Strapping a sprained ankle is a temporary stabilization technique that provides external support for damaged ligaments. Applying rigid athletic tape compresses the soft tissues, which helps manage swelling following an injury. Its primary function is to limit excessive motions, particularly the inversion movement common in lateral ankle sprains. This support allows controlled movement while protecting the joint, but it is not a substitute for a complete medical evaluation.
Assessing the Injury and Taping Readiness
Before attempting to strap an ankle, confirm the injury is not a severe fracture or high-grade sprain requiring immediate medical intervention. Taping is appropriate for a mild, or Grade 1, sprain, which involves ligament stretching, slight pain, and swelling. Signs necessitating professional evaluation include an inability to bear weight for four steps, severe pain directly over the bone, or a noticeable joint deformity. If a popping sound was heard or if there is significant instability, a Grade 3 tear or fracture may be present and should not be taped without medical clearance.
Initial first aid for soft tissue injuries, including ankle sprains, follows the RICE protocol: Rest, Ice, Compression, and Elevation. Rest means avoiding painful activities, while applying ice for 15 to 20 minutes several times daily reduces pain and inflammation. Gentle compression and keeping the ankle elevated above the heart level minimize swelling. Taping should only be considered after the initial swelling has subsided and acute pain has lessened, with the foot positioned at a 90-degree angle.
Necessary Supplies and Pre-Taping Steps
A supportive ankle strap requires high-quality, non-stretch, rigid athletic tape, often called zinc oxide tape, typically 1.5 inches wide. This rigid material mechanically restricts joint movement, unlike flexible tapes that offer less restraint. To protect the skin from irritation and blistering caused by the strong adhesive, a layer of porous pre-wrap or underwrap must be applied first.
Prior to applying materials, the skin must be clean, dry, and free of oils or lotions for optimal tape adhesion. Shaving hair from the ankle and lower calf twelve hours before taping prevents painful hair removal and increases the tape’s hold. An adhesive spray can be used before the pre-wrap to further secure the structure, especially during activity. The pre-wrap should be applied smoothly from below the calf muscle down to the base of the toes, ensuring no wrinkles are formed that could cause discomfort.
The Mechanics of Ankle Strapping
The strapping process begins with two anchor strips, which serve as attachment points for the supportive structures. The top anchor strip is placed around the lower calf, 4 to 6 inches above the ankle bone. The bottom anchor strip encircles the arch of the foot just behind the toes. Neither strip should be applied circumferentially tight, as they only provide a base for subsequent tape layers.
Next, vertical support strips, known as stirrups, are applied to counter the common inversion mechanism of injury. For an inversion sprain, the tape starts on the inside (medial) of the top anchor, runs down past the malleolus, under the heel, and up the outside (lateral) of the leg to the top anchor strip. Applying three overlapping stirrups, each covering about half of the previous strip, provides substantial vertical stability.
Following the stirrups, horizontal strips, often called horseshoes, are layered across the ankle to lock the stirrups in place and provide additional compression. These strips begin and end on the sides of the foot and leg, covering the malleoli. They should not wrap entirely around the leg, which could impede circulation. These layers are followed by the figure-six and heel lock strips, which stabilize against rotational movement.
The heel lock is a specialized figure-eight pattern that cups the heel bone (calcaneus) to limit excessive side-to-side motion. This strip starts at the top anchor, loops down under the arch, around the back of the heel, and finishes back at the starting point on the opposite side. This technique is repeated in the opposite direction to secure the heel from both the medial and lateral sides, enhancing stability.
The final step involves applying closing strips to cover all underlying tape and exposed pre-wrap, securing the structure and preventing unraveling. These strips are applied in an overlapping pattern, similar to the initial anchor strips, from the top calf anchor down to the foot anchor, ensuring all open gaps are covered. After the strap is complete, a circulation check must be performed by compressing the nail bed of one toe until it blanches white.
Upon releasing pressure, color should return to the toe in less than three seconds, indicating normal capillary refill time. A delayed return of color, numbness, tingling, or pulsing pain are signs that the tape is too tight. If this occurs, the tape must be immediately removed and reapplied more loosely. Failure to monitor circulation can lead to complications from compromised blood flow and nerve function.