FAQ Category: Ankle

Every surgeon has his or her own postoperative and/or rehab protocol. This refers to the step-by-step process of movement during recovery. What we present here is a summary of the typical program. You may experience some differences depending on your surgeon’s preferences.

At first you will be shown how to use a walker and probably allowed to put partial weight on that foot. The therapist will guide you through early post-operative range-of-motion exercises. That’s the extent of therapy for the first two weeks.

A formal physical therapy program is usually started four to six weeks after the surgery. The program is carefully designed to match each stage of healing as the patient transitions from remodeling to maturation of the graft site. It’s usually best if you only see one therapist for the entire rehab program. This should be someone who is familiar with the surgeon’s protocol.

The program may begin with cycling on a stationary bike without resistance. The idea is to get your full ankle motion back. Early on, the therapist will introduce you to proprioceptive exercises. These are designed to help restore the joint’s own awareness of itself — when, where, and how the joint is moving. Normal, healthy proprioceptive feedback in the ankle is especially important in avoiding future injuries. When the ankle moves even a little bit, adjustments are made to maintain stability and support.

Muscle strengthening begins with isometric muscle contractions. With isometric exercises, the muscles contract without moving the joint. Muscle training continues with concentric and then eccentric muscle contractions. Concentric contractions move the joint through normal motion. Eccentric contractions are done when a fully contracted muscle is slowly lengthened back to its normal resting position.

Everything in the rehab program is slowly progressed according to two things: your tolerance and X-rays taken showing the progress of the graft repair. Over time, you will be allowed to add activities such as walking, light jogging, and some time with your sport (if you are an athlete).

Sport-specific training will be included at the very end for those patients heading back into sports activity. The graft site must show fully mature, healed tissue. Care must be taken to avoid compromising this very delicate healing process.

According to a recent study from a group of Australian movement experts — yes. Taping does seem to reduce the likelihood of ankle sprains. And putting it on in such a way to mimic the natural movement of the skin may be important. The reason for this is a phenomenon called cutaneous receptor discharge.

Cutaneous refers to skin. Receptors in the skin that pick up messages and relay them to the muscles and joints may not be getting the message through with tape on that doesn’t allow the skin to move normally. Instead of a meaningful message, it adds to the noise entering the system.

It’s also possible that putting the tape on too loose or too tight alters the pattern of sensory signal patterns. If either of these situations occur, the ankle isn’t able to detect true sensory change.

In future studies, applying the tape in a way that mimics the natural skin stretch patterns will be tried. Finding ways to tape that avoid stretching the skin in multiple directions is an important next step. In other words, these same researchers say they will try and match the normal skin stretch patterns that occur with ankle motion during testing with tape in place.

Different types of tape will also be tested. And an effort will be made to find out where the communication break down occurs. Is it tape to skin, skin to muscle, or within the muscles themselves?

When you sprain an ankle over and over, it’s definitely time to do something different. Some experts do suggest taping the ankle. The idea is to increase the sensory messages to the joint and surrounding muscles. The hope is that this extra input will improve how quickly and accurately the ankle detects even the slightest change in position.

Proprioception is the term we use to describe the joint’s sense of its own position. Kinesthesia refers to detection of movement of a joint or body part. No one knows exactly why taping the ankle increases proprioception and kinesthetic awareness. It’s not really even clear if taping is what improves the joint’s ability to detect movement.

You may want to consider combining a program of exercises to restore normal proprioception with taping. Proprioception rehab has been shown to make a difference in how well your ankle responds to even small changes in ankle motion. Taping seems to work as well, though a recent study showed that it’s not because it improves proprioception. There’s likely some other (as yet) unknown reason.

A physical therapist can help you set up a program that you can do at the gym or health club (if you are a member somewhere). If you don’t have access to exercise equipment, it’s easy enough to make do with what you have at home. Expect to take four to six weeks to change movement patterns and improve joint position sense. You should see a difference in how often and how easily your ankles turn unexpectedly.

The tibialis anterior is the muscle along the front of the lower leg that dorsiflexes the foot. Dorsiflexion means the tendon pulls the ankle up toward the face. The tibialis anterior can tear partially or rupture fully as a result of trauma. Trauma includes lacerations (cuts) or blunt trauma of some sort. The description of your injury would fall under the category of blunt trauma.

