When I speak to Athletic Trainers about ankle bracing technology I find there is minimal to no education about the subject taught in the curriculum. Understanding the basics of ankle brace design is paramount for choosing the right brace for the specific ankle condition. For example, let’s say you have an athlete with a syndesmotic ankle injury – which would be the best stabilizing option for that condition? a) lace-up brace b) tape c) hinged brace d) hinged-cuff brace
If you guessed d) hinged-cuff ankle brace you are correct! The syndesmotic ankle injury is caused by excessive external ankle rotation, so to be successful in bracing this type of injury the brace must be designed to limit ankle rotation as well as inversion and eversion. Only one ankle brace design will limit this range of motion – the hinged-cuff design.
A hinged-cuff designed ankle brace has a hinge that will allow full plantar and dorsiflexion, and a cuff that encircles the lateral part of the lower leg. The “cuff” provides a rigid connection between both sides of the brace stabilizing the ankle in both the horizontal and vertical plane. The first hinged-cuff ankle brace design was introduced in 2000 and has rapidly gained popularity with both sports medicine professionals and athletes since it came on the market.
If your answer was to b) tape the ankle to remedy the syndesmotic ankle injury, you’re probably not alone. Taping can help compress and stabilize the tib/fib reducing the stress on the soft tissue, but this seems to provide only a temporary relief as the tape will stretch out and lose its integrity. The cuff portion of the hinged-cuff brace design can provide more long lasting tib/fib compression combined with rotational stability.
Next Question: Your athlete has an acute ankle injury with weight bearing pain – what ankle brace design do you select to reduce weight bearing pain? a) lace-up brace b) hinged brace c) hinged-cuff brace
For this condition the brace must absorb the vertical impact or energy, bypass the sore ankle, and apply that energy to the lower leg. I call this process ankle unloading or offloading because the ankle endures less impact therefore the weight bearing pain is reduced. Using a semi-rigid hinged or hinged-cuff ankle brace design can reduce weight bearing pain by providing the structural integrity to absorb painful impact; soft bottom lace-up designs cannot unload the ankle. If you guessed eitheroption B or option C you would be correct in this scenario.
Which type of ankle brace design can provide the most long-lasting ankle protection? a) lace-up brace b) hinged brace c) hinged-cuff brace
Isn’t the point of wearing an ankle brace to provide a level of support over the course of a practice or game, perhaps 2-3 hours? When I introduced the first hinged ankle brace in 1989 the biggest push back from ATC’s was, “how does all this free range of motion support anything?” Of course no one asks that question today because we all know if a brace can move with normal joint range of motion then the straps stay securely in place maintaining long-lasting ankle protection. Every hinged knee brace is designed upon that same principle.
Therefore, the answer is again both option B and option C – both the hinged and hinged-cuff ankle brace can provide the most long-lasting ankle protection.
Last question: What is the main reason athletes don't like wearing ankle braces? a) not comfortable b) lack of durability c) hard to apply
While all answers may be correct depending on the athlete, throughout my 30 years of developing ankle braces I have learned that no matter how much support an ankle brace provides if it’s a) not comfortable no athlete is going to wear it. The road to ankle brace stardom is littered with ankle braces that provide great support, but no athlete is going to wear them because they are too big, bulky, and uncomfortable. This point led us to develop a new type of ankle brace that is neither a rigid plastic nor a soft flexible fabric, but instead uses an advanced thermoplastic resin called Performathane® that uses body heat to custom-fit to the ankle. The result is an ankle brace that is incredibly comfortable to wear over long periods of time, durable enough to last three sports seasons, and doesn’t restrict athletic performance.
As for the quiz – how did you do? If you’ve never worked with Ultra Ankle® before and have yet to try hinged-cuff ankle braces, reach out to us and see if you qualify to receive a free ankle brace sample for your team. If your players have worn, or are currently wearing, Ultra Ankle® products we would love to hear your thoughts about the hinged-cuff brace design and what we can do to make this a product a staple for every athletic trainer.
Written by Rick Peters
Rick Peters is a Certified Athletic Trainer who has been advancing ankle bracing technology for three decades. Peters patented his first ankle brace in 1985, revolutionizing the industry by adding a hinge to traditional stirrup braces for greater mobility. In 1989 he was a founder and became President of Active Ankle Systems. In 1998 he co-founded Ultra Athlete LLC to develop the next generation of ankle bracing technology. Peters has 18 ankle brace patents and is considered an authority on ankle bracing technology worldwide.