To Brace or not to Brace?: That is the Question

Ankle braces will weaken your ankles mate, don’t stay on them too long’. I don’t know when or how this myth started, but guys, it ain’t true. We play Volleyball. We jump at the net, surrounded by many other people, land from crazy heights, into even more dangerous positions, feet are everywhere, uncoordinated idiots jumping under the net…please, protect your ankles.

What is Proprioception?

Proprioception is an important sense in the body. Unlike, sight, touch, hearing taste and smell, it focuses on only internal feedback from the body. Proprioception is the process by which you body can vary muscles contraction in immediate response to incoming information about your body in space. It is basically a sensory feedback for muscle control and posture.

Proprioception occurs by utilizing proprioceptors (little sensory things- Golgi tendon organs and Muscle spindle) in your muscles to monitor length, tension and pressure.

So why don’t they weaken your ankles?

OK, I get the reasoning behind everyone’s assumption that long-term ankle brace usage will cause ankle weakness. I hear a lot that it is doing the work for your ankle, so your ankle becomes detrained and won’t perform the proprioception itself. I get it, yeah, but it’s wrong. Let me try and explain.

Most people reading this would have worn an ankle brace at some stage in their career. Firstly you simply cannot take away your body’s proprioception. When you move in an ankle brace, your ankle still has to do a lot of work. You haven’t surrounded your ankle with a new joint and voila, no more ankle activation. When you land, or move, your ankle still must correct itself, and your proprioception is still very much hard at work. Your ankle will move a fair bit in the brace, and lots of forces will be applied, so in a healthy ankle the muscle spindles and Golgi tendons will be getting a fair workout. The fact of the matter is, that bracing will actually work to enhance your proprioceptive input, not override it.

All ankle braces are doing for you, is stopping you ripping the crap out of your ankle, shattering every bone, snapping all the ligaments and ending your career. OK, over dramatic, but you get the point? An ankle brace will not dull your senses; it will simply prevent a real disaster occurring. If you are going to go over your ankle badly, you probably will in an ankle brace anyway, it just means that the severity of the injury is a lot less.

Don’t believe me? Fair enough. I get that. But there are numerous studies supporting me.

Mitchell et.al (2000) did a study on the effects long-term ankle bracing has on the Peroneus Longus (muscle around the ankle) during sudden inversion in normal subjects. They did the study because

“ankle bracing in a healthy ankle over a sustained period has been scrutinized due to possible neuromuscular adaptations resulting in diminished dynamic support offered by the peroneus longus muscle. Although this claim is anecdotal in nature, we sought to investigate the effects of long-term ankle bracing using 2 commonly available appliances on Peroneus Longus latency (edit: time delay between and effect on the muscle and a reaction to that effect) in normal subjects. Our second purpose was to evaluate the effects of ankle bracing on Peroneus Longus latency before a period of extended use”

Their results? Ankle bracing had no effect on the latency of the Peroneus muscle. Short term or long term. Nothing at all.

“The duration of the Peroneus Longus stretch reflex (latency) is neither facilitated nor inhibited with extended use of an external ankle support. Proprioceptive input provided by the muscle spindles within the Peroneus Longus does not appear to be compromised with the long-term use of ankle braces.”

Feuerbach et.al (1994) also did a study looking at the effect of ankle orthosis (bracing) on ankle joint proprioception. The found that using an ankle brace would actually increase the feedback from your internal receptors, and will lead to an improved ankle joint position sense.

Nishikawa and Grabiner (1999) did a very similar study. They also found that application of the ankle brace excited the receptors, most likely those that are to do with the skin. Meaning bracing led to better proprioception and joint sense; helping make the candidates more aware. They also showed that Peroneus Longus latency was not affected at all by ankle brace use. They noted that this is very important for rehabilitation purposes, as an injured ankle needs to work on proprioception, and bracing may help to excite and stimulate that.

Sorry for the the technical crap, but now you have some evidence.

