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. 2003 Jun;37(3):233–238. doi: 10.1136/bjsm.37.3.233

The Football Association Medical Research Programme: an audit of injuries in professional football: an analysis of ankle sprains

C Woods 1, R Hawkins 1, M Hulse 1, A Hodson 1
PMCID: PMC1724634  PMID: 12782548

Abstract

Aim: To conduct a detailed analysis of ankle sprains sustained in English professional football over two competitive seasons.

Methods: Club medical staff at 91 professional football clubs annotated player injuries. A specific injury audit questionnaire was used together with a weekly form that documented each club's current injury status.

Results: Completed injury records for the two competitive seasons were obtained from 87% and 76% of the participating clubs. Ankle ligament sprains accounted for 11% of the total injuries over the two seasons, with over three quarters (77%) of sprains involving the lateral ligament complex. A total of 12 138 days and 2033 matches were missed because of ankle sprains. More sprains were caused by contact mechanisms than non-contact mechanisms (59% v 39%) except in goalkeepers who sustained more non-contact sprains (21% v 79%, p<0.01). Ankle sprains were most often observed during tackles (54%). More ankle sprains were sustained in matches than in training (66% v 33%), with nearly half (48%) observed during the last third of each half of matches. A total of 44% of sprains occurred during the first three months of the season. A high number of players (32%) who sustained ankle sprains were wearing some form of external support. The recurrence rate for ankle sprains was 9% (see methodology for definition of reinjury).

Conclusion: Ankle ligament sprains are common in football usually involving the lateral ligament complex. The high rate of occurrence and recurrence indicates that prevention is of paramount importance.

