The epidemiology of high ankle sprains in National Collegiate Athletic Association sports

Mauntel, Timothy C.; Wikstrom, Erik A.; Roos, Karen G.; Djoko, Aristarque; Dompier, Thomas P.; Kerr, Zachary Y.

Affiliations

¹Walter Reed National Military Medical Center, Bethesda, Maryland, USA

²University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA

³California State University, Long Beach, Long Beach, California, USA

⁴Datalys Center for Sports Injury Research and Prevention Inc, Indianapolis, Indiana, USA

Abstract and keywords

Background: Ankle sprains are among the most common injuries experienced by collegiate athletes. The type of ankle sprain is rarely differentiated in epidemiological studies. This differentiation is necessary, as each ankle sprain type has a unique injury mechanism and recovery period. High ankle sprains commonly result in long recovery periods. Thus, a further examination of the epidemiology of high ankle sprains is warranted.

Purpose: To describe the epidemiology of high ankle sprains in National Collegiate Athletic Association (NCAA) sports during the 2009/2010-2014/2015 academic years.

Study Design: Descriptive epidemiology study.

Methods: NCAA Injury Surveillance Program high ankle sprain data and athlete-exposures (AEs) from 25 sports were evaluated. Certified athletic trainers recorded sport-related injury, event, and AE data during team-sanctioned events. High ankle sprain injury rates per 10,000 AEs were calculated. Percentage distributions were calculated for the amount of time lost from sport and percentage of recurrent injuries. Injury rate ratios (RRs) and 95% CIs compared injury rates by event type, participation restriction time, and sex. 95% CIs not containing 1.00 were considered statistically significant.

Results: The overall high ankle sprain injury rate was 1.00 per 10,000 AEs. Overall, 56.7% of high ankle sprain injuries occurred during competitions, and 9.8% of high ankle sprain injuries were recurrent. Men’s football (2.42/10,000 AEs), wrestling (2.11/10,000 AEs), and ice hockey (1.19/10,000 AEs) had the highest high ankle sprain injury rates. In sex-comparable sports, men had higher injury rates (RR, 1.77; 95% CI, 1.28-2.44). Player contact was the most common injury mechanism (60.4%), and 69.0% of injuries resulted in ≥1 day of participation restriction, with 47.1% resulting in ≥7 days of participation restriction and 15.8% resulting in >21 days of participation restriction.

Conclusion: High ankle sprains resulted in significant participation restriction time from sport participation. The majority of high ankle sprain injuries resulted from player contact and were observed in contact/collision sports. The large proportion of high ankle sprains resulting from player contact, specifically in male contact sports, is worthy of further investigation.

Clinical Relevance: The enhanced understanding of the epidemiology of high ankle sprains provided in our study will aid clinicians in developing targeted injury prevention strategies to mitigate the negative consequences of these injuries.

Keywords: ankle; sprain; syndesmosis; distal tibiofibular joint

Links

DOI: 10.1177/0363546517701428

PubMed: 28423285

WoS: 000405756600028

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Cited By (3)

Year	Entry
2020	Prakash AA. Epidemiology of high ankle sprains: a systematic review. Foot Ankle Spec. October 2020;13(5):420-430.
2021	Chan JJ, Geller JS, Chen KK, Huang H-H, Huntley SR, Vulcano E, Aiyer A. Epidemiology of severe foot injuries in US collegiate athletes. Orthop J Sports Med. April 2021;9(4):23259671211001131.
2021	Erega A. "To Push or Not to Push?" Exploring Lived Experiences of Former Women Track and Field Student-Athletes Who Trained and Competed Through Pain and Injury [PhD thesis]. University of North Carolina at Charlotte; 2021.