There has got to be some negatives to bracing…

Speaking recently to Aussie Libero Phill DeSalvo and my roommate with vastly improving hip mobility, Sarah, both have a different view on the ankle brace. A very very high percentage of ankle sprains in Volleyball occur at the net. Now, if you are a libero and you are jumping to spike or block at the net, then you don’t know what you are doing, are in violation of a lot of rules, and should hand your different coloured shirt in. The point is, ankle injuries occur when jumping and landing, Liberos rarely jump or land. In fact, some feel that they maybe limit their range of motion a little. There is no evidence to support this, but it is a feeling held by quite a few liberos. As you try to get into a deep side lunge, the ankle brace can inhibit that slightly as your ankle obviously doesn’t have as much range. Some players also find that they don’t fit well with their shoe, or are simply uncomfortable. Try taping! Just a little food for thought on the negative aspect of bracing.

Some very good reasons to wear braces

Prevention

You jump. A lot. Surrounded by a few people. You land in the same environment. Yes, in elite Volleyball there are much less uncoordinated players unable to halt their momentum and jump under the net, but at even slightly lower level, it does become a little dangerous!

To put it simply, there are very little reasons not to wear an ankle brace. You won’t weaken your ankles, just won’t happen. So you can take that out of your mind when making your decision. I know as a coach, if one of my players did their ankle and wasn’t in a brace, my sympathy would be waning. The nature of the sport is one in which ankle sprains are common. Let’s try and prevent them a little hey, seems a stupid reason to miss games.

Rehabilitation

When you sprain your ankle, you lose some of your proprioceptive ability and muscle control. You have to retrain it with proprioception exercises to get it back to full functioning. This is a pretty tough gig and a lot of people don’t do it so well. We will have a post in the future on ankle proprioception exercises that can help you get back to full functionality.

Anyway, the point is, when you are returning to play, your ankle proprioception is still a little wayward, even though you are nearly back to full strength. Ankle brace or taping is imperative at this stage, as you are much more likely to do your ankle. In fact, for other sports, its recommended after an ankle injury that some sort of protection be worn for up to 6 months whilst you are trying to regain full or near to full proprioception.

Keep in mind that the best way to rehab a bad ankle is to do stuff without braces. When doing your fitness work, and proprioception training there is no need for them. You aren’t landing amongst people and have no need to wear them, a similar principle and argument for a libero not needing to wear them. Since they have very little effect on the proprioception of a joint, other than to create more awareness in certain situations, and there is no risk involved when doing balance training, lowering exercises and general ankle strengthening work outside of Volleyball play, keep them off.

So…

Bracing is very much an individual choice. However quite a lot of teams, especially at higher levels do require that braces are worn by everyone during games and trainings, as they simply don’t want to lose players. When factoring in your decision to wear a brace or not, please remember that you aren’t going to detrain your ankles, just help prevent a serious injury.

Ouch, check this out…(nope she wasn’t wearing a brace!) Don’t forget to vote on our poll in the sidebar!

37 Replies to “To Brace or not to Brace?: That is the Question”

  1. I fear that many do not recognize one of the other great issues with ankle braces.

    That is the impact on the knee.

    As you land on someone’s foot etc, there is going to be a stability issue, which you try and compensate with your whole body. If your ankle is locked in place, then that compensation has to be added elsewhere.

    Whilst having your ankle saved is great, losing a knee is far worse, and takes longer time to rehabilitate.

    Personally, I don’t wear ankle braces, simply for the fact that I would rather have a mild twinge through both knee and ankle than just through my knee alone.

  2. Hi Ed,

    Thanks for your comment. It’s good to create a bit of discussion. This is an often talked about problem with the brace, but I am going to have to disagree with you on this one.

    First of all, this comes from the fact that when you are skiing, you are at a big risk of knee injuries. Your ankle IS locked in, and the only joint that is going to move is your knee. You have no movement in any plane through your ankle when skiing.

    However, in an ankle brace you aren’t locked in. Not at all. You still have quite a lot of movement through the ankle, obviously you can flex and extend the ankle to nearly full range (unlike in ski boots), and your sideways range, although not great to begin with, isn’t really affected. What an ankle brace does, is stop you really ripping your ankle apart, it doesn’t stop the small intricate movements that the ankle does (Laterally you have very little range anyway). Hence why it actually promotes proprioception, rather than fully takes over the job. Your ankle will be the first thing (in most cases) to try to correct itself if you land badly, and the ankle brace will only really stop a severe injury occurring. If you are going to go over, you will anyway, it won’t go up through your knee.

