Ankle braces can help you to recover better from ankle sprains and prevent further sprains, but not everyone will need one. In this article, we discuss who needs to wear an ankle brace, what type of brace is best, and when and for how long to wear it. This article is specifically about lateral (outer) and medial (inner) ankle sprains; high ankle sprains may require different braces. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call.
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Do I need a brace for my ankle sprain?
Not all ankle sprains require braces, but a brace can help you to recover better and return to work and sport sooner.
Minor ankle ligament tears (Grade 1) usually don’t require a brace unless you have to walk over very uneven terrain or want to continue playing sport throughout your recovery.
You’re very likely to benefit from wearing an ankle brace if you have a significant ankle ligament tear (Grade 2 or 3).
(Read more about the grading of ankle ligament tears.)
What does an ankle brace do?
Research shows that wearing the correct type of brace at the correct time can:
Improve healing
Reduce swelling
Allow early return to work and sport
Prevent further ankle sprains.
To understand why an ankle brace may help treat and prevent ankle sprains, it’s useful to take a look at what happens when you sprain your ankle.
What happens when you sprain your ankle
When you sprain your ankle, you usually strain or tear the ligaments, but you may also injure the ankle joint itself and/or the muscles around your ankle, causing it to swell, hurt, bruise, and feel unstable.
Given enough time, protection, and the correct rehab exercises, even severe ankle sprains can recover without the need for surgery.
How ankle braces improve healing
Traditionally, moderate to severe ankle sprains were immobilised (kept totally still) in an orthopaedic boot or a cast. But the most recent research shows that this is not the best approach. Even severe ankle sprains recover better when they are exposed to “protected movement”.
Unlike muscles, joints don’t have a blood supply that feeds them with oxygen and nutrients and carries away bad stuff. The synovial fluid in joints does this work instead, but it needs movement to circulate through the joint.
So, movement means improved circulation, oxygen, and nutrients for the injured ankle. It also means that you can safely strengthen your muscles and regain lost agility, which allows you to get back to sport or work sooner.
Protected movement is achieved by wearing an ankle brace that allows your ankle and foot to move in all directions except for the direction that strains the injured ligaments, muscles, and joint surfaces. This is usually the same movement direction that caused the sprain.
For instance, lateral (outer) ankle sprains usually benefit from braces that prevent your foot and ankle rolling in (where the sole of your foot points towards your other foot). Medial (inner) ankle sprains benefit from a brace that stops your foot turning out (the sole of your foot pointing away from the other foot).
How braces reduce swelling
Ankle sprains usually cause some swelling in and around the ankle joint. Protected movement also helps to reduce swelling by improving circulation. Ankle supports that incorporate a compression sock or sleeve may further reduce swelling by improving lymph drainage.
If a brace causes pain or you notice that the area above or below the brace or compression sleeve is very swollen, it is very likely too tight or just not right for you. Remove it immediately.
Early return to sport and work
The protection an ankle brace offers you means that you can safely return to sport and work before your ankle sprain has fully healed. Without a brace, you would have to wait until your ankle ligaments, joint, and muscles have regained their full strength.
Your physio will usually give you specific movement tests (similar to what happens in your sport or work) and monitor how your ankle reacts to performing these while wearing the brace. If it copes well, it may mean that you can safely ease back into normal activities while wearing the brace. You should obviously continue with your rehab until your ankle has fully recovered.
How ankle braces prevent sprains
You’re more likely to sprain your ankle when you’re walking on uneven terrain or do a sport that is characterised by running, cutting movements, and jumping, such as basketball, football, tennis, and volleyball. The research also shows that your risk of injuring your ankle once more is much higher when you’ve had a previous ankle sprain.
Using an ankle brace can significantly reduce your risk of both first-time and recurring ankle sprains, especially when doing sports. It does this by preventing extreme ankle movements. Or, in other words, it stops the ankle from moving far enough to cause the ligaments, muscles, or joint to strain.
What type of brace is best for ankle sprains?
Stay away from braces that don’t allow your ankle to move at all; the same goes for plaster casts (unless you have a fracture). As mentioned before, in most cases total immobilisation leads to poorer healing.