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Selected References

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  1. Arnason A., Gudmundsson A., Dahl H. A., Jóhannsson E. Soccer injuries in Iceland. Scand J Med Sci Sports. 1996 Feb;6(1):40–45. doi: 10.1111/j.1600-0838.1996.tb00069.x. [DOI] [PubMed] [Google Scholar]
  2. Barrett J., Bilisko T. The role of shoes in the prevention of ankle sprains. Sports Med. 1995 Oct;20(4):277–280. doi: 10.2165/00007256-199520040-00005. [DOI] [PubMed] [Google Scholar]
  3. Callaghan M. J. Role of ankle taping and bracing in the athlete. Br J Sports Med. 1997 Jun;31(2):102–108. doi: 10.1136/bjsm.31.2.102. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Clanton T. O., Porter D. A. Primary care of foot and ankle injuries in the athlete. Clin Sports Med. 1997 Jul;16(3):435–466. doi: 10.1016/s0278-5919(05)70034-x. [DOI] [PubMed] [Google Scholar]
  5. Ekstrand J., Gillquist J., Liljedahl S. O. Prevention of soccer injuries. Supervision by doctor and physiotherapist. Am J Sports Med. 1983 May-Jun;11(3):116–120. doi: 10.1177/036354658301100302. [DOI] [PubMed] [Google Scholar]
  6. Ekstrand J., Gillquist J. The frequency of muscle tightness and injuries in soccer players. Am J Sports Med. 1982 Mar-Apr;10(2):75–78. doi: 10.1177/036354658201000202. [DOI] [PubMed] [Google Scholar]
  7. Ekstrand J., Tropp H. The incidence of ankle sprains in soccer. Foot Ankle. 1990 Aug;11(1):41–44. doi: 10.1177/107110079001100108. [DOI] [PubMed] [Google Scholar]
  8. Garrick J. G., Requa R. K. The epidemiology of foot and ankle injuries in sports. Clin Podiatr Med Surg. 1989 Jul;6(3):629–637. [PubMed] [Google Scholar]
  9. Garrick J. G. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med. 1977 Nov-Dec;5(6):241–242. doi: 10.1177/036354657700500606. [DOI] [PubMed] [Google Scholar]
  10. Gauffin H., Tropp H., Odenrick P. Effect of ankle disk training on postural control in patients with functional instability of the ankle joint. Int J Sports Med. 1988 Apr;9(2):141–144. doi: 10.1055/s-2007-1024996. [DOI] [PubMed] [Google Scholar]
  11. Gleeson N. P., Reilly T., Mercer T. H., Rakowski S., Rees D. Influence of acute endurance activity on leg neuromuscular and musculoskeletal performance. Med Sci Sports Exerc. 1998 Apr;30(4):596–608. doi: 10.1097/00005768-199804000-00019. [DOI] [PubMed] [Google Scholar]
  12. Hume P. A., Gerrard D. F. Effectiveness of external ankle support. Bracing and taping in rugby union. Sports Med. 1998 May;25(5):285–312. doi: 10.2165/00007256-199825050-00001. [DOI] [PubMed] [Google Scholar]
  13. Karlsson J., Swärd L., Andréasson G. O. The effect of taping on ankle stability. Practical implications. Sports Med. 1993 Sep;16(3):210–215. doi: 10.2165/00007256-199316030-00005. [DOI] [PubMed] [Google Scholar]
  14. Konradsen L., Olesen S., Hansen H. M. Ankle sensorimotor control and eversion strength after acute ankle inversion injuries. Am J Sports Med. 1998 Jan-Feb;26(1):72–77. doi: 10.1177/03635465980260013001. [DOI] [PubMed] [Google Scholar]
  15. Kuwada G. T. Current concepts in the diagnosis and treatment of ankle sprains. Clin Podiatr Med Surg. 1995 Oct;12(4):653–665. [PubMed] [Google Scholar]
  16. Liu S. H., Jason W. J. Lateral ankle sprains and instability problems. Clin Sports Med. 1994 Oct;13(4):793–809. [PubMed] [Google Scholar]
  17. Lüthje P., Nurmi I., Kataja M., Belt E., Helenius P., Kaukonen J. P., Kiviluoto H., Kokko E., Lehtipuu T. P., Lehtonen A. Epidemiology and traumatology of injuries in elite soccer: a prospective study in Finland. Scand J Med Sci Sports. 1996 Jun;6(3):180–185. doi: 10.1111/j.1600-0838.1996.tb00087.x. [DOI] [PubMed] [Google Scholar]
  18. Nielsen A. B., Yde J. Epidemiology and traumatology of injuries in soccer. Am J Sports Med. 1989 Nov-Dec;17(6):803–807. doi: 10.1177/036354658901700614. [DOI] [PubMed] [Google Scholar]
  19. Ogilvie-Harris D. J., Gilbart M. Treatment modalities for soft tissue injuries of the ankle: a critical review. Clin J Sport Med. 1995 Jul;5(3):175–186. doi: 10.1097/00042752-199507000-00008. [DOI] [PubMed] [Google Scholar]
  20. Orteza L. C., Vogelbach W. D., Denegar C. R. The effect of molded and unmolded orthotics on balance and pain while jogging following inversion ankle sprain. J Athl Train. 1992;27(1):80–84. [PMC free article] [PubMed] [Google Scholar]
  21. Putukian M., Knowles W. K., Swere S., Castle N. G. Injuries in indoor soccer. The Lake Placid Dawn to Dark Soccer Tournament. Am J Sports Med. 1996 May-Jun;24(3):317–322. doi: 10.1177/036354659602400312. [DOI] [PubMed] [Google Scholar]
  22. Renström P. A., Konradsen L. Ankle ligament injuries. Br J Sports Med. 1997 Mar;31(1):11–20. doi: 10.1136/bjsm.31.1.11. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Robbins S., Waked E. Factors associated with ankle injuries. Preventive measures. Sports Med. 1998 Jan;25(1):63–72. doi: 10.2165/00007256-199825010-00005. [DOI] [PubMed] [Google Scholar]
  24. Robbins S., Waked E., Rappel R. Ankle taping improves proprioception before and after exercise in young men. Br J Sports Med. 1995 Dec;29(4):242–247. doi: 10.1136/bjsm.29.4.242. [DOI] [PMC free article] [PubMed] [Google Scholar]
  25. Safran M. R., Zachazewski J. E., Benedetti R. S., Bartolozzi A. R., 3rd, Mandelbaum R. Lateral ankle sprains: a comprehensive review part 2: treatment and rehabilitation with an emphasis on the athlete. Med Sci Sports Exerc. 1999 Jul;31(7 Suppl):S438–S447. doi: 10.1097/00005768-199907001-00005. [DOI] [PubMed] [Google Scholar]
  26. Sandelin J., Santavirta S., Kiviluoto O. Acute soccer injuries in Finland in 1980. Br J Sports Med. 1985 Mar;19(1):30–33. doi: 10.1136/bjsm.19.1.30. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Sitler M., Ryan J., Wheeler B., McBride J., Arciero R., Anderson J., Horodyski M. The efficacy of a semirigid ankle stabilizer to reduce acute ankle injuries in basketball. A randomized clinical study at West Point. Am J Sports Med. 1994 Jul-Aug;22(4):454–461. doi: 10.1177/036354659402200404. [DOI] [PubMed] [Google Scholar]
  28. Stiell I. G., McKnight R. D., Greenberg G. H., McDowell I., Nair R. C., Wells G. A., Johns C., Worthington J. R. Implementation of the Ottawa ankle rules. JAMA. 1994 Mar 16;271(11):827–832. [PubMed] [Google Scholar]
  29. Surve I., Schwellnus M. P., Noakes T., Lombard C. A fivefold reduction in the incidence of recurrent ankle sprains in soccer players using the Sport-Stirrup orthosis. Am J Sports Med. 1994 Sep-Oct;22(5):601–606. doi: 10.1177/036354659402200506. [DOI] [PubMed] [Google Scholar]
  30. Thacker S. B., Stroup D. F., Branche C. M., Gilchrist J., Goodman R. A., Weitman E. A. The prevention of ankle sprains in sports. A systematic review of the literature. Am J Sports Med. 1999 Nov-Dec;27(6):753–760. doi: 10.1177/03635465990270061201. [DOI] [PubMed] [Google Scholar]
  31. Tropp H., Askling C., Gillquist J. Prevention of ankle sprains. Am J Sports Med. 1985 Jul-Aug;13(4):259–262. doi: 10.1177/036354658501300408. [DOI] [PubMed] [Google Scholar]
  32. Tropp H., Odenrick P., Gillquist J. Stabilometry recordings in functional and mechanical instability of the ankle joint. Int J Sports Med. 1985 Jun;6(3):180–182. doi: 10.1055/s-2008-1025836. [DOI] [PubMed] [Google Scholar]

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