Splinting Techniques for Athletic Trainers and Rehabilitation Professionals

Athletic trainers use splinting techniques to provide immediate support and protection.

Splinting is a technique used in athletics to immobilize and support a body part that has been injured, like a broken bone or a sprained joint. Athletic trainers use splinting techniques to provide immediate support and protection to the affected area until the athlete can be examined and treated by a physician.

Splinting plays a major role in the management of musculoskeletal injuries that occur during sports, both in practice and competition. Splinting is used to treat overuse and soft tissue injuries like tendonitis and sprains. It is also used for acute traumatic injuries like extremity fractures and joint dislocations.

When used properly, splinting immobilizes the affected area. It helps decrease pain and bleeding and prevent further soft tissue, vascular, or neurologic damage. In many cases, splinting may also be used as part of a comprehensive treatment plan for some injuries.

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Splints or casts?

Compared with casts, splints permit tissue swelling and may prevent neurovascular damage. Apply a splint as soon as possible after the injury for maximum benefit and pay close attention to the proper splinting technique.

When used quickly and effectively, splinting can increase patient comfort due to overuse or injuries, decrease the likelihood of further damage following an acute injury, and facilitate recovery.

Common splinting materials

Athletic trainers use three common splinting materials. These are:

1. Rigid Splints. Rigid splints are pre-made or custom-made plastic, metal, or fiberglass devices designed to immobilize and support the injured area. Also, Rigid splints are commonly used for fractures, dislocations, and other more serious injuries that require immobilization.
2. Soft Splints. Soft splints are devices made from materials such as foam, felt, or neoprene, and are often used for sprains or strains. The intent of a soft splint is to provide support while allowing for some tissue swelling and joint range of motion.
3. Pneumatic Splints. Also known as air splints, pneumatic splints are lightweight, inflatable devices that can be used to immobilize and support an injured body part following an immediate need like on the field. Because they are easy to transport, they are a popular choice for athletic trainers who need to provide acute, in-game care.

Effective splinting procedure

Sprints are only effective when they are properly placed. To placing a splint on an athlete, follow these steps:

1. Immobilize the affected limb into a neutral position.
2. Examine and prepare the affected limb. Check for open wounds, and if present, cover any open wounds first with a sterile dressing.
3. Select the appropriate splint. Choose a rigid, soft, or pneumatic splint. The type of splint is determined by the type of injury and the availability of on-sight materials.
4. Apply the splint to the affected limb. The splint should extend beyond the injured area to immobilize and support the limb. To test for efficacy, make sure that the splint is snug but not too tight. A tight splint will restrict circulation and can be counterproductive.
5. Place padding between the splint and the affected area to prevent pressure on joints and bony projections.
6. Secure the splint with bandages, adhesive tape, or other materials. The materials used to secure the splint should be tight enough to hold the splint securely, but not tight enough to cut off circulation or place unnecessary pressure on joints, bony projections, or skin.
7. Ask for feedback. Does the athlete report numbness, tingling, or swelling that would indicate poor blood circulation? If yes, adjust the splint if necessary.

Is a splint or brace better following an acute injury?

When researchers looked at the effectiveness of a functional ankle brace versus an immobilization device like a splint, the brace was better for functional outcomes following an acute ankle sprain and for the prevention of future ankle sprains (Sprouse, et. al., 2018).

This data indicates that the best practice is to immediately splint an acute injury. However, for recovery and return to sport, a brace should be used as soon as it is feasible.

Knees injuries behave differently than ankle injuries. The same meta-analysis study above showed that immobilizing splints are best for long-term functional knee outcomes following acute knee injury. For less severe knee conditions like persistent patellar pain and tendonitis, most trainers prefer soft braces and straps.

How long should a splint be worn?

The length of time an athlete should wear a splint depends on the type and severity of the injury, as well as recommendations from their healthcare provider. In general, the athlete should wear the splint for as long as necessary to allow the injured area to heal properly.

Take care to make sure the athlete does not wear the splint too long. Muscle atrophy, joint range of motion losses, and sport-specific losses are risks to lengthy immobilization.

For minor injuries, such as sprains or strains, the athlete should wear the splint for a few days and up to a week. For more severe injuries, like bone fractures or joint dislocations, the athlete may need to wear the splint for several weeks.

Splints are valuable tools to athletic trainers and rehabilitation professionals, both in practice and competition. When to use them and how to place them depends on the type and site of injury, the materials, and devices available in the moment, and the feedback from the athlete.

This article was written by Amy Ashmore, PhD.