발목 관절 안정성의 핵심(ankle heel lock)

[문형철]

평생 많게는 1억보를 걸어야 하는 삶속에서 ankle heel lock이라는 개념을 모르고 살뻔 했네요. 

http://www.youtube.com/watch?v=L5RsAw0Wihs

동영상에서는 엘라스틱밴드를 사용했는데, 확실하게 발목관절의 안정성을 갖추려면 스포츠밴드로 해야..

Effectiveness of external ankle support. Bracing and taping in rugby union.

Hume PA, Gerrard DF.

Source

Department of Sport and Exercise Science, University of Auckland, New Zealand. p.hume@auckland.ac.nz

Abstract

Ankle inversion sprain is common in rugby. This review outlines research evidence relating to the effects of external ankle support by means of bracing and taping, on the incidence of ankle injuries, how performance is affected by support, how support may act at the joint (with respect to end range of motion, strength, resistive torque, muscle activation patterns and proprioception) to prevent injury, and how exercise changes the effectiveness of support. In addition, the implications of the laws of rugby for the use of external support are discussed. Prospective epidemiological studies have shown a decrease in the incidence of ankle injury with external ankle support use. The effectiveness of external ankle support was dependent upon the material properties and application method of the tape or brace, and on the athlete's status of ankle stability or previous injury. Experimental studies have indicated that the degree of ankle inversion restriction provided, and the degree of loss of restriction after exercise, were dependent upon the external support tested. External ankle support has been reported to have no effect on performance, or to have an adverse effect on performance in a variety of movement tasks. No prophylactic external ankle support has been shown to improve performance. If an external support is to provide mechanical support to a ligament it should exceed the strength of the ligament, which for the anterior fibular ligament is a force limit of between 6 and 56 kg. Tape can provide only limited mechanical support of the ankle joint complex, but it may have proprioceptive effects.Taping may work as a psychological reminder, so that the athlete consciously moderates lower limb-loading behaviour. There is equivocal evidence of the effect of brace use on ground reaction force excursions, balance ability andankle strength. It is concluded that while there have been many investigations of the effects of tape and some forms of brace on ankle range of motion with and without exercise, there is equivocal evidence regarding the mechanism by which an external support acts. It is recommended that future research address the effects of external ankle support during dynamic exercise and that brace manufacturers utilise the information in the development of future brace designs to help reduce the risk of ankle inversion sprain injury. As external support can decrease the incidence of ankle inversion sprain the International Rugby Board should consider the use of ankle braces in rugby, allowing for stiff lateral components of the brace.

The effect of taping on ankle stability. Practical implications.

Karlsson J, Sward L, Andreasson GO.

Source

Department of Orthopaedics, East Hospital, Gothenburg University, Sweden.

Abstract

Ankle ligamentous injuries are very common in sports. One of the most popular methods of supporting the weakened ankle is external support with ankle tape. The tape can be used to prevent ankle injuries, to stabilise the injuredankle to prevent further injury, and as a stabiliser during the rehabilitation phase. Of the various taping methods, basket weaves (combined with stirrup and a heel-lock) are the most effective for increasing the mechanical stability of the ankle, especially in the frontal plane (talar tilt). A combination of increased mechanical stability, decreased range of ankle motion and an improvement in the proprioceptive function of the ankle ligaments are factors associated with effectiveness of ankle taping. The major drawbacks of ankle taping are the high costs and decreased support after exercise.

A new ankle laxity tester and its use in the measurement of the effectiveness of taping.

Kirk T, Saha S, Bowman LS.

Source

R.W. Christensen Biomechanics Laboratory, Department of Bioengineering, Clemson University, Clemson, SC 29634, USA.

Abstract

Damage to the lateral ligaments of the ankle, namely the anterior talofibular (ATFL) and the calcaneofibular (CFL) ligaments, is a frequently reported sports injury. The anterior drawer test is generally used to eval‎uate whether the ATFL has been torn, while the talar tilt test is used to determine if the CFL has been injured. Although these two manual tests are often utilized for quick diagnosis, they have been criticized because of their subjective nature and their inability to produce quantitative and reproducible results. A prototype ankle tester was manufactured that could measure the input force and torque, as well as the linear and angular deprivations for the anterior drawer test and the talar tilt test, respectively. This device was used to take readings on 10 human volunteers of a mean age of 21.6 years. This device was X-ray compatible, adjustable for varying patient sizes, relatively small, portable, and easy to operate. Testing was performed to determine how the stiffness of the ankle would respond to taping, and the effect of walking on the taped ankle. The overall mean anterior drawer was 5.93 mm and the mean talar tilt was 51.6 degrees for bare ankles using a force of 111 N (25 lbs) for the drawer and a torque of 16 N m for the tilt. Taping provided an average increase in stiffness of 11.3%, demonstrating that it did provide increased stability. However, statistically significant (P<0.05) decreases in the stiffness subsequent to taping were observed between the initially taped ankles and after 20 min of walking, when it was shown that talar tilt had increased. The prototype ankle tester produced repeatable measurements, and results show that the increase in stiffness due to taping did decrease after a short period of time.

