Best Splint for Sprained Ankle
For acute ankle sprains, use a semirigid ankle brace or lace-up ankle support for 4-6 weeks during weight-bearing activities—these are superior to elastic bandages, tape, or immobilization for functional recovery and return to work/sports. 1, 2
Why Semirigid Braces Are the Optimal Choice
Semirigid ankle braces demonstrate the greatest treatment effects compared to all other support types, including tape, elastic bandages, and compression wraps. 1 The evidence from the British Journal of Sports Medicine guidelines shows that:
- Patients return to sports 4.6 days sooner with semirigid supports compared to immobilization (95% CI, 1.5 to 7.6). 1
- Patients return to work 7.1 days sooner than those treated with immobilization (95% CI, 5.6 to 8.7). 1
- Less ankle instability develops compared to elastic bandage treatment. 1
A high-quality Lancet trial comparing mechanical supports found that below-knee casts for 10 days followed by functional support showed the widest range of clinical benefits (9% improvement in ankle function at 3 months, 95% CI 2.4-15.0), while Aircast braces also demonstrated significant benefits (8% improvement, 95% CI 1.8-14.2) over simple tubular compression bandages. 3 However, this short immobilization period should transition immediately to functional bracing, as prolonged immobilization beyond 10 days causes worse outcomes. 1
Specific Brace Selection Algorithm
Choose based on injury severity and patient factors:
- Mild to moderate sprains: Lace-up ankle brace with adjustable straps worn during all weight-bearing activities for 4-6 weeks. 1, 4
- Severe sprains with significant pain/swelling: Consider 7-10 days maximum in a below-knee cast or rigid boot, then immediately transition to semirigid brace for remaining 3-5 weeks. 1, 3
- Athletes requiring rapid return: Aircast-style semirigid brace allows functional movement while providing superior stability compared to tape. 3, 5
What NOT to Use
Avoid elastic bandages (ACE wraps) or Tubigrip as primary treatment—these provide insufficient support and lead to slower recovery, more instability, and delayed return to activity. 1, 4 The Cochrane review evidence is clear that these compression-only devices are the least effective treatment option. 1
Do not use tape as the primary support device for treatment (though it may be used for prevention after recovery). Tape is less effective than braces for acute injury treatment and requires frequent reapplication. 1
Duration and Wearing Schedule
Wear the brace during all waking hours when weight-bearing for the full 4-6 week period, not continuously for 24 hours. 1, 4 Removing it at night prevents muscle weakness while maintaining protection during functional activities. 4
Continue brace use throughout the entire rehabilitation period, even as you progress through exercise therapy phases. 2 This combination of bracing plus supervised exercise therapy provides Level 1 evidence for optimal outcomes. 1
Critical Pitfall to Avoid
The most common and harmful error is prolonged immobilization beyond 10 days. 2, 4 This delays recovery, increases chronic instability risk, and prolongs disability by over a week compared to functional treatment with bracing. 1 If you must immobilize for severe pain, limit it to maximum 10 days, then immediately transition to functional support with a semirigid brace. 1
Integration with Other Treatment
Combine the brace with early exercise therapy starting at 48-72 hours post-injury for optimal outcomes. 1, 2 The brace provides mechanical stability while exercises restore neuromuscular function—this combination has Level 1 evidence for reducing recurrent injuries and functional instability. 1
For high ankle sprains (syndesmotic injuries), use the same semirigid bracing approach but expect significantly longer recovery times and consider extended bracing duration. 2