Ankle sprains are the most common acute injury in indoor and beach volleyball, and very few things spark intense debate in the volleyball community more than the question about using ankle braces to prevent these type of injuries.
The majority of ankle sprains are when the ankle inverts (rolls in) and this most often occurs with play at the net where athletes make contact with another players foot when landing from a jump during hitting or blocking. The theory behind bracing is to reduce abnormal ankle motion, but some fear that depending on a brace might make lower leg supporting muscles weaker and maybe even increase the risk of knee injuries.
What does the medical literature say about this?
Recently a study from the University of Wisconsin School of Medicine and Public Health showed that high school basketball players who wore stabilizing lace-up ankle braces had 68 percent fewer injuries than athletes who did not.
What do our expert volleyball medicine colleagues have to add?
In his experience working as the Director of Sports Medicine and Performance and the Head Men's Athletic Trainer for USA Volleyball, Aaron Brock has the following insight:
- The great majority of ankle sprains seen with the US Men's National Team have been to the unprotected ankle.
- No conclusive evidence exists that ankle braces adversely affect on-court performance
- It is still possible to sprain an ankle while wearing ankle braces but the risk is significantly diminished. Also, ankle sprains while wearing braces usually result in a less severe sprain.
- In his opinion, the best way to prevent ankle injuries is the use of ankle braces
As the Head Athletic Trainer for the USA Women's National Team and formerly the athletic trainer for Penn State Men's and Women's Volleyball Teams, Jill Wosmek offers her professional recommendations:
- Type of shoe is also important for proper heel position that isn't "too high" and thus having more side to side motion
- For younger players, she recommends braces as the type of volleyball play is a bit more chaotic and the athletes are not as strong
- Many college teams have bracing/taping as team rules that influence decisions
- On the US Women's National Team, the majority do not tape or brace but must heed disclaimer that level of play is higher, there are not a lot of under the net collisions, and the team spends a lot of time with strength and proprioceptive training
Does My Child Need to Wear an Ankle Brace?
It's important to note that the age range of the kids in the study was 14 - 18 years old. The answer is based on that age range.
According to Dr. Brooks, before the study was completed, the answer to that question was yes -- if they had a previous injury or sprain. There was good evidence that a brace would prevent an injury from recurring.
The results of the recent study seem to show that every teen should wear an ankle brace to prevent injuries in the first place.
Should Ankle Braces Be Worn on One or Both Ankles?
Because the results of the recent study showed that wearing ankle braces prevented injury, it would make sense to wear them on both ankles.
Should Ankle Braces Be Worn by Recreational Athletes?
According to Dr. Brooks, any teen athlete playing in an organized league such as a church league or YMCA can benefit from wearing ankle braces. However, it's harder to say whether there's any benefit if someone is just occasionally playing pick-up games with friends.
Essentially, the more time an athlete plays, the more time they are exposed to potential injury. Therefore, wearing the braces when playing regularly can help.
Is there a Certain Age That Kids or Teens Should Start Wearing Braces?
"Our study only evaluated 14-18-year-olds - and didn't look at younger kids," comments Dr. Brooks. "So, I can't say definitively. I think as long as there is a size of brace that fits them well, it is probably appropriate."
Even the smallest brace may be too large to fit younger kids properly. So parents need to ensure the brace fits properly in order to prevent injury.
How Often Should Ankle Braces Be Worn - Just Game Day or Practice Too?
For sports like volleyball and basketball, the braces should definitely be worn for both practice and game day. There are more opportunities for injury during practice - athletes are just as likely to roll an ankle, for example - so wearing the braces can help.
Should Athletes in Other Sports Wear Braces?
The answer to the question depends on the sport. The ankle brace study was repeated in football players with similar results. According to Dr. Brooks, volleyball requires similar movements to basketball, and athletes could likely benefit from wearing the braces. On the other hand, soccer is a more difficult sport to answer definitively. The movements are different and the braces could affect the playing abilities of the athletes, so in that case, braces may not be appropriate. Parents or athletes can talk with their physician or athletic trainer to help determine what is best for them.
For Ankle Strength, we recommend:
- Performing both compound, multi-joint strength training to strengthen the legs as a whole
- Performing additional, targeted ankle strengthening if there’s a past history of ankle injury, joint-laxity (looseness) or just a strong fear of injury.
- REMOVING the braces for controlled sport-specific activities that aren’t inherently high risk. This means allowing the body to jump and land without ankle braces at least some of the time. This will have a strengthening effect.
- REMOVING the braces for strength training activities, especially ones that are low-impact or stationary like squats, lunges, etc.