Ankle Taping vs. Bracing: Effectiveness and Cost Comparison

Foot Anatomy and Injury Significance

The human foot has an extremely complex structure of bones, joints, and muscles. Meadows (2006) points out, "The human foot has 26 bones, 33 joints, and more than 100 tendons, muscles, and ligaments. With such a complex structure, a lot can go wrong. While some foot problems are inherited, many occur because of years of wear and tear."

Meadows identifies several warning signs and symptoms that can lead to foot injury, including excessively dry skin, thickened or discolored nails, swelling, redness, and unusual sensations. Foot injury is significant and cannot be overlooked, and even initial signs should not be treated lightly. However, research has shown that most doctors overlook foot inspection during routine patient visits.

Ankle sprains are perhaps one of the most frequently occurring foot injuries in America. A number of studies have shown that taped ankles cause less injury, while other studies have concluded that by wearing braced ankles, athletes can minimize foot injury (Reeves and Emel, 2009).

Variations in Ankle Tape

This paper provides an in-depth analysis on the differences between ankle tape and ankle braces and player satisfaction between the two. It presents information about the different types of tape and braces. The tapes discussed include white/cotton tape, power-tape, and elastikon. The braces discussed include lace-up ankle braces and rigid ankle braces. The research study also examines what athletes prefer between bracing and taping.

Reeves and Emel (2009) synthesized peer-reviewed studies on ankle injuries and found that many athletes are starting to prefer power-tape. They write, "Power tape has a higher tensile strength and is more water resistant than traditional white tape. However, it has the disadvantage of being harder to tear." Athletes look for stability, and elastic tape provides them the comfort they need in their heels. Reeves and Emel (2009) report, "Elastic tape may be used for the heel locks, or it may be used to reinforce the normal heel locks. This is often reported as both more comfortable for the athlete or to give the athlete a sense of more stability."

Sometimes athletes start games with minor foot injuries and demand that the injury does not worsen. An athlete who is previously injured uses "1.5-in (3.8-cm) moleskin strips for stirrups and is referred to as power-strapping" (Reeves and Emel, 2009). A number of studies have shown that athletes are now turning to flex tape and moving away from white-cotton tape, also known as pre-wrap.

Reeves and Emel (2009) note, "The most recent variation in ankle taping is to replace pre-wrap white-cotton tape with 'flex' tape. This tape is more durable than pre-wrap and resembles elastic tape, but flex tape is adherent only to itself and not to skin. In some training rooms, this type of tape is being incorporated more and more into the ankle application with less use of white athletic tape." This evolution reflects ongoing efforts to improve both comfort and durability for athletes across different sports and activity levels.

Variations in Ankle Bracing

A number of studies have shown that ankle bracing offers more advantages than traditional ankle taping. In fact, braces are considered to be a modified form of taping. Reeves and Emel (2009) report that "the concept of ankle bracing evolved from ankle taping. Braces are being used instead of traditional taping by many athletes at all levels of competition. They offer several advantages in that they are self-applied, reusable, and readjustable." When thinking long term, bracing is considered to be more cost-saving and productive than taping (Pedowitz et al., 2008; Ivins, 2006).

Braces generally come in two types: non-rigid and semi-rigid. Both have different purposes and benefits. The most commonly used types are non-rigid and semi-rigid. With regards to non-rigid ankle bracing, Reeves and Emel (2009) write that it "resembles a thick canvas or nylon lace-up sock. Some non-rigid braces are also made of neoprene. The non-rigid style imparts some compression to the ankle and may help in injury prophylaxis but provides little medial or lateral stability to the ankle."

With regards to semi-rigid bracing, Reeves and Emel (2009) assert, "Its construction is similar to the non-rigid but with the added feature of molded plastic struts or air cushions. These are incorporated into the medial and lateral sides of the brace, similar in orientation to the stirrups used in ankle taping. These braces provide more stability and are often chosen during the rehabilitation and return-to-play phases of ankle injury." The evolution from taping to bracing reflects advances in athletic medicine aimed at providing superior support while reducing repeated treatment costs.

Research Studies on Taping and Bracing Effectiveness

A number of studies have been carried out on shoe gear, taping, and bracing with regards to ankle injuries. The significance of ankle injuries can be gauged from the fact that thousands of athletes get ankle-related injuries every day. Mickel (2006) writes, "It has been estimated that over 25,000 ankle sprains occur per day in the United States, and ankle sprains have been shown to account for 10% to 15% of all injuries sustained in American football" (p. 360).

Furthermore, ankle injuries can gravely affect athlete performance if not treated promptly. Mickel (2006) reveals, "When an ankle sprain occurs, the anterior talofibular ligament is most commonly injured, followed in frequency by the calcaneofibular ligament. Moreover, inversion sprains of the ankle can significantly affect performance and result in lost practice and game time, and they can lead to the development of chronic ankle instability and pain" (p. 360).

The use of bracing and taping varies from one sport to another. Athletes in cricket, for instance, may prefer taping, while in football, where ankle sprains occur more frequently, athletes often prefer bracing. Mickel (2006) asserts, "The prophylactic use of semirigid ankle braces appeared to be warranted, especially for athletes who participated in activities that had the highest risk of ankle injury" (p. 361). Similarly, research has shown that "ankle braces reduced the incidence of initial and, in particular, recurrent ankle sprains" (Mickel, 2006, p. 361).

While ankle bracing appears to be a popular choice for athletes in high-risk sports, ankle taping seems to benefit athletes in medium-risk or low-risk sports. In one study, researchers used 2,526 basketball athletes over a period of two years to analyze the benefits of taping. The results showed that "ankle taping reduced the incidence, severity, and long-term complications of ankle sprains, and that this resulted in less time lost from athletic performance" (Mickel, 2006, p. 361).