Med Sci Sports Exerc. 2010 Nov;42(11):2089-97.

Effect of ankle taping on knee and ankle joint biomechanics in sporting tasks.

Stoffel KK, Nicholls RL, Winata AR, Dempsey AR, Boyle JJ, Lloyd DG.

Source

Department of Orthopaedic Surgery, Fremantle Hospital, Fremantle, Western Australia, Australia. nkstoffel@hotmail.com

Abstract

INTRODUCTION:

Prophylactic taping is commonly used to prevent ankle injuries during sports. However, unnatural constraint of the ankle joint may increase the risk of injury to proximal joints such as the knee. The association between ankle taping and knee joint loading during open sporting tasks has not been quantified. This research aimed to measure changes in knee and ankle kinetics and kinematics during dynamic athletic activities undertaken with and without ankle taping.

METHODS:

A kinematic and inverse dynamics model was used to determine ankle and knee joint motion and loading in 22 healthy male participants undertaking running and sidestepping tasks. Both tasks were randomized to planned and unplanned conditions and undertaken with and without the use of ankle tape.

RESULTS:

At the knee, peak internal rotation moments (P < 0.001) and peak varus moments (P < 0.05) were significantly reduced during all running and sidestepping trials (planned and unplanned) when undertaken with ankle tape. Internal rotation impulse (P < 0.001) was reduced for sidestepping tasks. Varus impulse during unplanned sidestepping maneuvers (P = 0.04) was reduced with the use of ankle tape. However, there was a trend toward increased valgus moments and impulse for planned sidestepping trials undertaken with ankle tape(P = 0.056). Taping reduced the range of motion at the ankle in all three planes (P < 0.05). Peak inversion (P < 0.001) was reduced for running trials only. Average eversion and peak dorsiflexion moments were significantly reduced in sidestepping tasks by use of taping.

CONCLUSIONS:

By limiting motion at the ankle, taping increased mechanical stability at this joint. Ankle taping also provided protective benefits to the knee via reduced internal rotation moments and varus impulses during both planned and unplanned maneuvers. Medial collateral and anterior cruciate ligament injuries may, however, occur through increased valgus impulse during sidestepping undertaken with ankle tape.

[오리야 놀자]

좋은 자료 감사합니다.

[송영석]

감사합니다. 한두번 해보면 손에 익겠네요..

[한지혜]

발목 염좌에 실제로 응용해 보기 좋은 테이핑 요법 동영상이네요 감사합니다 :)

[왕성민]

작년 이때쯤 축구하다가 미끄러져 발을삐긋하고는 고생했던기억이있어서 더 유의깊게 보았네요.
제가 뛰기전 발목테이핑을 했었다면 위의 논문에서 말했던거처럼 예방이 되었거나 덜다치게 되어 덜 고생했을거같고 부상 후 그냥 아무생각없이 테이핑을 발목에 둘둘 감았던 기억이 있는데 이 테이핑방법을 알았었으면 회복에 도움이 되지 않았을까 생각해봅니다.
또한 맨 아래의 논문에도 나와있든 발목 테이핑은 발목관절의 안정성을 강화시키고 무릎에서의 varus impulse는 줄여줄 수있지만 valgus impulse는 증가할수도 있다고 나와있는데 이는 무릎의구조와 연관시켜 더 생각해봐야 할거 같습니다.

[박수홍]

테이핑 좋습니다. 저도 발목의 문제로 테이핑을 하고 운동하는 경우가 있습니다. 테이핑 말고 기성 종류의 발목보호대를 했을때는 오래 운동하면 족저가 아픈경우가 많은데, 테이핑은 그러지 않았습니다.
테이핑의 방법이 많은데 비복근쪽으로 길게 올려서 같이해주는 테이핑이 더 안정적이었습니다.

[09함형규]

교수님 항상 말씀하시는 대안이 있는 공부의 관점에서 보면
3족보행, 4조보행이 아마도 가장 좋겠으나, 그것이 곤란한경우에 깁스를 대신할수 있는 좋은 방법 같습니다.
밴드와 테이핑 요법도 운동치료를 하려면 필수적인것 같습니다. 잘보았습니다!

[이영호]

겨울 방학에 기회가 닿아 스포츠taping 강좌를 들으려 합니다. 이론과 실기를 같이 해볼 수 있어서 기대됩니다.
이후에 한 번더 댓글 달겠습니다.

[문형철]

굿잡 ㅎㅎㅎ

[장은석]

산에서 발목(외측인대)을 삔 친구에게 비신축성 테이프으로 heel lock 테이핑을 했줬었는데 확실히 발목이 안정되었습니다. 좀 더 숙달되게 연습해서 키네시오 테이프로 감싸준다면 고정뿐 아니라 안정적으로 활동하기에 더 좋을 것 같습니다.
더불어 십자형태(외측인대부터 비골근을 따라 길게, 외측 복사뼈에 가로로 짧게)로 키네시오테이핑을 해주는 것도 효과가 좋았습니다.