Twist and Shout: How to Minimize Ankle Sprains
"Shoes do make a tremendous difference," says Perry
Julien, DPM, of the Atlanta Foot and Ankle Center. "When shoes are worn
out, they lose some of their inherent stability. So replacing the shoes
regularly is important. Also, getting the specific shoe for the specific sport
[is key]. What often happens is people will go on vacation and take just one
pair of shoes. But running shoes lack lateral stability." No lateral
stability means that you run the risk of an ankle sprain should you hit the
basketball or tennis court wearing them. According to Julien, high-tops don't
necessarily offer higher protection, but they do provide a degree of
proprioception that will allow the ankle to react to potential injury. Studies
on high-tops, however, have been mixed.
"The bottom line is: The shoe construction does not
significantly decrease the incidence of ankle sprains," says Albohm.
So what about a brace or taping? Albohm says there's a bottom
line there, too. "If you're dealing with healthy ankle joints with no
previous injuries -- and ones that have been properly strengthened -- then you
don't need any preventative measures externally," she says. But for those
with a history of ankle sprains -- especially ones that have kept them out for
2-3 weeks -- it's a different story. "Then you've compromised the ligaments
in that joint and created some instability that will not return to normal,"
Albohm says. "For those individuals, external protection is recommended and
Julien warns that some 'bracing' is ineffective. "The
elastic braces provide very little stability," he says. "Some
proprioception, some bracing -- but not a significant amount of
Albohm prefers the lace-up type of braces but says that nothing
works better externally than a good taping. 'Good,' she warns, does not mean
'amateur.' "Taping must be applied by a trained, skilled practitioner who
knows what he's doing," she says. Otherwise, more damage can be done --
especially if the ankle gets fixed in the wrong position and the athlete plays
Green notes that taping is not a substitute for strength --
just an enhancement. "There's a little bit of controversy -- if I'm taped
or braced does it make the ankle weaker? There is a feeling among some athletes
and coaches that it might. But I feel if you have [enough strength to begin
with], it gives [added] support," he says.
Some sports may be harder on the ankles than others.
Basketball, soccer, and football, for instance, place more strain on the joint.
But Green says that nearly every athlete is vulnerable to an injury because
they engage in "dry-land conditioning."
All the experts agree that ankle injuries shouldn't be taken
lightly because one can more easily lead to another. "It's important to be
evaluated. You might have torn a ligament or fractured something," Julien
says. But before heading to the doctor, there may be a couple of things that
can be done at home. "Get it on ice -- 15-20 minutes every couple of
hours," he says. "Limit weight bearing as much as possible; apply some
medium compression, such as an ACE wrap. Start from the toes and wrap
upward" to avoid more swelling in the foot.
"Don't treat it as a minor injury," says Julien.
"Most ankle sprains are undertreated, and people tend to have problems down