Active Ankle Braces: A Guide to Proper Application and Care

How to put on an active ankle brace?

Properly applying an active ankle brace is crucial for maximizing its effectiveness in providing support, preventing injury, and facilitating rehabilitation while allowing for functional movement. Correct fit ensures optimal stability without compromising circulation or comfort.

Understanding Active Ankle Braces

Active ankle braces are designed to provide support and stability to the ankle joint during physical activity, whether for injury prevention or as part of a rehabilitation program. Unlike rigid casts, they allow for a degree of controlled movement, making them suitable for athletes and active individuals. Their primary functions include:

• Mechanical Support: Limiting excessive inversion or eversion, which are common mechanisms of ankle sprains.
• Proprioceptive Feedback: Enhancing the body's awareness of the ankle's position in space, which can improve neuromuscular control.
• Compression: Reducing swelling and providing a sense of stability.

Common types include lace-up braces, semi-rigid or hinged braces, and compression sleeves with integrated straps. While application methods vary slightly by type, the underlying principles of proper alignment and secure fastening remain consistent.

General Principles for Brace Application

Before you begin, ensure you have the correct size brace. An ill-fitting brace can be ineffective or even harmful.

• Clean and Dry Skin: Always apply the brace to clean, dry skin to prevent irritation and ensure a secure fit.
• Foot Position: The foot should generally be in a neutral position (neither pointed nor flexed excessively) or slightly dorsiflexed (toes pulled up towards the shin) during application, as this is often the most stable position for securing the brace.
• Smooth Out Fabric: Ensure there are no wrinkles or bunched-up fabric under the brace, as this can cause discomfort or pressure points.

Step-by-Step Guide to Applying an Active Ankle Brace

The application process will depend on the specific type of active ankle brace you are using. Below are general guidelines for the most common designs.

1. For Lace-Up Ankle Braces (e.g., ASO, Swede-O):

• Preparation: Sit down and remove your shoe and sock from the affected foot. Ensure the brace is fully unlaced and the tongue is pulled forward.
• Insert Foot: Slide your foot into the brace, ensuring your heel is seated firmly at the back of the brace. The tongue should lie flat over the top of your foot.
• Lace Up: Starting from the bottom eyelets closest to your toes, begin lacing the brace. Pull each lace snugly, working your way up. Ensure tension is even across all laces to avoid pressure points. The brace should feel snug, but not uncomfortably tight or restrictive of circulation.
• Secure Top Laces: Tie the laces securely at the top, just as you would a shoe.
• Apply Straps (if applicable): Many lace-up braces include additional figure-8 or stirrup straps.
  • Figure-8 Straps: Take one strap, typically starting on the outside of the ankle, wrap it under the arch of your foot, cross over the top of your foot, and then anchor it to the opposite side of the brace (often with hook-and-loop fasteners). Repeat with the other strap, creating an "X" pattern over the front of the ankle. These straps mimic athletic taping and provide additional inversion/eversion control.
  • Stirrup Straps: Some braces have straps that loop under the heel and attach to the sides. Pull these evenly for added support.
• Final Check: Flex and extend your foot a few times to ensure the brace moves with you comfortably and doesn't pinch or bind.

2. For Semi-Rigid or Hinged Ankle Braces (e.g., Air-Stirrup, various hinged designs):

• Preparation: Sit down and remove your shoe and sock. Open the brace fully, typically by releasing all straps.
• Position Brace: Place the brace around your ankle. The rigid side supports (malleolar pads or shells) should align with the bony prominences on either side of your ankle (medial and lateral malleoli). Your heel should rest comfortably within the bottom of the brace.
• Secure Bottom Strap: Fasten the lowest strap first, usually around the arch or lower shin, ensuring the brace is centered.
• Secure Remaining Straps: Work your way up, fastening each strap snugly but comfortably. Ensure the brace feels secure and stable, but not overly restrictive.
• Adjust Air/Gel Pads (if applicable): If your brace has inflatable air cells or gel pads, follow the manufacturer's instructions for inflation or adjustment. This customizes the fit and compression.
• Final Check: Stand up and take a few steps. The brace should feel stable and provide support without causing discomfort or excessive rubbing.

