Epidemiology of U.S. high school sports-related ligamentous ankle injuries, 2005/06-2010/11

Clin J Sport Med. 2013 May;23(3):190-6. doi: 10.1097/JSM.0b013e31827d21fe.


Objective: Describe ankle injury epidemiology among US high school athletes in 20 sports.

Design: Descriptive prospective epidemiology study.

Setting: Sports injury data for the 2005/06 to 2010/11 academic years were collected using an Internet-based injury surveillance system, Reporting Information Online.

Participants: A nationwide convenience sample of US high schools.

Assessment of risk factors: Injuries sustained as a function of sport and gender.

Main outcome measures: Ankle sprain rates and patterns, outcomes, and mechanisms.

Results: From 2005/06 to 2010/11, certified athletic trainers reported 5373 ankle sprains in 17,172,376 athlete exposures (AEs), for a rate of 3.13 ankle sprains per 10,000 AEs. Rates were higher for girls than for boys (rate ratio [RR], 1.25; 95% confidence interval [CI], 1.17-1.34) in gender-comparable sports and higher in competition than practice for boys (RR, 3.42; 95% CI, 3.20-3.66) and girls (RR, 2.71; 95% CI, 2.48-2.95). The anterior talofibular ligament was most commonly injured (involved in 85.3% of sprains). Overall, 49.7% of sprains resulted in loss of participation from 1 to 6 days. Although 0.5% of all ankle sprains required surgery, 6.6% of those involving the deltoid ligament also required surgery. The athletes were wearing ankle braces in 10.6% of all the sprains. The most common injury mechanism was contact with another person (42.4% of all ankle sprains).

Conclusions: Ankle sprains are a serious problem in high school sports, with high rates of recurrent injury and loss of participation from sport.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Ankle Injuries / epidemiology*
  • Athletic Injuries / epidemiology*
  • Confidence Intervals
  • Female
  • Humans
  • Ligaments / injuries*
  • Male
  • Population Surveillance
  • Prospective Studies
  • Sprains and Strains / epidemiology
  • United States / epidemiology