Delays can occur because at first, the problem isn’t obvious. Other muscles and tendons take over for the damaged tibialis anterior. Motion appears normal but symptoms eventually develop. Patients report ankle weakness. There may be a visible mass that can be felt along the front of the ankle. This is where the ruptured tendon has pulled back and bunched up. The weakness can result in changes in the way the person walks.

Once the diagnosis has been made, then surgery is advised. Even if it is somewhat delayed, studies show good results after the tendon has been repaired or reconstructed. A direct repair (reattaching the torn end of the tendon to the bone) isn’t as likely after two months. The tendon retracts far enough that the surgeon can’t pull it back down all the way.

Instead, a tendon graft is taken from some other tendon in the foot or ankle and used to reconstruct the tibialis anterior. The tendon graft is called interpositional as it help bridge the gap between the end of the ruptured tendon and the bone.

There will be a post-operative period of immobilization in a cast. This is followed by a rehab program. Weight-bearing is gradually allowed as patients progress from a cast to a hinged-ankle boot. Motion is restricted somewhat until the boot is no longer needed. The end results can be very satisfactory with return of motion, strength, and function.

As with any surgical procedure, complications or postoperative problems are possible. This doesn’t happen very often. Your surgeon will go over with you any precautions and risk factors that might increase your chances for problems. But as the old saying goes, don’t borrow trouble before it comes your way.

Most people are familiar with the typical ankle injury that occurs just below the ankle bones. But there are other types of ankle injuries. One of those is the syndesmosis ankle sprain. The syndesmosis is a specific location in the upper ankle where the tibia and fibula (bones of the lower leg) meet.

Athlete and soldiers have the highest incidence of syndesmosis injuries. Football players, skiers, and hockey or basketball players are at increased risk of this injury.

Once the injury has been identified and evaluated, the surgeon uses the information to classify it as a grade one, two, or three injury. The difference between the grades is based on amount of edema, tenderness, and ability to put weight on the foot. Distance between the two bones as seen on imaging studies is also factored into the classification.

The final step is to plan a course of treatment. There are two basic choices: conservative (nonoperative) care and surgery. There haven’t been enough studies done to show what’s the best way to approach conservative care. Right now, nonoperative treatment is broken down into three parts or phases.

Phase one is the acute phase. When there is swelling, the ankle joint must be protected until the inflammation is controlled. Moderately painful injuries are aided by an ankle brace or taping to provide compression and stability along with ice, rest, and elevation. Severe pain may require immobilization in a cast or splint. Physical therapy to restore normal joint motion and neuromuscular control may be needed.

Therapy continues during phase two, the subacute phase with strength and functional tasks. The program is progressed until the patient is no longer using assistive devices (splints, braces, crutches). When the athlete is ready for more advanced training, then phase three begins. The focus will be on returning the athlete to active sports participation at the preinjury level whenever possible.

There’s no set amount of time before players return to sports. This varies according to the severity of the injury. Studies report anywhere from three and a half weeks up to two months before rehab is complete. In some cases, conservative care isn’t even possible. Surgery to repair the damage and restore ankle stability is required. Recovery is delayed by three to four months.

Two weeks probably isn’t enough time to get back on skis, but your physician will be the one to say yes or no. There are some tests he or she can perform to help predict who can treat this problem with physical therapy and who needs surgery. It’s best to follow any recommendations made by the surgeon in order to avoid reinjury.

If your surgeon tells you the ankle is stable, then you should be able to see a physical therapist and get an exercise program going. The therapist will first do some testing to find out what needs to be worked on. Joint range-of-motion, strength, balance, and motor control will be measured. There are some specific functional tests that can be done, too.

Once motion and strength for simple tasks have been restored, then more complex strengthening and balance exercises can be prescribed. Returning to activities such as bronc riding may require a few changes to the rehab program normally offered to a football player or other sports athlete.

For example, neuromuscular control can be restored through different types of training exercises such as plyometrics and closed kinetic chain tasks. Plyometrics is a type of exercise training designed to produce fast, powerful movements. The goal is to improve the functions of the nervous system in order to improve performance in a specific sport.

During plyometric movements muscles are loaded and then contracted in rapid sequence. The muscle generates as strong a contraction as possible in the shortest amount of time. The muscle is being reprogrammed to contract faster and with more force. This will allow the athlete to jump higher, run faster, throw farther, or hit harder. The specific exercises used and muscles trained depend on the desired training goal.

Closed kinetic chain exercises are performed with the foot in contact with the ground (or floor). The athlete uses his or her own body weight to place a compressive force through multiple joints at one time. For the leg, some examples of closed kinetic chain activities include squats, lunges, leg and presses. Not only the ankle, but also the knee and ankle are affected by these exercises.

