**5.7 Taping and bracing**

Taping and bracing the ankle can be used for prevention as well as for rehabilitation. Application of tapes and braces is helpful in the prevention of lateral ankle sprains and in the recurrence of injuries. Application of a tape or a brace increases the afferent feedback from cutaneous receptors, which lead to improved ankle joint position sense. This increased stimulation results in a more appropriate positioning of the unstable ankle and protects it from re-injury. Hence it helps improve joint position sense through proprioceptive mechanism.

a.Taping: The major role of taping is to prevent extreme range of movements and to reduce abnormal patterns of movements of the ankle. Various techniques are in use, but the most common techniques are basket weave with stirrup and heel lock and basket weave and heel lock techniques. Taping has mechanical effects: it decreases movement of inversion and plantar flexion and increases the force required for a specific displacement in inversion and plantar flexion. Taping helps in decreasing the extent of non-weight-bearing talar tilt. It also limits the full weight-bearing talar tilt. Athletes with the greatest instability benefit most

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*Rehabilitation of Lateral Ankle Sprains in Sports DOI: http://dx.doi.org/10.5772/intechopen.89505*

> from the tape. Although taping does improve mechanical instability, the restricting effect is lost after varying periods of exercise. About 40% of taping effect is lost after 10 min of vigorous exercise like jumping, pivoting, running, etc.

b.Kinesio™ taping: Unlike structurally supportive tape, such as white athletic tape, Kinesio™ tape is therapeutic in nature. It differs from the traditional athletic tape with respect to its elasticity, i.e., it can be stretched up to 140% of its original length before applying it on the skin. It provides a constant pulling (shear) force to the skin unlike traditional white athletic tape. The fabric of this tape is air permeable and water resistant and can be worn for repetitive days. The

proposed mechanisms in which the Kinesio™ tape works are:

bleeding beneath the skin by moving the muscle.

iii.It reduces pain through neurological suppression.

mechanoreceptors [22].

i.Restrict ankle range of motion.

ii.Reduce injury and recurrence rate.

i.It corrects muscle function by strengthening weakened muscles.

ii.It improves circulation of blood and lymph by eliminating tissue fluid or

iv.It repositions subluxated joints by relieving abnormal muscle tension,

v.It improves proprioception through increased stimulation to cutaneous

c.Bracing: Ankle bracing can make a significant contribution to preventing lateral ankle sprains. It also shows a significant reduction in the frequency of ankle sprain recurrence. Ankle braces have certain advantages over tape allowing selfapplication without the expertise of qualified personnel. They are convenient to apply and to remove; they are reusable, readjustable, and washable. There are nonrigid and semirigid braces. The nonrigid ones are often made of canvas or a neoprene-type material, which can easily be slipped on and off, and some are with additional lacing. The semirigid braces mostly consist of bimalleolar struts made of thermoplastic materials attached by Velcro straps. Nowadays different braces are used such as lace-up braces and the Swede-O (Swede-O-Universal, North Branch, MN) and multiple models by McDavid Sports Medical Products (Woodridge, IL); lace-up braces with straps such as the ASO (Medical Specialties, Charlotte, NC), the RocketSoc (DonJoy Orthopedics, Inc., Vista, CA), and the Ankle Brace Lock (Breg, Vista, CA); and semirigid plastic braces with strapping configurations such as the Ankle Ligament Protector (DonJoy Orthopedics, Inc.), the Universal Ankle Stirrup (DonJoy Orthopedics, Inc.), the T2 Active Ankle Support (Active Ankle, Louisville, KY) and the Ultra Ankle,

helping to return the function of fascia and muscles [21].

and the Guardian Ankle (McDavid Sports Medical Products).

Semirigid brace like Swede-O-Universal and nonrigid brace like subtalar supports provide a better non-weight-bearing restriction in plantar flexion, dorsiflexion, and eversion than taping after 15 min of activity. A strong thermoplastic semirigid ankle brace significantly reduces talar and subtalar motions of plantarflexion, inversion, and adduction. In summary, ankle taping and bracing:

*Essentials in Hip and Ankle*

**Figure 1.**

1–2 times/day (**Figure 1**).

**5.7 Taping and bracing**

**5.6 Criteria for return to sports**

to complete a full practice without pain or swelling.

position sense through proprioceptive mechanism.

*Star excursion balance test [20]. Note: Star Excursion Balance Test for left-leg dominant participants (Posterior direction is behind athlete's right leg). Abbreviations: A, anterior; AM, anterior-medial; M, medial;* 

This should be done for 15–20 repetitions 1–2 times/day and with increasing progression. Specific training can include functional activities on various surfaces, e.g., trampoline and foam, and in water with weights. Repetitions should be 5–20,

The athlete can participate fully in the sporting activity once the pain has been reduced completely. The progression should be gradual in order to stress the ligaments without causing further harm. Full participation should be allowed once the athlete has complete range of motion, 80–90% of preinjury strength and a normal gait pattern including the ability to perform sports-specific activities such as cutting and landing without any compensation due to the injury. The athlete should be able

Taping and bracing the ankle can be used for prevention as well as for rehabilitation. Application of tapes and braces is helpful in the prevention of lateral ankle sprains and in the recurrence of injuries. Application of a tape or a brace increases the afferent feedback from cutaneous receptors, which lead to improved ankle joint position sense. This increased stimulation results in a more appropriate positioning of the unstable ankle and protects it from re-injury. Hence it helps improve joint

a.Taping: The major role of taping is to prevent extreme range of movements and to reduce abnormal patterns of movements of the ankle. Various techniques are in use, but the most common techniques are basket weave with stirrup and heel lock and basket weave and heel lock techniques. Taping has mechanical effects: it decreases movement of inversion and plantar flexion and increases the force required for a specific displacement in inversion and plantar flexion. Taping helps in decreasing the extent of non-weight-bearing talar tilt. It also limits the full weight-bearing talar tilt. Athletes with the greatest instability benefit most

*PM, posterior-medial; P, posterior; PL, posterior-lateral; L, lateral; AL, anterior-lateral.*

**108**

from the tape. Although taping does improve mechanical instability, the restricting effect is lost after varying periods of exercise. About 40% of taping effect is lost after 10 min of vigorous exercise like jumping, pivoting, running, etc.

	- i.It corrects muscle function by strengthening weakened muscles.
	- ii.It improves circulation of blood and lymph by eliminating tissue fluid or bleeding beneath the skin by moving the muscle.
	- iii.It reduces pain through neurological suppression.
	- iv.It repositions subluxated joints by relieving abnormal muscle tension, helping to return the function of fascia and muscles [21].
	- v.It improves proprioception through increased stimulation to cutaneous mechanoreceptors [22].

Semirigid brace like Swede-O-Universal and nonrigid brace like subtalar supports provide a better non-weight-bearing restriction in plantar flexion, dorsiflexion, and eversion than taping after 15 min of activity. A strong thermoplastic semirigid ankle brace significantly reduces talar and subtalar motions of plantarflexion, inversion, and adduction. In summary, ankle taping and bracing:


iii.Improve proprioception.

iv.Lose limitation of movement after exercise.

