Ankle Taping For Trail Runners To Prevent Ankle Injury

Published November 16, 2020 03:36PM

Let’s start with a statement that isn’t quite medical terminology, but is medical honesty. Preventative ankle taping may be complete bullshit.

Or not. There are no good studies on the efficacy of ankle taping for trail runners. And I imagine it would be difficult to design an effective study to evaluate taping that isn’t subject to 100 confounding variables.

When it’s difficult to isolate the variables that form complex webs of causation, I like to see what people actually do in the real world. Our brains can incorporate hundreds of variables into a decision tree without even knowing it, spitting out behaviors. Note: our brains can also incorporate hundreds of variables and spit out the Cats movie and keto diets, so this approach has limits.

I was always skeptical about preventative ankle taping until this summer. Then I saw elite runners and coaches Bailey Kowalczyk (coaching site here) and Johnny Luna-Lima (coaching site here) tear up the trails above Boulder, Colorado. Their uphills? Mind-blowing. But their downhills? The speed with which they could consistently run down the rocky, steep terrain seemed almost unfathomable.

How did their ankles survive?

They do everything right. Great form, great strength work, great hair (I’m not sure how that helps the ankles, but I just want you to have all the information). But when Megan and I crewed their Boulder Skyline Traverse FKT attempts, we got another clue. As we blasted “WAP” from our phones to get hyped, they put their race shoes on over light ankle tape.

I was intrigued and excited! I asked around on our team, and a few of the best technical runners sometimes used tape. Taping seems somewhat common for international skyracers, though by no means universal practice. It just didn’t seem like enough empirical evidence to say anything in an article.

Then Megan twisted her ankle for the 647th time this year. Like Bailey and Johnny, Megan did everything right—strength work, wobble board for balance, great hair. But her ankle did not stop turning on technical terrain, leading to changed weekend plans and lots of frustration. We all know that feeling. Running along freely, open to the possibilities of the universe, when … CRACK. And a second later. “F WORD!” A second after that, it echoes across the valley, teaching all the woodland creatures the most versatile word in the English language.

That side benefit of educating animals was not worth it. We had to do something different. Before becoming a runner and doctor, Megan was a field hockey player in college, and she had similar issues. Back then, she got through it with taping. It took seeing Bailey and Johnny for that memory to click in.

Desperate for any possible solution, we tried taping.

And on the first run with tape, Megan noticed a change. She had confidence. By the final few miles, she was running down technical hills with confidence and speed. Running behind her, I saw a few of the old missteps that often led to disaster. This time, though, she was onto the next step without even thinking about it.

Was it the tape? Here’s where we get into the intersection of empirical evidence and empirical bullshit. Theoretically, tape could provide stability that prevents a full roll when inversion or eversion starts from one of those missteps. My guess is that benefit would be more pronounced in athletes with certain biomechanical issues and health histories that predispose them to constant turns. Possibly, the tape improves proprioception, enhancing an athlete’s ability to understand where the foot is in space. Or maybe the tape harnesses the placebo effect. Just as dogs that are scared of lightning may get better with a thunder shirt, runners that are scared of ankle sprains may get better with what amounts to a thunder sock.

We shared the taping technique with a few runners with similar histories, and all reported some benefit. That small sample is subject to a million biases, but we figured that the sooner we can give desperate athletes a potential solution, the better.

Some disclaimers!

Taping may not work at all. Taping could be actively harmful if it reduces natural feedback cycles, leading to worse sprains or compensation injuries. Different methods may work for different athletes depending on the source of the sprains, so try other options if this doesn’t work. Proper form (see this article on technical running), strength training and balance work are likely much more important than taping. Only try taping if you are desperately seeking answers to persistent ankle turns or anxieties about turns. This article is not medical advice, and only do what your doctor or physical therapist tells you. A PT and running coach we love is Asher Henry, who works with athletes remotely here.

What you need: medium-width athletic tape, ideally waterproof. It may help to shave the area starting a couple inches above the ankle joint.

Step One (1:03): Use tape for a circular anchor just above the ankle bones

Step Two (1:18): Engage foot gently with toes facing up. Make a stirrup strap starting at the anchor strap, over the center line of the ankle joints wrapping directly under the foot, with some tension. You can stop here and skip to step five, just doing stirrup straps to start

Step Three (1:50): Starting slightly behind the first stirrup, wrap the tape under the foot and then around the ankle, connecting to the anchor on the other side, with some tension

Step Four (2:28): Same, but on the other side

Step Five (2:45): Another layer of tape around the anchor to hold it all in place

Finish by putting a high sock over the tape to avoid it coming off from rubbing with your shoe. This taping approach should provide full range of motion. Try it on a hike before you run to make sure it works for you. An alternate approach just uses multiple stirrups without the twist, and you can see that here.

Does ankle taping work? Maybe, sometimes. Is there any approach that fully prevents ankle sprains on technical trails? No, unfortunately. Are you an awesome superboss even when your ankles look and feel like overripe grapefruits? To paraphrase some woodland creatures near us, [F-Word] yes!