    There isn’t a lot out there to suggest that this is the case with bracing (increase risk of knee injuries), although it really is an individual choice, and there are a lot of different comfort complaints regarding different kinds of braces.

  3. I have never worn the active ankle braces. Sometimes i would wear a lace up brace but eventually i decided that this was also too restricting and learnt to strengthen my ankles. However in saying this if for some reason someone comes under / through the net and i land on their foot then i tend to fall with the way the ankle goes rather than righting or compensating and spraining my ankle. I have seen many a sportsperson wear ankle braces and still sprain the ankle but not on the sides but at the front of the ankle. But once again it is everyones choice and many players land from different heights. Some players are more stable on their feet than others. I guess good foot alignment also helps and if someone is flat footed or have high arches this could be a factor as to whether they tend to sprain their ankles more often than not.

    This is an interesting topic however

  4. Hey Sally,

    I find a lot of players just simply dislike to wear them, for various reasons. It really is an individual choice. Players just need to remember the one fact that their ankle won’t weaken with braces, when factoring in their decision.

    I have seen a couple of front sprains too, and a fair few popped active ankles!

  5. One thing that the video shows is that the net padding was at fault here, I have always hated those sloppy net pads (as opposed to the form fit rubber ones).
    Ankle braces don’t stop the injuries they just seem to lessen the severity. I have seen ankle braces break with a bad ankle sprain but I am yet to see any knees go as a result of an ankle brace, as someone mentioned earlier they are just not that rigid, say like a ski boot.

    Now here is an interesting question, why don’t you see (or very rarely) Asian teams wearing ankle braces. Do they just tape, or do nothing at all?

  6. Hey, not true. I have seen many asian teams wearing ankle braces.

    I have also seen lots of people say that their ankle brace just saved them.

    I don’t wear them because I don’t like the feel of them but if I was a spiker or setter then I think I would wear them anyway. I think they are good insurance when volleyball is your job because lets face it. Once a week some idiot will jump though the net.

  7. This has long been an argument at all levels for a number of years. I am not to keen on players being told that they have to wear ankle braces, as I have always believed that it’s the players choice. Having said that, I can also understand that high level programs will mandate that their players wear braces. I lost two players before the National Junior Championships a numbe of years ago to rolled ankles at the net. Both these players where wearing ankle braces. The new ankle braces that have emerged in recent years allow more movement in the ankle. In doing so, this they have reduced the stress that was placed on the knees by the older style and less mobile braces. It has also allowed the ankle to be ‘more active’ and improve its stability.
    I am sure this thread will stir up some discussion.

  8. I am 13 years old, and I play setter. I am not sure what my coaches think about braces, but I was considering using Active Ankles. I have rolled my ankles a few times, and I am scared of more serious injuries. Do you think I should use them? Why or why not? My knees are also not the strongest, so I am not sure what to do.

  9. Hi Hayley,

    My advice would be to wear active ankles. I have worn them for many years. The research shows they don’t weaken your ankles or translate to an increased risk of knee injuries. Some players have an issue with comfort and feel too restricted. This has never been a problem for me, but it varies from person to person.

    You can still roll an ankle in with braces on, but it should reduce the severity of the injury.

    Ankle braces will certainly help in preventing injuries, but you should consider starting a conditioning program to help keep you injury free, and improve your performance.

  10. My daughter just went down with a severe injury even with the active ankles. Now we have conflicting opinions – surgery vs. non
    She hopes to play in college and we are confused as to best course of treatment. BUT our general feel is that it might have been worse without that brace – yeah, she came down on someone’s foot at the net. Thanks for clearing up a lot of the questions because we’d been hearing pros and cons about braces for a long time

  11. Hi Volleyball Mom,

    Sorry to hear about your daughter. Even though braces do reduce the severity of injuries, you can still cop some nasty ones; and there is not much you can do when you land on someone’s foot.

