Chris Ashton, MS, ATCUniversity of Minnesota

Minneapolis, MN

1. List the challenges and benefits of off-the-self versus custom bracing options.

2. Identify bracing options for return to play based on injury location, severity and playing position.

3. Choose the appropriate bracing option for return to play based on injury location, severity and playing position.

Clinical Experience vs. Evidence-Based

Injury Severity

Playing Position

Timing of injury

Success of patient

Success of team

Always included aconsultation with the Team Physician!

PROS May stock in clinic

Clinician can fit

Billable as DME “School” Discount

Re-usable

CONS Sizing Issues

Comfort

Less support/protection

PROS Custom to patient

More support/protection

Comfort

CONS $$$ & often not

billable

Not re-usable

Need specialist for fabrication-ORTHOTIST

Plantar Plate Injury

Hyper Dorsiflextion

Collateral Ligament Injury

Traumatic Hallux Valgus

Sesamoid Injury

Bracing Options Taping Options Padding Options

Lis Franc Complex Mid-foot Sprain

Taping Options Bracing Options

Metatarsal Stress Fractures

2nd-3rd

5th

Arch Tape, Orthotics, Steel Shank & Carbon Fiber Insoles

Custom Bracing Options

Taping Options Bracing Options

Syndesmosis (External Rotation) Sprain

Deltoid (Eversion) Sprain

Taping augmented with Mole Skin and/or Elastic Tape

Bracing with Hinged Ankle Brace

Collateral Ligament Injuries

Hyperextension Injuries

Cruciate Ligament Injuries

ACL-Decision must be made with MD, patient & family input.

PCL Strap may need to be added

CUSTOM BRACES OFTEN BILLABLE TO INSURANCE

Patellar Instability

Condral Issues

Adjustable Unloader

Custom & OTS options

Both Anterior & Posterior Instabilities

Neoprene w/ Elastic StrapsPolyester-Lycraw/ strapsHarness:Attached to Pads

Protection AC Joint

Quad Contusion

Hip Pointers

Other Contusion

Stability Wrist

Hand

Thumb

Padding Open Cell

Closed Cell

Combo

Semi-Rigid Cast

Thermo-Moldable Plastic Splint Adhere with tape or

Ace wrap, or

Adhere with Cover-Roll

Protection

Grade 1-2

Stability

Grade 3-4

Combo…

Shoulder Pad Inserts

Channel Pads

AC Pads

Quad Contusion Hip Pointer

Wrist Wraps Semi-Rigid Cast

Thermo-moldable Plastic Splint Semi-rigid Cast

Find a good Orthotist!

Be creative!!!

Protection(Injury

Severity)

Function(Playing Position)

BALANCE