Effectiveness of External Ankle Support Bracing and Taping in Rugby Union Patria A. Hume 1 and David F. Gerrard 2 1 Department of Sport and Exercise Science, University of Auckland, Auckland, New Zealand 2 School of Physical Education, University of Otago, Dunedin, New Zealand Contents Summary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 285 1. External Ankle Support and Ankle Injury Rates . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 287 2. Effect of External Support on Performance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 290 3. How the External Support May Act on the Joint to Prevent Injury . . . . . . . . . . . . . . . . . . . 296 4. Degree of Restriction in the End Range of Motion (ROM) Provided by an External Ankle Support . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 299 5. Effectiveness of External Ankle Support in Restricting End ROM During Exercise . . . . . . . . . . 299 6. Effect of External Ankle Support on Strength . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 301 7. Resistance to Inversion Torque Provided by External Ankle Supports . . . . . . . . . . . . . . . . . 302 8. Effect of External Ankle Support on Muscle Activation Patterns . . . . . . . . . . . . . . . . . . . . 303 9. Effect of External Ankle Support on Balance and Proprioception . . . . . . . . . . . . . . . . . . 304 10. Effect of External Ankle Support on Ground Reaction Forces . . . . . . . . . . . . . . . . . . . . . 307 11. Implications of the Laws of Rugby on the Use of External Ankle Support . . . . . . . . . . . . . . . 307 12. Conclusions and Recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 308 Summary Ankle inversion sprain is common in rugby. This review outlines research evidence relating to the effects of external ankle support by means of bracing and taping, on the incidence of ankle injuries, how performance is affected by support, how support may act at the joint (with respect to end range of motion, strength, resistive torque, muscle activation patterns and proprioception) to prevent injury, and how exercise changes the effectiveness of support. In addition, the implica- tions of the laws of rugby for the use of external support are discussed. Prospective epidemiological studies have shown a decrease in the incidence of ankle injury with external ankle support use. The effectiveness of external ankle support was dependent upon the material properties and application method of the tape or brace, and on the athlete’s status of ankle stability or previous injury. Experimen- tal studies have indicated that the degree of ankle inversion restriction provided, and the degree of loss of restriction after exercise, were dependent upon the external support tested. External ankle support has been reported to have no effect on performance, or to have an adverse effect on performance in a variety of movement tasks. No prophylactic external ankle support has been shown to im- prove performance. If an external support is to provide mechanical support to a ligament it should exceed the strength of the ligament, which for the anterior fibular ligament is a force limit of between 6 and 56kg. Tape can provide only limited mechanical support of the ankle joint complex, but it may have pro- REVIEW ARTICLE Sports Med 1998 May; 25 (5): 285-312 0112-1642/98/0005-0285/$14.00/0 © Adis International Limited. All rights reserved.