Evidence for a Lace Up Ankle Brace
The most common ankle injury seen in sports medicine clinics are inversion ankle injuries (1). Inversion ankle sprains can injure and tear the anterior talofibular ligament, the calcaneofibular ligament, and the posterior talofibular ligament. Ankle braces are typically used to help prevent excess motion and prevent inversion and eversion of the ankle joint (1,2). Ankle support braces that cover more of the forefoot will decrease plantarflexion of the ankle and can lead to decreases in athletic performance (2). As a result, there has been a gain in popularity of the lace up ankle brace. A lace up ankle brace has been found to decrease the incidence of ankle sprains from 1.41 to 0.47 injures per 1000 events (4). A study looking at ankle sprain incidence found that there was a 61% reduction in ankle sprain incidence in high school football players who wore a lace up ankle brace (7).
One of the most prevalent deterrents to wearing an ankle brace is athletes are concerned that braces may decrease their performance. A study published in the American Journal of Sports Medicine compared an adaptive ankle brace, lace up ankle brace, and a rigid ankle brace. They found that the lace up ankle brace was viewed by participants as providing as much stability as a rigid and adaptive brace on a patient survey. The lace up brace did slightly decrease a patient’s vertical countermovement jump (1). Researchers were unsure of the clinical significance of this.
A further study in the Journal of Sports Rehabilitation found that lace up ankle braces had a negative affect on vertical jump height and standing long jump distance (2). They found that the lace up ankle brace did not affect speed and agility (2).
Use of a lace up ankle braces can be sport specific. In a study in the Journal of Athletic Training, they found that soccer players found the brace to be a hindrance and not comfortable (3). Volleyball athletes felt that the lace up ankle brace provided more stability than a compression brace or semi-rigid brace (3).
There have also been hypotheses that a lace up ankle brace can affect knee dynamics (4). In a study published in the American Journal of Sports Medicine, they found that a lace up ankle brace can increase knee internal rotation by 1.9 degrees (4). The significance of this is not clear at this time (4). Further studies have also shown that there is an increase in knee flexion at initial contact with the ground when a lace up ankle brace is worn (5).
Lace up ankle braces have been found to decrease the incidence of ankle sprains. The lace up ankle brace can also be used in the treatment of acute ankle sprains (8). Multiple studies have looked at changes in knee dynamics and sport performance with use of an ankle support brace. With changes in knee dynamics and sports performance, more studies are needed.
By Gregory Rubin, DO
1) Willwacher, Steffen, et al. “A Multidimensional Assessment of a Novel Adaptive Versus Traditional Passive Ankle Sprain Protection Systems.” The American Journal of Sports Medicine, Feb. 2023, p. 3635465221146294. PubMed, https://doi.org/10.1177/03635465221146294.
2) Mann, Brittany, et al. “The Influence of Ankle Braces on Functional Performance Tests and Ankle Joint Range of Motion.” Journal of Sport Rehabilitation, vol. 28, no. 8, Nov. 2019, pp. 817–23. PubMed, https://doi.org/10.1123/jsr.2018-0315.
3) Janssen, Kasper, et al. “User Survey of 3 Ankle Braces in Soccer, Volleyball, and Running: Which Brace Fits Best?” Journal of Athletic Training, vol. 52, no. 8, Aug. 2017, pp. 730–37. PubMed Central, https://doi.org/10.4085/1062-2050-52.4.06.
4) Klem, Nardia-Rose, et al. “Effect of External Ankle Support on Ankle and Knee Biomechanics During the Cutting Maneuver in Basketball Players.” The American Journal of Sports Medicine, vol. 45, no. 3, Mar. 2017, pp. 685–91. PubMed, https://doi.org/10.1177/0363546516673988.
5) DiStefano, Lindsay J., et al. “Lower Extremity Kinematics and Ground Reaction Forces after Prophylactic Lace-up Ankle Bracing.” Journal of Athletic Training, vol. 43, no. 3, 2008, pp. 234–41. PubMed, https://doi.org/10.4085/1062-6050-43.3.234.
6) Cinque, Mark E., et al. “The Effect of Silicone Ankle Sleeves and Lace-up Ankle Braces on Neuromuscular Control, Joint Torque, and Cutting Agility.” Journal of Orthopaedics, vol. 20, 2020, pp. 359–66. PubMed, https://doi.org/10.1016/j.jor.2020.05.019.
7) McGuine, Timothy A., et al. “The Effect of Lace-up Ankle Braces on Injury Rates in High School Football Players.” The American Journal of Sports Medicine, vol. 40, no. 1, Jan. 2012, pp. 49–57. PubMed Central, https://doi.org/10.1177/0363546511422332.
8) van den Bekerom, M. P. J., et al. “Randomized Comparison of Tape versus Semi-Rigid and versus Lace-up Ankle Support in the Treatment of Acute Lateral Ankle Ligament Injury.” Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA, vol. 24, no. 4, Apr. 2016, pp. 978–84. PubMed, https://doi.org/10.1007/s00167-015-3664-y.