In another study, the use of ankle taping among 297 college football players was compared with the use of laced ankle stabilizers. Results showed that "laced ankle stabilizers were significantly more effective than taping in preventing ankle injuries (2.56 sprains per 1000 exposures vs 4.91 sprains per 1000 exposures)" (Mickel, 2006, p. 361).

Similarly, in another study, researchers analyzed the benefits of ankle orthosis on 439 male football players and found that "the orthosis group demonstrated a 3% incidence of ankle sprains, whereas the control group demonstrated a 17% incidence, and this difference was statistically significant" (Mickel, 2006, p. 361).

In another study examining semi-rigid ankle bracing, researchers chose 1,601 basketball players as subjects over nearly two years. The results showed that "the brace group demonstrated a contact-related ankle injury rate of 1.6 sprains per 1000 athlete-exposures, whereas the control group demonstrated a statistically significantly greater injury rate of 5.2 sprains per 1000 athlete exposures" (Mickel, 2006, p. 361). However, Mickel notes there was no statistically significant difference for non-contact-related ankle injuries.

In a similar research project, investigators examined semi-rigid ankle bracing on 504 football players divided into two groups: one with a history of ankle injuries and one with no previous ankle injury experience. The first group was randomly given semi-rigid orthosis, while the control group received prophylactic ankle support. Results revealed that "athletes with a history of previous ankle injury who were braced showed a statistically significantly lower incidence of ankle sprains (0.46 per 1000 playing hours) in comparison with those who were treated without any form of ankle support (1.16 per 1000 playing hours)" (Mickel, 2006, p. 361).

Researchers have also investigated the impact of traditional taping on ankle injuries. The most common benefit associated with traditional taping is that it prevents twisting of ankles and provides athletes added stability. Mickel (2006) notes, "Traditionally, prophylactic ankle taping has been the mainstay for prevention of ankle injuries. Proper ankle taping is generally understood to reduce plantarflexion and inversion of the ankle, and this has been shown to be the most common mechanism associated with ankle sprain injuries."

Nonetheless, the benefits of taping are reduced after about an hour of sporting practice. Researchers assert that taping becomes loose and cuts down the support to nearly negligible levels (around 40%), with further decreases after a couple of hours of sporting activity. Researchers have also criticized the long-term cost associated with taping. Mickel (2006) compares the cost-effectiveness of both ankle taping and bracing and concludes, "One study reported a cost of $1.75 per ankle when taping was used to prevent ankle sprains, resulting in a cost of more than $400 per athlete over 1 college football season. For these reasons, a number of ankle braces, both laced and semi-rigid with Velcro straps, have been developed. Such braces can be applied by the athlete, retightened during play, and present a one-time cost to the athlete or athletic program."

In their study, Dizon and Reyes (2010) found that approximately 30% of all sports-related injuries are ankle sprains. These ankle sprains can sometimes be critical, leading to athletes being absent from sporting activities for extended periods. Most athletes prefer to wear ankle support before their match to prevent sprains. Dizon and Reyes investigated the effectiveness of ankle sprain prevention methods and assessed the best quality ankle support available. Their research strategy involved a synthesis of medical literature from online databases such as MEDLINE, PubMed, CINAHL, and EMBASE (Dizon and Reyes, 2010).

The inclusion and exclusion criteria required that researchers select only studies where subjects were adolescents, adults, elite, or recreational players, and where either ankle taping or bracing was used to prevent or treat injuries. The researchers measured the frequency of sprained ankles. The results showed "reduction of ankle sprain by 69% (OR 0.31, 95% CI 0.18–0.51) with the use of ankle brace and reduction of ankle sprain by 71% (OR 0.29, 95% CI 0.14–0.57) with the use of ankle tape among previously injured athletes." The researchers concluded, "No type of ankle support was found to be superior than the other" (Dizon and Reyes, 2010).

In another study, researchers investigated the use of ankle bracing versus taping among 50 athletes and found that "the use of an Aircast ankle brace for the treatment of lateral ligament ankle sprains produces a significant improvement in ankle joint function at both 10 days and one month compared with standard management with an elastic support bandage" (Boyce, Quigley, and Campbell, 2005).

Nagao (2002) investigated three inter-related characteristics of ankle injury: initial fit, degree of mobility during exercise, and total cost of treatment. He used six kinds of ankle bracing methods and one ankle taping method for the initial fit and degree of mobility assessments and calculated the total cost incurred during testing. Tests were conducted among 10 subjects suffering from lateral ligament injuries in one ankle. X-rays of both ankles were taken to determine the degree of mobility. The researcher found, "The results of measuring between the injured ankle before and after using a brace or taping showed an overall difference of five degrees in the polar tilt of the injured ankle."

Conclusion

Nagao further noted that "overall results show the more expensive braces provide both a better fit and better stability during exercise. Taping, however, provided the best fit and the least instability during exercise when compared to the braces. The question of cost also plays a role in the overall results of our research. Braces are inexpensive when compared to the costs of taping." He concluded that taping had been more effective, but athletes must choose between effectiveness and cost considerations.

This paper provided an in-depth analysis of the differences between ankle taping and ankle bracing and player satisfaction between the two. It presented information about different types of tapes and braces, including white/cotton tape, power-tape, elastikon, lace-up ankle braces, and rigid ankle braces. The findings indicate that both taping and bracing are roughly equal in terms of effectiveness for preventing ankle injuries. However, ankle taping is far more expensive than ankle bracing over time. Furthermore, when treating ankles with braces, semi-rigid bracing has been shown to be more popular and effective than non-rigid bracing, making it a more practical choice for athletes seeking long-term injury prevention at reduced cost.