The therapist will work with you to create a sport specific program. With an injury of this type, expect a two to three month process of recovery and rehab.

You might be able to do this in hindsight (looking back) but it can be difficult. You would have to remember dates; precipitating events; and the frequency, intensity, and duration of all your symptoms. If you have this written down or your doctors have documented what you’ve told them, then you may be able to sort this out carefully.

Sometimes patients feel as if they have had one continuous episode of back pain. In fact, it’s possible there was enough of a break in symptoms that any new pain could really be constituted as a new episode.

The definition of an episode of back pain isn’t always the same from one doctor to the next. This may be changing as authors of some of the more recent studies have become aware of the problem and are making efforts to use a more standardized definition.

The current definition proposed for future studies is as follows. An episode of low back pain is a period of pain in the lower back lasting for more than 24 hours. It is preceded by and followed by a period of at least one month without low back pain.

So, in other words, if you have experienced 30-days without back pain at any time in the past year, then your two episodes of back pain are really separate. They may or may not have the same precipitating risk factors. That would be something to explore with your health care providers. A previous history of back pain does increase your risk of recurrence — but it doesn’t guarantee it.

It sounds like your daughter might have a condition called os trigonum syndrome. An extra piece of bone is present (usually at birth) in the ankle of affected individuals. It is located behind the talus bone (part of the ankle complex). It is connected to the talus by a band of fibrous tissue. When this bony bump gets separated from the main body of the talus, it is referred to as an os trigonum.

For the person who has an os trigonum, pointing the toes downward catches the os trigonum between the ankle and heel. The repetitive force downward on the os trigonum every time the foot is pointed causes the bone fragment to pull loose. As the os trigonum pulls away, the tissue connecting it to the talus is stretched or torn. The area becomes inflamed causing pain and loss of ankle motion.

This can be a very serious problem for a ballerina. Pointing the toe or rising up on the toes causes pain. Whether it’s a bone fragment that gets caught in the joint or some other soft tissue getting pinched, limited motion occurs preventing the dancer from performing movements essential to ballet.

Surgery to remove the bone can be done with an open incision or endoscopically. Endoscopic surgery involves a tiny incision (big enough to allow a scope to pass through the skin into the joint). A tiny TV camera on the end of the scope allows the surgeon to find the free-floating fragment and remove it.

This can be done without disrupting any blood vessels or nerves in the area. There are fewer complications and a faster recovery time. Most dancers are able to return to dancing without any problems after just a few weeks. If there is any other damage in the joint already present at the time of the operation, the surgery may be more extensive and the recovery longer.

You may be experiencing something called posterior ankle impingement. This is the pinching of soft tissue, bone, or scar tissue causing painful and limited ankle motion. Plantar flexion (pointing the toe) is affected most often. It’s the movement you are using to push off from the starting block.

Posterior ankle impingement is caused by traumatic injury or overuse. Dancers, soccer players, runners, and other athletes are affected most often. Sometimes dancing or running on a hard surface contributes to the problem.

In other cases, there is a slight difference in the normal foot and ankle anatomy that eventually leads to posterior ankle impingement. The joint capsule may be thickened causing pain when it gets pinched between two bones in the ankle.

There may be bone fragments inside the joint that have broken off the bone and become free-floating agents that get stuck. Whatever the cause, the end result is the same: chronic ankle pain along the back of the ankle at rest and with palpation, pain with movement, and loss of ankle plantar flexion.

One common cause of posterior impingement syndrome is called the os trigonum. There is an extra piece of bone present (usually at birth) in affected individuals. It is located behind the talus bone (part of the ankle complex). It is connected to the talus by a band of fibrous tissue. When this bony bump gets separated from the main body of the talus, it is referred to as an os trigonum.

For the person who has an os trigonum, pointing the toes downward catches the os trigonum between the ankle and heel. The repetitive force downward on the os trigonum every time the foot is pointed causes the bone fragment to pull loose. As the os trigonum pulls away, the tissue connecting it to the talus is stretched or torn. The area becomes inflamed causing pain and loss of ankle motion.

The best way to find out what’s causing your symptoms is to see an orthopedic surgeon. A clinical exam, X-rays or other imaging studies, and history will result in a diagnosis. An early diagnosis and subsequent treatment may be able to reduce your painful symptoms and restore normal alignment with nonoperative care (e.g., physical therapy, antiinflammatory medications, steroid injection).

