Physical therapists and athletic trainers working with high school football players are concerned about the high number of players benched because of ankle injuries. They conducted this study to compare the number and severity of ankle injuries in players with and without a lace-up ankle brace. They also looked to see if there were more knee injuries in athletes who did not wear the brace.
Over 2000 football players from 50 high schools participated in this study. They were divided into two groups: those who wore a DonJoy lace-up ankle brace and those who did not wear a brace (the control group). The study was conducted over one football season.
The brace was worn on both ankles by players in the brace group. Athletic trainers made sure the braces fit properly and were worn during practice, conditioning sessions, and games. The players could wear their own shoes (low- or mid-top height) and their preferred cleat type (molded or detachable).
Injuries were reported along with information about the field surface (grass or synthetic) and the type of injury (ligament sprain, muscle strain, contusion, fracture). Only injuries that occurred during sports activities were counted.
Records were kept to show whether the athlete was seen by a physician, required surgery, and/or suffered other bodily injuries as well. Severity of ankle injuries was measured by the number of days the athlete was unable to play.
By the end of the season, between one-fourth and one-third of the players (27 per cent) suffered some type of injury. Two-thirds of the players were treated on the field while the remaining one-third was sent to the hospital or to a physician for follow-up.
Injury rates for the ankle and knee were much higher in the non-braced (control) group. In fact, there were 70 per cent fewer ankle injuries for players who had a prior history of ankle injuries. And there was a 57 per cent reduction in ankle injuries measured in players who had never had a previous ankle injury. These rates were calculated based on comparing results to the control group.
The severity of these injuries was not different from players injured while wearing the brace as compared to players injured in the control group (no brace). There was no difference in number or severity of knee injuries (or other leg injuries) between the two groups.
Before coming to any conclusions, the researchers pointed out a few limitations in their study. The most notable was the fact that shoe brand and type (mid- versus high-top) could have made a difference in outcomes. The shoe as a factor in injuries was not investigated.
The second important limitation was the fact that other studies show neuromuscular training programs work well to prevent ankle injuries. The brace was not compared with this type of exercise program either directly (one against the other) or when combined together (brace plus neuromuscular rehab versus brace alone or rehab alone).
And a third consideration was the notion that an ankle brace reduces ankle motion and may increase the risk of stress fractures, low back injuries, or upper leg and hip injuries. These topics will be potential areas for future study.
The results of this study as it was designed and carried out can be summarized by saying lace-up ankle braces do reduce the number (but not severity) of acute ankle injuries in high school football players. The authors point out that there are financial savings to consider from this study.
Reducing the number of ankle injuries and especially the number of injuries that require hospitalization or medical care also lowers overall health care costs. With the high number of high school football injuries in the U.S. every year, this could add up to millions of dollars in savings.