    Glad the article could help. Good luck to your daughter with her recovery.

    Cheers.

  12. Hello, I have recently mandated the T2 active ankle braces (or above in quality) for all my hitters, blockers and my setter because she is a blocking setter. I have had 6 injuries from mild to severe in the past 3 years and to be honest I never want to hear that noise again (not the screaming or crying folks…the “POP”) If this is what I can do as a coach I feel morally responsible to mandate the brace.
    Now my ? for you is a parent believes this may cause weak ankles and has asked for literature. I am not say this site is not good enough however you have refered to studies proving they don’t, can you direct me to those studies? Thanks!

  13. Hi Coach,

    Sorry for the late reply. Here are a few sources you might find useful.

    http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=164368&blobtype=pdf
    This review found that braces decrease the risk of re-injury in people who have already sprained an ankle.

    http://www.pubmedcentral.nih.gov/picrender.fcgi?artid=1323365&blobtype=pdf
    This research is quoted in the post. Its basically saying long term bracing wont effect proprioception in the ankle.

    http://bjsm.bmj.com/cgi/content/abstract/37/3/258
    This abstract is saying the same thing.

    Hope this can help convince the parents.

    Good luck with your team, let me know how you go, and what your injury rate is.

  14. Hey there,
    i have played volleyball for ages now yet only just started wearing Active Ancles last year… i don’t wear them EVERY time i play v-ball. is this an issue?? or am i ok to wear them as i please….

    cheers

  15. Hi Jase,

    The article is pretty much saying that bracing is a personal choice, but wearing them will not have a deconditioning effect on your ankles. It comes down to comfort and personal preference but if they don’t annoy you I’d certainly be advicing you to wear them every time you play. Its Murphy’s Law, the one day you don’t wear them will be the day you do your ankle.

    Cheers & good luck.

  16. I’m only 11 years old and i already have problems with both my ankles. In soccer whenever I kick the ball, they hurt so bad. I wear ankle braces on both ankles but they don’t work very well. My parents told me to find exercises online, but I can’t find any thing on it. Any suggestions? If so email me at hollyangel2015@aol.com.

  17. 1)Thank you for the advice I’ll try it.
    2)New problem! I’ve been doing some research and I found out that wearing ankle braces leads to knee problems. I’ve been wearing ankle braces for 5 months. Does everyone get knee problems or just some?

  18. Hey Holly,

    There is some logic to thinking wearing ankle braces can lead to knee problems. Decreased range in the ankle means that when landing, the force must be absorbed at other joints, such as the knee. In a sport like volleyball, this problem is amplified by the amount of jumps we do.

    Whilst decreased ankle range is a problem, bracing doesn’t limit plantar flexion and dorsiflexion (pointing foot up and down) that much. So I don’t think bracing will translate to knee problems.

    A large percentage of volleyball players out there have knee problems, and there are many things that can be done to prevent knee problems. Perhaps this is better tackled with another post.

    Good luck Holly.

  19. I fear that many people will read these posts and believe them to be absolute truths.

    I am a physiotherapy student, in my final year of study, and I work as a therapist for my university’s volleyball team.

    One can argue both sides of this debate, and there are numerous articles to support both sides.

    So here is my two cents.

    Ankle braces are great… for some. A player who has never had an ankle injury and does not present with ankle instability should NOT wear ankle braces as a preventative measure. Contrary to prior posts, they can weaken your ankle and decrease your ankle’s proprioception.

    Ankle braces should be worn post-injury. They provide temporary stability to the ankle and also serve as a reminder to yourself, and to the ankle that there is an injury present. It protects the ligaments from over-stretching while they are trying to repair — ligaments are poorly vascularized and therefore take a lot of time to repair… if at all, depending on the severity of the injury.

    There are many studies that state that ankle taping is more efficient than bracing for a variety of reasons. I agree, however it is more time-consuming and costly than bracing, especially long-term.

