Risk factors for acute ankle sprains in field-based, team contact sports: a systematic review of prospective etiological studies

ABSTRACT

Objective

The aim of this systematic review was to identify prospectively measured ankle sprain risk factors in field-based team contact sports.

Methods

Eight databases including SPORTDiscus, CINAHL Complete, MEDLINE (EBSCO), Education Source, Web of Science, Scopus, Embase, and Pubmed were searched using specific Boolean terms. A modified-CASP diagnostic test assessed the quality of the included studies. Extensive data extraction included but was not limited to injury definition, protocols for injury diagnosis and recording, and outcomes associated with ankle sprain.

Results

4012 records were returned from the online search and 17 studies met the inclusion criteria for this review. Twelve different risk factors including anatomic alignment of the foot and ankle, joint laxity, height, mass, BMI (body mass index), age, ankle strength, hip strength, single leg landing performance (ground reaction force, pelvic internal rotation, and knee varus), and single leg reach were all found to be associated with ankle sprain incidence. Injury definitions and methods of diagnosis and recording varied across the 17 studies.

Conclusion

This review updates the literature on prospective risk factors for ankle sprain in a specific population rather than heterogeneous cohorts previously studied. From more than 20 categories of risk factors investigated for ankle sprain association across 17 studies in field-based team contact sports, 12 variables were found to be associated with increased incidence of ankle sprain. In order to reduce the risk of ankle sprain, BMI, ankle plantar and dorsiflexion strength, hip strength, and single leg landing performance should be factored in to athlete assessment and subsequent program design. More studies utilizing standardized definitions and methods of recording and reporting are needed. Future prospective etiological studies will allow strength and conditioning coaches, physiotherapists, and physicians to apply specific training principles to reduce the risk and occurrence of ankle sprain injuries.

KEYWORDS:

• ankle
• athletic injuries
• athletic performance
• epidemiology
• etiology
• risk factors
• sports
• sports medicine
• sprains and strains

Disclosure statement

No potential conflict of interest was reported by the author(s).

Ethics

All procedures set out in this paper have been approved by the relevant institution’s ethics committee.

Data Availability

The original datasets analyzed from included studies during the current review are available from the corresponding author upon request.

Supplementary material

Supplemental data for this article can be accessed online at https://doi.org/10.1080/00913847.2022.2093618

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.