Fusing bones is often a last resort when treating for arthritis. Fusing the bones is like welding them together so they are as one. As a result, their movement is very limited because instead of a moving joint, you have a solid bone mass.

So the quick answer is no, your ankle won’t be as flexible as it was before it developed arthritis. To understand this better, it would be best to discuss this with your doctor what your treatment options may be.

Injection of hyaluronic acid into the knee to treat osteoarthritis is an approved treatment now. The Food and Drug Administration (FDA) has given the use of this type of viscosupplementation in the knee a green light. The FDA has NOT approved the use of this viscosupplement for the ankle yet. Why not?

The underlying cause of osteoarthritis in the knee versus the ankle is often different. Experts think this may make a difference in how effective viscosupplementation may be for the ankle. The main difference in cause is trauma: arthritis in the ankle joint is more likely to be caused by trauma. Knee osteoarthritis is usually just that — arthritis that started in the knee without a history of trauma.

Studies show that viscosupplementation isn’t really effective for knee post-traumatic osteoarthritis. So there’s no reason to believe (and minimal proof yet) that this type of treatment will work in patients with posttraumatic ankle osteoarthritis. Why not?

No one is exactly sure yet why viscosupplementation works well for primary arthritis affecting the knee but not posttraumatic joint arthritis. Some studies have been done with this treatment for ankle osteoarthritis. But the number of patients involved was small and the results have only been measured for up to six months. The results did show a positive effect of viscosupplement injections when compared with placebo (fake) injections. SAs you found out, some viscosupplements have been given approval for use with ankle patients in Europe.

Research efforts are now underway in the U.S. to test hyaluronic acid in the treatment of ankle osteoarthritis. The hope is to find equal (if not better) results as have been reported with knee viscosupplementation. Minimizing adverse side effects is a secondary goal of current studies. Reports of temporary effects such as pain, warmth, swelling at the injection site have been noted. Up to one third of the patients treated with viscosupplementation experience some type of negative side effect.

When larger studies with more long-term results are available, the FDA may approve the use of viscosupplementation as a treatment tool for ankle osteoarthritis. The complex nature of the joint with its many bones (compared to the single hinge-type knee joint) make it necessary to research this treatment option carefully before approving it for use in the U.S.A.

The ankle is a complicated joint – it’s small, like the wrist, but complicated because of its structure. While certain types of surgeries are easier to do on the larger joints, surgeons have to find ways to access the inside of the ankle without causing more damage.

Arthroscopy is a type of minimally invasive surgery that allows doctors to make tiny incisions in which they insert cameras on the end of long, thin instruments. These cameras allow the doctors to see inside the joint and even to perform surgery. The problem with the ankle is that while the front or anterior part of the ankle is easy to access, the back, or posterior isn’t. Therefore, the surgeons have to know what approach to use for what part of the ankle.

There has been a great deal of progress in this area over the past 30 years and more and more ankle arthroscopies are being performed.

While it’s not possible to tell what exactly is wrong with your niece’s foot without examining it, it does sound like it may be a case of anterior ankle impingement. This is, simply, what you said – something, in this case soft tissues in the ankle, have been caught in the ankle joint and cause pain whenever she moves her toes upwards, reducing the angle of the ankle.

Treatment for ankle impingement may involved rest and bracing, or it may involve surgery.

We can’t answer this directly since we don’t know from your question just what kind of program you have been following. But we can tell you the proposed factors in recurrent ankle sprain and the principles physical therapists follow when treating a patient with chronic ankle stability (CAI).

First, it’s likely that there is a change in neurologic function with chronic ankle injuries. Messages from the muscles around the ankle to the spinal cord (and then to the brain) are not the same for someone with CAI compared to someone who has a normal, healthy functioning ankle. A loss of neural control leads to reduced joint proprioception (sense of joint position) and kinesthesia (awareness of movement). The end result can be joint instability, loss of function, and disability.

Edema or swelling in and around the ankle can also decrease sensory feedback from the joint. Messages from the joint through the nerves to the nervous system are reduced. With injury to the joint also comes arthrogenic muscle inhibition.

Arthrogenic means the cause is coming from the joint. Muscle inhibition means the muscle isn’t contracting as it should. This is another way that the muscles are affected after injury and don’t fire normally. The person suffers from a loss of both motor control and postural control. The slightest change in surface or environment can result in another ankle sprain.

