Ankle Support in Netball Players
...t (talocrural) itself is a uniaxial, modified hinge joint capable of only two active movements, extension (planterflexion) and flexion (dorsiflexion), with the subtalar joint, transverse tarsal joints (talocalcaneonavicular and calcaneocubois) and other midtarsal joints acting in combination to allow the foot a more diverse range of motion. Stability of the joint is dependant upon the integrity of the surrounding capsular and ligamentous structures, the musculotendinous units, and the alignment of these osseous components (Isakov and Mizrahi, 1997) as well as efficient processing of proprioceptive information. Due to the relative weakness of the lateral ligaments compared to the medial deltoid ligament, coupled with the less bony stability laterally than medially, the ankle is particularly susceptible to lateral ankle injury (Anderson and Hall, 1995). Damage to the lateral ligaments can be a direct result of ankle inversion (turning the ankle inwards) from landing awkwardly due to interaction from another player, landing on the base of the netball post, uneven playing surfaces, and incorrect landing techniques. It can also be the result of subjecting the ligaments to unnatural stresses; excessive, repeated vertical ground reaction forces (VGRF) and braking forces in both the anterior-posterior and mediolateral components. Excessive impact forces can have a negative influence on the musculoskeletal system, especially if it is not aligned correctly as a result of incorrect foot placement. Both peak impact VGRF and braking forces have been found to be significantly greater during netball actions than in normal running action, breaking forces reaching 6.5BW (body weight) at times (Steele, 1986), compared to only 1.0 BW during distance running (Cavanah and Lafortune, 1980). Depending upon the severity of the injury, from 1st degree-minor injury, to 3rd degree-severe injury involving complete rupture of the ligament (Rochester, 1989), such an injury can prevent play and training for a number of weeks, require extensive physiotherapy and treatment, and render the ankle mechanically and/or functionally unstable. In considering ways to combat the frequency with which netball players suffer ankle injury, topics including footwear, court surface (Hopper, 1986), training regime, and technique and movement patterns (Steele and Lafortune, 1989) have been raised. However, in practical terms, the most common tactic is the use of ankle tape or commercial or experimentally adapted ankle braces, usually as a post-injury method of returning to play before rehabilitation of the ankle is complete. “Ankle support is used to control swelling and range of motion in the acute stage, and to provide support or stability to the ligament and joint in the chronic stage when the athlete returns to sport.” (Collaghan, 1997) It can also be used as a preventative method to 1st time ankle sprain in the athlete. A number of different methods of taping and types of braces are currently available, and the choice is more often than not determined by factors such as comfort, cost, ease of application, patient and physiotherapist personal preference, and availability. However, at present a growing band of research is providing evidence to assist with a more scientific justification for choice. Although a decade old now, a statement from Hanlon (1988) remains consistent with today’s approach to ankle support “tape is king, and ankle braces are the new kid on the block.” Ankles can be taped using adhesive zinc-oxide material in a number of techniques. Convenient to use, ankle taping in its most basic acts as an external ligament (Greene and Hillman, 1990). Although the advantages of taping have been consistently documented to include a reduction in range of motion (ROM) and incidence of ankle injury in the stable and unstable athlete, Morris and Musinicki (1983) amongst others have established that a substantial amount of the protective support offered by taping is however lost after short bouts of exercise. Ankle taping and its effect on ROM has also been linked to a decrease in performance, although studies in this respect are numerous and in cases contradictory (Juvenal, 1972; Mayhew, ...