches, strengthening & stability exercises,
• Potential prescription of supportive orthotics,
• Soft tissue release techniques (e.g. massage, foam roller),
• Taping techniques to de-load the area at risk or to facilitate changes to biomechanics.

If a stress fracture is actually diagnosed in the foot, the aim of treatment is to facilitate optimal healing, reduce pain levels in the early stages and ultimately facilitate return to pre-injury activity, whilst minimising the risk or recurrence. Treatment may include the following (in addition to the things listed above):

• Immobilisation of the foot for a period of time (e.g. moon boot or cast),
• Rest from foot loading activities (e.g. running, jumping, dancing),
• Mobilising with crutches to eliminate/limit stress applied to the foot,
• Use of anti-inflammatory measures (e.g. medications & ice)
• Personalised plan to return to the loading activities that you desire!

Got a foot complaint?

No problem, we’ve got you covered.

Here’s what you need to do:

Simply call us at the practice on 8850 7770 and we will prioritise you as a matter of urgency.

Keep those feet happy!

I've strained my calf! What now?

Our team of expert physiotherapists have found over the years that whilst summer sports are in full swing, patients experiencing calf strains are at a peak.

Calf strains are very common among athletes, especially runners and those participating in sports that involve lots of explosive movements like tennis. This injury is caused by a combination of overuse and lack of strength, flexibility and general conditioning.

Suffering from a calf strain can cause you a lot of grief. You will fell a lot of sudden pain up the back of your leg (predominantly in the calf area), have difficult standing on your toes and experience swelling and/or bruising of the calf muscles.

If you want to ensure that you don't re-strain your calf, risking further (or repeat) damage, and want to be pain free again, it is highly recommended that you opt to get physiotherapy treatment to restore full function to the area.

What can you do for pain relief?

The best form of relief for the typical initial symptoms of a calf strain (sudden pain, pain rising on tiptoes, swelling and bruising) can be gained by utilising the RICE method - rest, applying ice and compression and keeping the affected area elevated.

In addition to this, physiotherapy treatment is required in order to restore full function to the area and to aide prevention of injury recurrence.

So, what are typical treatments for a calf strain?

Great question! Typical treatments can include manual therapy, strengthening and stretching exercises, footwear analysis, running technique analysis and a range of other options. After initial treatment and once the muscles have returned to full strength, a plan of progressive running and sport-specific exercises will be recommended to build condition and pave the way for return to active sports.

Can you tell who is at risk of developing a calf strain?

Whilst these is no crystal ball to tell who will sustain a calf strain, there are some factors that can indicate who is at risk. These include those having had previous calf and hamstring strains, especially if they were not completely rehabilitated. Many people sustaining calf strains report a feeling of tightness or lack of strength before sustaining the injury!

So if you or someone you know is experiencing tight calves or has a calf strain, contact the clinic today to take the first step on the road to recovery so you get get back to pain free activity.

The original article can be found here.

Is Knee Pain Holding You Back?

Knee pain is one of the most common injuries we see in our clinic. This is partly due to there being many different types of knee pain. Today we want to talk to you about the most common knee injury we treat here, it’s known as Patellofemoral Pain Syndrome.

Keep reading…

So, what is Patellofemoral Pain Syndrome and who is at risk?

Great question!

Patellofemoral Pain Syndrome is a term to describe the pain in and around your knee cap.

For some patients the source of pain can be hard to locate and even harder to describe. As clinicians we describe the pain as vague and diffuse in nature.

Almost everyone who is active is at risk of knee pain, including Patellofemoral Pain Syndrome, but there are certain groups that are more susceptible.

People who exercise or play sports, particularly those that involve sudden changes in movement or speed could be vulnerable to knee injuries. This is because when you run, jump, twist and turn, the extra force and impact is taken by the knee joint.

What leads to Patellofemoral Pain Syndrome?

Just like any injury, the exact causation can vary tremendously from one person to the next.

