Sometimes athletes are seen wearing a brace or some sort of supportive strapping whether around the ankle, knee, wrist or shoulder.
Braces are used as a source of additional support when the anatomical structures have been compromised. In other words, the ligaments, tendons or muscles have been injured in some way.
It is a perfectly legitimate way of helping oneself get through an injury while not having to miss a training session or competition.
To think that this is all there is to it, however, is to tell on one's own limited knowledge in this area of injury management.
When an athlete complains repeatedly about a pain they are experiencing, a coach should feel a sense of obligation to encourage the athlete to have it addressed, not pretend like this is a normal occurrence in the sport and that it will pass. Unfortunately, in 2013 there are still coaches who operate in this fashion and too often parents say nothing despite the obvious truth. Meanwhile, the athlete ends up the victim.
So here is a little more insight on the truth about braces, just to help you keep it in perspective. While braces are useful, and I have recommended them in injury management, I am very careful about when and how it is used.
The bottom line is, when overused, the body's progress through healing can be affected negatively.
Particularly through the acute phase, braces can sometimes serve a significant purpose.
Other times, the athlete is not fully recovered but has commenced his/her gradual return to full participation in training and/or competition. In the former case, they serve to limit and gradually reduce inflammation through its support. In the latter case, a brace helps the body meet the physical demands of dynamic movement and/or collisions as needed in any sport.
In both cases, however, if not properly applied, they can hinder the athlete's full recovery.
Braces tend to limit the joint's range of motion. If kept on for too long during the first and into the second phases of healing, this joint can become very stiff, which can lead to some tissue adhesion and this can affect recovery time.
If in the recovery stages the brace is used too much, the mental and physical dependency can develop. The athlete becomes so accustomed to having the brace that they think they cannot perform as well without it. The physical dependency comes in because the muscles are not being trained to handle the full load of the body's weight, neither the challenges being placed on the muscles or joint thanks to the assistance of the brace. Ironically, while the athlete thinks that he is helping to make the joint more reliable, the reality of the situation is that the joint is being made structurally weaker with limited reliability.
While I was at university, I remember a lesson I learned from the decision of another trainer working with our women's volleyball team. In an effort to prevent injury, a rule was enforced that all the ladies on the team had to have their ankle taped prior to training and competition.
This came after the setter and captain of the team was badly injured at the net, coming down on an opponent's ankle, a very common injury inherent to that sport. It was only a few weeks before the conference finals, for which Troy State University seemed headed towards. Her participation was important to the team's success. She rehabilitated aggressively, successfully managing to play by the time the finals came, albeit with a taped up ankle. It was an impressive display of persistence and commitment.
Unfortunately, the well-intentioned rule that followed did not benefit all. Some of the other top athletes, in complying with the team rules, actually had their ankles–that had never caused them any problems prior–weaken on them.
One athlete in particular, who ended up doing a stint in professional volleyball, told me that if she played without taping her ankles, she could feel her ankles fatigue and eventually ache her.
So, listen up coaches. If you have an athlete perpetually wearing a brace, encourage them to get checked out by a sports physician. If they were wearing some sort of supportive taping or strapping and no longer feel the need for it having become pain-free, consider going with it, observing whether the athlete continues to improve in their overall performance but remain diligent.
As a rule of thumb though, leave any consultation about braces, taping and strapping of any sort for the athletic therapists to advise on.
Asha De Freitas-Moseley is a certified athletic trainer with the National Athletic Trainers' Association of the USA. She has over ten years of experience in athlete and active population rehabilitation. She can be reached at #17 Henry Pierre St., St. James. Tel: 221-2437 or at dirtunderthenails@gmail.com.
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