3. For Compression Sleeves with Straps:

• Preparation: Ensure your foot and ankle are clean and dry.
• Pull On Sleeve: Roll the sleeve down, similar to putting on a sock, and slide your foot through. Pull the sleeve up over your ankle, ensuring it sits smoothly without wrinkles. The heel cut-out should align with your heel.
• Apply Straps: Most of these braces have integrated elastic straps. Follow the manufacturer's specific instructions, but generally, these straps are wrapped in a figure-8 pattern around the ankle and foot to provide targeted compression and support. Secure them with hook-and-loop fasteners.
• Adjust Tension: Adjust the tension of the straps until you feel firm, even compression and support.

Ensuring Optimal Fit and Comfort

• Snug but Not Constricting: The brace should feel snug and supportive, but it should never cause pain, numbness, tingling, or restrict blood flow (check for coldness or discoloration of toes). You should be able to comfortably wiggle your toes.
• Full Range of Motion (Controlled): An active brace should allow for necessary dorsiflexion and plantarflexion while limiting excessive inversion and eversion. It should not completely immobilize your ankle.
• No Pressure Points: Feel around the brace for any areas of excessive pressure or rubbing. Adjust the lacing or straps as needed. If persistent pressure points exist, the brace may be the wrong size or type for your anatomy.
• Footwear Compatibility: Always try on the brace with the shoes you intend to wear. Active ankle braces are often designed to fit inside athletic footwear, but some bulkier models may require shoes with a wider fit or removable insoles.

Common Mistakes to Avoid

• Wearing a Brace That's Too Loose: A loose brace offers minimal support and can shift, leading to discomfort or ineffective protection.
• Wearing a Brace That's Too Tight: This can cut off circulation, cause nerve compression, and lead to skin irritation or swelling.
• Improper Alignment: If the brace is not centered or its support elements don't align with your ankle anatomy, it won't provide effective support.
• Ignoring Discomfort: Persistent pain, chafing, or numbness are signs that the brace is not fitted correctly or is the wrong type for you.
• Wearing Over Thick Socks: While a thin, moisture-wicking sock is often recommended to prevent skin irritation, overly thick socks can alter the fit of the brace and reduce its effectiveness.
• Not Maintaining the Brace: A worn-out brace with frayed straps, stretched elastic, or damaged components will not provide adequate support.

When to Consult a Professional

While applying an ankle brace might seem straightforward, professional guidance is invaluable, especially after an injury. Consult a healthcare professional (doctor, physical therapist, certified athletic trainer) if:

• You experience persistent pain, swelling, numbness, or tingling despite wearing the brace.
• You are unsure which type of brace is best for your specific condition or activity.
• The brace does not seem to be providing adequate support or comfort.
• You need guidance on incorporating bracing into a comprehensive rehabilitation program that includes strengthening, flexibility, and proprioceptive exercises.

Brace Care and Maintenance

To prolong the life of your active ankle brace and maintain hygiene:

• Follow Manufacturer Instructions: Always adhere to the specific cleaning and care instructions provided with your brace.
• Hand Wash: Most braces can be hand-washed with mild soap and water. Rinse thoroughly.
• Air Dry: Allow the brace to air dry completely before storing or re-wearing. Avoid direct heat, which can damage materials.
• Inspect Regularly: Check for signs of wear and tear, such as fraying straps, stretched elastic, or damaged fasteners. Replace the brace if it shows significant signs of degradation.

The Role of Bracing in Holistic Ankle Health

It's crucial to understand that an active ankle brace is a supportive tool, not a standalone solution for chronic ankle instability or injury. While it provides immediate support, true ankle resilience comes from a comprehensive approach that includes:

• Strengthening Exercises: Targeting the muscles around the ankle and lower leg.
• Flexibility Training: Maintaining optimal range of motion.
• Proprioception and Balance Training: Re-educating the ankle's ability to sense its position and react quickly to uneven surfaces.
• Proper Footwear: Wearing shoes appropriate for your activity.

By correctly applying your active ankle brace and integrating it into a broader strategy for ankle health, you can enhance your performance and reduce your risk of injury.