The physical therapist understands all these mechanisms. The rehab program is designed to include activities to restore joint proprioception and kinesthetic awareness. Exercises to strengthen the muscles and improve sensorimotor input are carried out. Rehab programs with a neurologic component are essential when trying to prevent CAI or when treating a condition of chronic instability.

Expect at least a 12-week period of time before your situation is balanced. The nervous system is plastic (modifiable or changeable) and can adapt in order to restore joint stability.

Every day in the United States, 23,000 people sprain their ankles. More than two-thirds of those folks will end up with CAI. There are several theories to help explain the mechanism behind chronic sprains.

Mechanical factors, such as the change in tissue tension around the ankle when a ligament is sprained, have always been part of the picture. But this is only one factor. Another is the loss of normal sensorimotor responses.

This refers to the ankle joint’s ability to receive and interpret neurologic information about sensation and movement. This is the neurologic side of ankle injury and instability. A decreased awareness of the foot and ankle position (especially with changes in the ground or surface we are walking on) contributes to repeated ankle sprains.

Using a rocker or wobble board is an effective way to help restore neural pathways and regain more normal proprioception (joint sense of position) and kinesthetic awareness (sense of movement through space).

It resensitizes the sensory and motor nerves. The effect is to increase messages to the motoneuron pool in the spinal cord. When there’s enough excitability in the motoneuron pool, messages are sent to contract the muscle(s). A lack of motoneuron pool excitability means the muscles don’t contract to protect the joint and accommodate to a change in position. This puts a strain on the ligaments that are already damaged an increases your risk of repeated injuries.

It takes a while to re-establish all of the proper neural pathways from joint to muscle and muscle to spinal cord then back to the muscle and joint. The rehab program usually starts with a less difficult activity such as rolling a ball under the foot or using the rocker board in a seated position. When the joint receptors have been retuned in this fashion, then the program adds strengthening of the muscles around the ankle.

Combining these two components of the rehab program allow you to progress to the more difficult upright standing balance activities. At first, the rocker board is used under the injured foot but while still standing on the other leg. Eventually, you will move to a one-legged stance (injured foot on the board) while holding onto a support. The final step is to balance one-legged without holding on.

If you have missed any of these steps, you must back up and start again. A physical therapist can assist you with this process. After testing your muscle strength, proprioception, and sensorimotor function, the therapist will know what level you should be at and how to move you through the program successfully.

Ankle sprains are very common injuries. Multiple sprains are not uncommon — especially when the damage hasn’t been repaired. Even minor changes in sensation, motor control, and proprioception (joint sense of position) can lead to reinjuries.

Ankle rehab has a major role in restoring normal joint function. A physical therapist can help you regain proprioceptive sense, motion, and strength. Specific training for balance, postural control, and proprioception is essential.

The ankle can be taped or supported in an Air-cast, or lace-up support. For more serious ligamentous tears, the injured athlete may be put in a cast for a few weeks to allow for healing and to prevent reinjury.

Studies show that lace-up supports may work the best. Taping can irritate the skin and takes quite a bit of time and expertise to apply. Elastic bandages are the least helpful. Semi-rigid supports such as the Aircast (also known as the Air-Stirrup) are about as effective as taping but provide for easier on and off application.

The fact that you have reinjured the same side three times suggests the need for some professional help. See an orthopedic surgeon or physical therapist for a full evaluation and plan of care. Rehabilitation is usually advised first. If a three-to-six month program isn’t successful and you keep reinjuring it, surgery may be needed to restabilize the joint.

Most experts agree the road to recovery and prevention of reinjuries is a solid, consistent rehab program at the time of the acute sprain. Once the swelling is under control and the acute injury has been dealt with, then it’s time to retrain the joints and soft tissues.

This is done most safely under the supervision of a physical therapist. Range-of-motion exercises, strengthening, and proprioception training are introduced and gradually progressed. Proprioception refers to the joint’s sense of position.

Specific training is also needed to restore balance and postural control. This phase is referred to as functional training. With this type of management, patients return to sports and/or work faster with fewer symptoms. They report higher levels of personal satisfaction with their results. And they have fewer episodes of reinjury.

Delayed repairs can also cause recurrent injuries. Overstretching the ligaments and multiple injuries can end in a failed result. When conservative care isn’t enough and ankle instability persists, then surgery may be needed to repair or reconstruct the ankle.

The new injury of the calf muscle and Achilles tendon may or may not be as a result of the previous ankle injury. With all that is going on, it may be a good idea to see an orthopedic surgeon for an evaluation.

