Nancy A. Melville

July 12, 2011

July 12, 2011 (San Diego, California) — The use of lace-up ankle braces is beneficial in significantly reducing the rate of ankle injuries among high-school basketball players, regardless of previous injuries, according to research presented here at the American Orthopaedic Society for Sports Medicine 2011 Annual Meeting.

Injuries to the ankle are among the most common injuries in basketball, accounting for as much as 34% to 60% of all basketball injuries, according to Timothy A. McGuine, PhD, the study's lead author.

"In the United States, an estimated $2 billion was spent on direct and indirect costs in treating ankle sprain injuries of high-school athletes in 2007," said Dr. McGuine, a senior scientist from the University of Wisconsin–Madison.

High-school players are often encouraged to wear lace-up ankle braces to prevent such injuries; however, there is debate about the effectiveness of the braces in injury prevention.

To investigate whether the braces reduce the incidence of acute first-time and recurrent ankle injuries, the researchers conducted a prospective randomized controlled study involving 1460 male and female basketball players, ages 13 to 18 years, from 46 high schools in the United States.

Mcdavid Ultralight lace-up ankle brace

The players, who were evaluated during the 2009/10 sports season, were allocated to 1 of 2 groups: 740 wore Mcdavid Ultralight lace-up ankle braces, and 720 did not wear a brace during the season (control group).

In the control group, there were 78 acute ankle injuries, including sprains and fractures, over the course of the season; in the braced group, there were just 27 acute ankle injuries.

In the control group, there were 15 acute knee injuries, including anterior cruciate ligament tears, medial collateral ligament sprains, meniscus tears, hyperextensions, and patellar instability; in the braced group, there were 13 acute knee injuries.

In the control group, there were 18 other lower extremity injuries, including muscle strains, other sprains, tendonitis, and acute and stress fractures; in the braced group, there were 35 other lower extremity injuries. The difference was not statistically significant.

"There were nearly twice as many other lower extremity injuries in the braced, compared with the control group, but most of these injuries consisted of mild muscle strains and/or tendonitis," Dr. McGuine said.

The ankle injuries included 1 fracture in each group; 91% of the remaining injuries were lateral sprains, 6% were medial sprains, and 2% were syndesmotic sprains.

The acute knee injuries included 5 ACL tears in each group.

Dr. McGuine noted that the injury reduction among players using the ankle braces was similar for players with and without previous ankle injury.

Ankle braces might help reduce injury because of a neuromuscular effect, not necessarily because of their mechanical support, Dr. McGuine said.

"We used to think it was mechanical support limiting the motion, and that does occur to a certain extent. Our results showed the injury incidence was reduced, but the severity wasn't changed, so it may be because the braces provide a limited amount of support and more neuromuscular feedback to the brain to let the muscles react better," he explained.

"Once the ankle goes over, it will go over, but if we stop that initial movement, maybe we can prevent ankle injuries."

According to Dean C. Taylor, MD, Col (Ret.) US Army, professor of surgery, Department of Orthopaedic Surgery, Duke University in Durham, North Carolina, there is some debate about ankle braces related to the risk for other injuries, but the benefits do seem to outweigh the drawbacks.

"Other lower extremity injuries are a concern, but they do not seem to be a significant issue with these lace-up ankle braces, and there was not a statistically significant difference in this study," he said.

"Certainly, additional studies that evaluate for other injuries would be helpful, but I think that this work and other work that has been done at West Point suggests that using ankle braces decreases injuries and reduces costs associated with these injuries."

Another concern is "whether school systems can afford to purchase them for all athletes, and whether the athletes will be compliant — they may be concerned about how these braces limit performance," he added.

"But I have had experience with these braces and believe that they are helpful."

The study received no financial support. Dr. McGuine and Dr. Taylor have disclosed no relevant financial relationships.

American Orthopaedic Society for Sports Medicine (AOSSM) 2011 Annual Meeting: Abstract 25. Presented July 8, 2011.

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