Some of the most common contributing factors include:
- Feet which roll inwards (pronate),
- Having a knee cap which sits towards the outside of the knee,
- Lower limb muscle tightness,
- Poor muscle function or weakness/imbalance (very common),
- External factors such as poor training routines or inadequate footwear (also very common and often missed in differential diagnosis to the untrained eye).

In many of the Patellofemoral Pain Syndrome cases that we treat, there is often a combination of several of the above contributing factors present.

What can you do to help combat this injury?

First of all, you will need to be assessed by an expert who sees Patellofemoral Pain Syndrome and successfully treats it often.

When you do present to your practitioner, it will really help in our differential diagnosis and subsequent management if you can keep a record of how your pain has been behaving up to that point.

Important aspects for you to note are:
- The specific location of your pain (although this is often difficult),
- What activities make your pain worse,
- A thorough history of when your pain started,
- Whether you are experiencing any clicking, or giving way of your knee,
- The presence of any swelling around the knee.

You should also always inform your therapist of any previous injuries you have suffered that may be affecting your present condition and future management.

The more accurate the information you are able to provide your physiotherapist, the easier it is to determine the best management plan for you so that you can make a successful recovery.

So if knee pain is preventing you for performing the activities you enjoy, or if you believe the way your body moves may be placing you at risk of developing knee pain in the future, please call our clinic for an initial consultation and we can get you on the road to recovery.

That’s all from us today.

Netball Injury Prevention Program Launched

Netball Australia has launched The KNEE Program, which is a warm-up program aimed to reduce lower limb injuries (specifically Anterior Cruciate Ligament injuries in the knee) in netballers.

Anterior Cruciate Ligament injuries account for roughly a quarter of all serious netball injuries and have a significant impact on the lives of the injured individual.

The majority of injuries sustained during netball occur when the player lands from being in the air. The KNEE Program “targets safe take off and landing technique with specific attention to the overhead position required of netballers.”

The KNEE Program stands for Knee injury prevention forNetballers to Enhance performance and Extend play. There are 3 variations of the program catering to all netballers – Junior, Recreational & Elite. The program can be found at http://knee.netball.com.au/ and has a host of resources to explain the program in detail including videos of the program components.

All players, coaches and clubs should be encouraged to commence using the program on a regular basis to help reduce the overall number of serious lower-limb netball injuries.

Busting the Myth: You Need a Referral to see a Physiotherapist

Physiotherapists in Australia are considered to be primary contact practitioners. This means that a referral to see a physiotherapist from a medical practitioner is NOT required. This has been the situation in Australia since 1978. Australian physiotherapists were the first in the world to attain primary contact status. Many countries around the world have subsequently followed this move.

The only exception to this rule in Australia is if the patient's injury is subject to workers compensation or a compulsory third party insurance claim.

Concussion - Do You Know How To Recognise It?

Concussion is a serious injury which can result from direct or indirect impact to the head. The ramifications of concussion can be serious and therefore must be managed appropriately by trained medical professionals. How though do you determine whether someone is concussed and when to seek medical attention? Earlier this year, a group of world leading concussion experts met and developed a Pocket Concussion Recognition Tool. If you, your partner, your children or anyone that you know participates in activity whereby concussion may occur, I urge you to download a copy of the Pocket Concussion Recognition Tool and have it accessible to you.

Physio Fast Facts #4

1. Did you know that you have "core muscles" in your neck? "Core muscles" are regularly referred to in relation to your back, however they exist in your neck to help with your posture and to support the weight of your head.
2. Not everyone has the same number of bones! You can have little extra bones in many areas of the body although most commonly in the feet.
3. Try standing balancing with one foot directly in front of the other. Now try with the other foot in front. More than likely you were more balanced with one foot in front than the other!
4. Have you ever been referred to as being "double-jointed"? You won't actually have any additional joints. Your joints more than likely just allow you to have more movement than most people and this is referred to as being hypermobile.
5. After you injure yourself, your body doesn't necessarily move as it did before! Physiotherapists can help you to move "normally" again after you have an injury.

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.

ž