    Another argument is the time post-injury a brace should be worn. This depends on several factors and should be determined on an individual basis. Some studies indicate up to a year post-injury. Personally, for high level athletes, I constantly re-evaluate the ankle for pain and instability. Once I can no longer reproduce pain and I am satisfied with the ankle’s stability, I leave the brace on a little longer and begin to wean the player off the brace.

    However, an athlete who has chronic ankle instability or a history of multiple ankle traumas (ie. 3+ ankle sprains) I would recommend the use of ankle braces at all times.

    I do support the comments above about ankle bracing affecting the knee. I have read numerous articles on this subject and have witnessed it myself. However, it usually applies to an athlete with a pre-existing knee instability, weakness or previous injury.

    I’ll end off with this advice. Give your ankle time to rest!!! The ligament fibers need time to repair and realign themselves. Premature return to play with weaken the newly formed fibers and will set you back or cause a permanent instability.

    A rehabilitation program is key. Make sure to include ankle proprioception exercices to improve the ankle’s stability and overall balance.

    I’m sure there will be many who disagree with my post — take it or leave it, that’s all I can say.

  20. Hi Mary,

    Great to get your point of view. It definitely is an interesting debate, and its good to hear both sides of it. I’d be interested to read the articles you refer to relating to bracing decreasing ankle strength and proprioception.

    Cheers.

  21. In the interest in remaining objective and encouraging thought provoking discussion, I have compiled a list of articles that both support and question my views. I`ve also thrown in some interesting articles that I think are worth reading.

    Happy reading!

    Midterm effects of ankle joint supports on sensomotor and sport specific capabilities (Jerosch et al, 2000)

    The prevention of ankle sprains in sports: A systematic Rewview of Litterature (Thacker et al, 1999) ***excellent article

    Functional Instability following a lateral ankle sprain (Hertel et al, 2000)

    Prophylactic ankle taping and bracing: A Numbers-Needed-to-Treat and Cost-Benefit Analysis (Olmstead et al, 2004) ***great read

    Predictive factors for lateral ankle sprains: A litterature review (Beynnon et al, 2002)

    Braces and splints for musculoskeletal conditions (Gravell et al, 2007)

    The effect of ankle bracing on athletic performance (Bot et al, 1999)

    The effect of a proprioceptive balance board training program for the prevention of ankle sprains (Verhagen et al, 2004)

    The effect of preventitative measures on the incidence of ankle sprains (Verhagen et al, 2000)

    Prophylactic ankle bracing reduces rearfoot motion during sudden inversion (Cordova et al, 2007)

    Intrinsic predictors of lateral ankle sprain in adolescent dancers: A prospective cohert study (Hiller et al, 2008)

    Lower re-injury rate with a coach-controlled rehabilitation program in amateur male soccer: A randomized controlled trial (Hagglund et al, 2007)

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  23. hey,
    im 15 years old and ive been playing volleyball since i was about 11. The only injuries i’ve had are with my knees (i horseback ride as well, so that was the main effect) and they only hurt when i’m sitting down for long periods of time. anyways, about a week ago i was scrimmaging and i did something to my ankle, but wasnt aware of it till afterwards. It hurts the back of my ankle to point my toes too far downward, but it doesnt effect me until i do. I’m a libero, true, but i am considering wearing a brace for the sake of my ankle. not EXACTLY sure whats wrong with it, but, seeing how the pain hasnt increased, i havent needed it to be check out yet. ankle brace or not?any suggestions?

  24. I agree. I do not think Ankle Braces will weaken your ankles. They do prevent a bigger injury from happening. It may be psychological that since it somehow prevent movements, your ankle will get limp. If someone does need ankle braces, I don’t see a reason why he or she should be hesitant to wear it.

  25. Hey, I’m 16 and have been playing since around 11 years old. I started out as a setter but was moved to libero about 4 years ago. I very often back row attack and jump serve, and have received MANY ankle injuries due to it. None mattered much until the beginning of my club season I got a major sprain in my left ankle and although I was said to be at 100% and able to play again I still have a lot of pain in my ankle. My mother refuses to buy me active ankles because she feels it will restrict my movement as a libero. I dont want to undergo another bad injury however, especially with college just around the corner. I guess my question is, should I get them, or will it really restrict my movement ?