The best type of brace for lateral and medial ankle sprains is a semi-rigid brace (see examples in next section) with metal, carbon fibre, or hard plastic rods on the sides. These braces:
Stop your ankle from rolling in and out, which protects the injured ligaments, joint, and muscles
Allow the ankle to move into dorsiflexion (toes moving towards shin) and plantar flexion (toes pointing away from you), which enables you to walk and move as normal.
Soft ankle braces or sleeves are not useful, as they don’t provide enough support.
Not all semi-rigid ankle braces are the same
High-stability ankle braces
The most stable ankle braces are the ones that come slightly higher up above the ankle and, in addition to having supportive rods, lace up or tightly wrap around your ankle. They are the best type of brace to wear if you are prone to ankle sprains and play sports like basketball or soccer.
If you order any of the ankle braces below, remember to select the correct foot.
Examples:
Medium-stability ankle braces – with support rods
These braces have support rods on the sides, but they don’t wrap as securely around the ankle. They may not offer enough support for sports that involve quick changes of direction, but are perfect for walking, jogging on relatively even ground, or if you just want to wear a brace during the early stages of recovery.
Examples:
Medium-stability ankle braces – without support rods
These braces don’t have support rods but still provide a fair level of support thanks to the type of material used and by wrapping tightly around the ankle. They may be appropriate for someone who has fully regained their ankle control and just wants a bit of extra support during sport or while walking. They may not offer enough support for sports that require quick, forceful changes of direction.
Examples:
When should you wear your ankle brace?
Your need for a brace usually diminishes as your injury recovers. Initially you may have to wear it for most daily tasks, whilst towards the end of your rehab you will only need it for sport.
At home
If you have a severe ankle sprain, you may benefit from wearing your brace inside the house. Most mild and moderate sprains don’t require a brace inside the house unless you have animals or children who might bump into you, causing you to lose your balance, or you’re at risk of stepping on toys.
In bed
You can usually remove your ankle brace when you go to bed. The only exceptions are if you have a complete tear of the ligaments, a fracture, or if you find that the position you sleep in strains your ankle.
Out and about
Until you’ve completed your rehab, it is usually beneficial to wear a brace whenever you walk on uneven terrain or in crowds where someone might bump into you. Here's our article with more advice on walking on a sprained ankle.
When doing rehab exercises
Whether you need an ankle brace will depend on what exercises your physio gives you and the severity of your sprain. In most cases, the exercises will be pitched at a level that you can safely complete without the need of a brace. Ask your physio if you're unsure.
During sport
If you do a sport that carries a higher risk for ankle sprains (like volleyball, basketball, tennis, football, and trail running), a brace can help you return to sport more quickly and reduce your risk of spraining an ankle.
Should I wear the brace all day?
If you have a severe ankle sprain, your doctor or physio may advise that you wear your brace all day during the first few weeks. In all other cases, ankle braces only have to be worn when you do an activity that is likely to twist or roll the ankle. The need for a brace will reduce as your rehab progresses and your ankle heals.
How long to wear an ankle brace for
How long you should wear the brace for depends on the severity of your injury and what type of sport or activities you do.
Daily activities
Lateral ankle sprains
Severe lateral ankle sprain: at least 6 weeks and sometimes longer
Moderate sprains: 4 to 6 weeks
Minor sprains usually don’t require a brace unless the terrain or activity is very challenging.
Medial ankle sprains
Medial ankle sprains are usually much more severe and take a lot longer to recover. You may have to wear a brace for 6 to 12 weeks.
Sport
Some athletes find that they are prone to ankle sprains, and no amount of rehab is enough to prevent them effectively. The basketball player Stephen Curry is an example. In such a case, wearing a brace routinely during sport may be a good idea.
If your rehab goes well and your sport doesn’t involve a lot of quick changes of direction, you may be able to discard your brace as soon as you’re able to perform all movements and train at full intensity without problems.
How we can help
Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.
We're all UK Chartered Physiotherapists with Master’s Degrees related to Sports & Exercise Medicine. But at Sports Injury Physio we don't just value qualifications; all of us also have a wealth of experience working with athletes across a broad variety of sports, ranging from recreationally active people to professional athletes. You can meet the team here.
About the Author
Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.
References:
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