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. 2022 Nov 1;57(11-12):1030-1038.
doi: 10.4085/1062-6050-0664.21.

The Epidemiology of Ankle Sprains in US High School Sports, 2011-2012 to 2018-2019 Academic Years

Zachary Yukio Kerr  1 , Aliza K Nedimyer  1 , Janet E Simon  2 , Melissa K Kossman  3 , R O Corbett  4 , Avinash Chandran  5
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Free PMC article

The Epidemiology of Ankle Sprains in US High School Sports, 2011-2012 to 2018-2019 Academic Years

Zachary Yukio Kerr et al. J Athl Train. .
Free PMC article

Abstract

Context: Continued monitoring of ankle sprain rates and distributions is needed to assess temporal patterns and gauge how changes in incidence may be associated with prevention efforts.

Objective: To describe the epidemiology of ankle sprains in 16 US high school sports during the 2011-2012 to 2018-2019 school years.

Design: Descriptive epidemiology study.

Setting: Online injury surveillance from high school sports.

Patients or other participants: High school athletes who participated in practices and competitions during the 2011-2012 to 2018-2019 school years.

Main outcome measure(s): A convenience sample of high school athletic trainers provided injury and athlete-exposure (AE) data to the National High School Sports-Related Injury Surveillance Study (data provided by High School Reporting Information Online [HS RIO]). Ankle sprain rates per 10 000 AEs with 95% CIs and distributions were calculated. Yearly rates were examined overall and by event type, injury mechanism, and recurrence.

Results: Overall, 9320 ankle sprains were reported (overall rate = 2.95/10 000 AEs; 95% CI = 2.89, 3.01). The highest sport-specific rates were reported in girls' basketball (5.32/10 000 AEs), boys' basketball (5.13/10 000 AEs), girls' soccer (4.96/10 000 AEs), and boys' football (4.55/10 000 AEs). Most ankle sprains occurred during competition (54.3%) and were due to contact with another person (39.5%) or noncontact (35.0%). Also, 14.5% of injuries were recurrent. Across the included academic years, ankle sprain rates generally increased. Compared with the 2011-2012 academic year, rates in the 2018-2019 academic year overall were 22% higher; noncontact-related and recurrent ankle sprain rates also generally increased by 91% and 29%, respectively.

Conclusions: Time trends suggested that ankle sprain rates have increased across the past decade, particularly among those with noncontact-related mechanisms, contrasting with previous research that indicated decreases in incidence. These findings may pinpoint specific etiologic factors that should direct prevention efforts, including considering both person-contact and noncontact mechanisms by mitigating illegal contact through rule changes and enforcement, as well as bracing and proprioceptive and balance-training programs.

Keywords: lower extremity injuries; noncontact injuries; youth sports.

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Figures

Figure
Figure
Yearly ankle sprain rates among high school student-athletes in 16 sports, by A, event type; B, ankle sprain type; C, injury mechanism; and D, injury recurrence, 2011–2012 through 2018–2019 academic years. Error bars represent 95% CIs. Abbreviation: AE, athlete-exposure.
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