  26. As a 40 year old guys who’s been playing competitive vball for 20 years:

    Jumping *typically* does not cause ankle injures: LANDING causes ankle injuries 😉 That being said, I’ve seen some pretty weird injuries including rolling an ankle on takeoff, tearing an achille’s tendon while in the back row turning to dig/face the passer… an advanced-level setter (played D1 college ball coming under the net (legally) and hitting another advanced level player in the side of the knee and blowing it out.

    Both of the players mentioned above are 30+ years old, have children of their own and compete at a very high level. Both have had their BOTH of their knees surgically repaired :-/ (as has my wife) I would almost say if you’re a female athlete and you plan on playing sports that involve twisting motions on your knee (basketball, volleyball, soccer, softball) your whole life to start planning on knee work at some point. Cleats just exasperate the situation as they do not allow the foot to ‘give way’ and so the knee blows.

    When you’ve been playing as long as I have (and you wish to continue to play and remain competitive so you can play with your girls), there are certain things that make you cringe:

    Seeing relatively inexperienced volleyball players wearing kneepads — and using them/depending on them by sliding and having both ankles braced all the time.

    The physiology of the female lower body after puberty is the the hips widen to prepare for childbirth, resulting in the knees no longer being directly under the hips puts torque on the knee joint:

    http://www.nismat.org/ptcor/female_knee

    Combined with the typically weaker musculature around the knee than with their male counterparts:

    http://www.ur.umich.edu/0001/Mar05_01/11.htm

    Leads me to form the basis of my opinion: If something’s gonna give, you WANT it to be your ankle, not your knee. As you play longer and later in life, knee injuries become more likely (either from wear and tear from landing impact or loss of muscle tone)…

    Therefore you brace ankles when you need to heal or if there’s a medical reason to do so, otherwise you focus on daily strengthening and stretching exercises such as wobble boards, heel raises (standing and stair) as well as balance/proprioception strengthening exercises such as yoga. Many ankle sprains are due to weak ankles, poor balance and poor form (e.g. I’ve seen both an ankle roll AND a knee blown due to an inexperienced hitter starting their outside hitting approach too far in (hint, if you’re inside the court when hitting outside, you’re about 5-feet too far inside ;-), taking off too early, then jumping laterally to the outside to try and compensate… and twisting the left ankle/knee on the landing. Fading (lateral movement along the net) instead of sticking your block (going straight up) or your co-blocker. When injuries do occur, ankles that have gone through stretching and strengthening exercises recover more quickly.

    Braced ankles still get injured, they just typically turn into high ankle sprains. High enough, we call ’em knees 😉

    http://www.myyogaonline.com/about-yoga/yoga-anatomy/yoga-and-developing-proprioception

    http://www.wikihow.com/Perform-a-Heel-Raise

    Pools are great places to rehab ankle injuries (the water pressure at the bottom of the pool drives the fluid back out of the foot), and you can also work on zero-impact jump strength training in the deep end (go down to the bottom of the pool, compress your knees and explode back up to the surface (imagining that you’re blocking).

  27. Hi! I am14 and I have had this weird thing going on with my ankles since I was in like 5th or 4th grade. And its that very time I start to run, sprint, climbing stairs too fast, and if I run for a long time ,I almost ALWAYS sprain my ankles and they hurt so bad i couldn’t stay in cross country 😥 because it hurt every time I started to run after that. It’s not any specific ankle both of them do this I tried to figure out what to do and my Tai-Kwon-Do instructor advices that I wear ankle braces on each foot to strengthen them. Will this really work? does it matter what kind of ankle braces I wear?

    Thank you 🙂 😐

  28. OH ! and my school has stairs. Does that mean I should wear the braces at school or what? Like are there any specific reasons or times to wear them aside from workouts?

  29. Ok I have another question… So I went ahead and put a brace on the ankle that sprained the most. And it was really sore when I removed the brace. It’s like it hurts without it now… Is this good or no cuz idk and the other one has stopped being a bother
    😳
    Sorry for having so many questions 😕
    Luv ,
    Jamie lol 😎

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