Bracing in Sports Medicine
Jessica M. Poole
Casey Hulsey
RM Barney Poole
INTRODUCTION
Bernhart and Anderson (1) state that, “In an attempt to reduce sport injuries, many athletes are turning to prophylactic and functional braces for protection, support, compression, restriction of movement, immobilization, and proprioceptive enhancement.”
There are two principal types of braces used in sports medicine: rehabilitative and prophylactic.
In rehabilitative bracing, the prime focus is to allow a protected range of motion after surgery for the injured joint.
Prophylactic braces are designed to stop or lessen the severity of injuries, so their focus is prevention.
Custom-made braces, which non-restrictive are principally rehabilitative, provide security for unstable joints and are fabricated from measurements and/or cast molds to fit the athlete for a specific purpose (11).
INDICATIONS
There are two principal indications for bracing: support of injured tissue and prevention of injury (10).
Prevention of injury may also include support for safe and early return to activity.
When choosing a brace, consider the type of injury to be prevented and the area that needs to be supported.
SELECTING A BRACE
Braces may be purchased in a variety of shapes, sizes, and colors and range in price from the relatively inexpensive off-the-shelf variety found in large-box athletic stores and some grocery store pharmacy areas to custom-fabricated braces fitted and personalized for the athlete.
Braces are made to fit a wide variety of joint types and come in various sizes. When choosing a brace, the most important factor is the purpose for which the brace is intended. For example, an ankle brace for a basketball athlete may not be the same as one chosen for an airline baggage handler.
When choosing a brace, consider the type of injury to be prevented and the area that needs to be supported.
Braces should increase the stability of joints and limit pathomechanical stress to adjacent joints.
Braces should not interfere with normal joint function.
Bracing worn in contact sports should not endanger others.
Bracing should be adaptable to all somatotypes.
Braces should be chosen that are cost effective.
Selected bracing should have evidence to support its use (5).
SITE-SPECIFIC INDICATIONS
Ankle
Ankle sprains are one of the most common traumatic injuries in sports; the most common mechanism of injury for the ankle is an inversion ankle sprain.
Two types of braces can be worn to help reduce ankle injuries: lace-up braces and rigid support braces. Both types of braces derive some of their support of the ankle from the shoe in which they are worn.
Lace-up ankle braces fit comfortably in a shoe and may have extra lateral support from figure-eight straps that provide assistance to support the ankle in cutting situations that may stress the lateral structures.
Rigid support ankle braces fit in a shoe or boot and may be better for supporting injured workers who may not be exposed to running or cutting forces or athletes needing firmer support.
Size shoe and heel width properly; apply over sock.
Ankle range of motion should be within normal limits for dorsiflexion/plantarflexion; inversion and eversion should be limited.
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