Find out what’s wrong first before trying different methods of treatment. It’s possible that a program of retraining is needed for the ankle and surrounding soft tissues. Now is a good time to pursue this before more serious injuries occur.

You are asking about the natural history of a condition called osteochondral lesion of the talus (OTL). Other terms used to describe OLT include osteochondritis dissecans, transchondral fracture, talar dome fracture, and flake fracture.

In this condition, damage to the talus after an ankle sprain or other ankle injury causes a loose fragment. This piece of cartilage gets stuck between the top of the talus and the bottom of the tibia (shinbone) located just above the talus. The talus is a bone in the ankle wedged between the calcaneus (heel bone) below and the tibia above.

Although the problem is fairly uncommon, there have been studies to report long-term outcomes. The main finding has been that the frayed or torn cartilage does not heal well. Symptoms of pain, swelling, and locking up of the joint simply do not go away. Less than half the patients treated nonoperatively have success with nonoperative treatment.

On the other hand, surgery isn’t always successful. Three-fourths of the patients in one study had a good-to-excellent outcome. Twenty-five per cent (one in four) developed degenerative arthritis. Researchers are still trying to identify factors that might predict ahead of time who will have a good result with surgery.

So far, it does not look like the results of treatment are linked with age, gender, or the side affected (right or left ankle). Delays between injury and surgery did not seem to make any difference in the final results. Worker’s compensation patients did have poorer results compared with those who were not on worker’s comp.

The best advice of experts on this condition is to give the nonoperative plan of care a good try before having surgery. If your symptoms are not improved after four to six months of conservative care, then consult with your surgeon about what surgery can do for you, the risks, possible complications, and expected outcomes.

An accurate diagnosis is always the best way to provide a healing plan of care. Examination by a sports medicine or orthopedic physician is advised. Acute ankle injuries can be either high or low. Low ankle sprains involve damage to any of the short ligaments that hold the bones of the ankle together and stabilize the ankle.

Low ankle sprains can occur on either side of the ankle. But most often, it’s the ligaments along the lateral (outside of the ankle) that are affected. This is because the mechanism of injury is usually plantar flexion (ankle and toes pointed downward) and inversion (toes pointed inward).

A high ankle sprain involves the ligaments above the ankle joint. This is called a syndesmosis injury. In an ankle syndesmosis injury, at least one of the ligaments connecting the bottom ends of the tibia and fibula bones (the lower leg bones) is sprained. Recovering from even mild injuries of this type takes at least twice as long as from a typical ankle sprain.

Low ankle sprains are most common. Swelling, pain, and difficulty walking are typical. An inability to put weight on the foot is suggestive of a severe ankle sprain or even bone fracture. X-rays are needed to rule out fracture.

Treatment for an acute low ankle sprain begins with nonsteroidal anti-inflammatory drugs (NSAIDs) to control inflammation. Rest, ice, compression, and elevation (RICE) are important at first.

A physical therapist guides the athlete through a rehab program of motion, proprioception (joint sense of position), and strengthening exercises. Movement and mobility while supporting the ankle with a brace (or some other type of removable, external support) are equally important. This is called functional therapy. Later in the rehab program, sport-specific exercises are added.

It sounds like your son may have a history of previous ankle sprains. A history of ankle sprains increases the risk of sprain recurrence. Shoe wear does not seem to make a difference.

Studies of athletes wearing high-top versus low top basketball shoes do not show a significant reduction of ankle injuries in one group over another. High-tops with inflatable chambers were also tested. They weren’t any more protective than other shoe types.

External ankle supports or braces have been shown to prevent ankle sprains. It’s not clear yet if the type of splint makes a difference. Ankle stirrup, semi-rigid bracing, elastic bandages, and lace up braces are available. Elastic wraps are less supportive than the more rigid supports. Some studies show faster results using a combination of elastic bandages and bracing.

Splinting is less expensive than the cost of taping for an entire sports season. But it does not appear to prevent ankle sprains in athletes who have already had three or more sprains.

Chronic sprains lead to ankle instability from loss of strength and impaired joint proprioception (sense of position). A physical therapy rehab program of exercises to restore normal ankle function is essential.

Preventive measures may not be helpful for athletes who have sprained the same ankle more than three times. Ankle instability from repeated sprains may require reconstructive surgery. If your son has a history of chronic, recurring ankle sprains, and he not been evaluated by an orthopedic surgeon, then a preseason exam may be a good idea.