Background:​ Although syndesmosis sprains are less common in sports than lateral ankle sprains, they represent a significant source of morbidity. Several studies have described the increased recovery time for these injuries in a variety of sports. No previous study has described this injury in hockey players.

Hypothesis:​ Syndesmosis ankle sprains require a longer recovery time and are less common than lateral ankle sprains in elite hockey players.

Study Design:​ Uncontrolled retrospective review.

Methods:​ The medical records of the St Louis Blues (1994–2001) and Dallas Stars (1991–2001) National Hockey League teams were reviewed by the head athletic trainers. Ankle sprains were identified and divided into 2 groups:​ syndesmosis and lateral sprains. Player demographics, treatment, and time lost to play were recorded for each injury.

Results:​ Fourteen players were diagnosed with syndesmosis sprains, and 5 players sustained lateral sprains during this time period. Mean time to return to play in games was 45 days (range, 6–137 days) for syndesmosis sprains versus 1.4 days (range, 0–6 days) for lateral sprains.

Conclusions:​ Syndesmosis sprains represent a significant injury in hockey players with an extended time lost and, unlike in other sports, are a more common injury than lateral ankle sprains.