Skręcenie stawu skokowego

Skręcenie stawu skokowego
Epidemiologia

Skręcenie stawu skokowego jest jednym z najczęstszych urazów układu mięśniowo-szkieletowego, z roczną zapadalnością w USA wynoszącą około 2 miliony przypadków, co przekłada się na 1 przypadek na 10 000 osób dziennie. Epidemiologia wskazuje na wyższą częstość występowania u kobiet (13,6 na 1000 ekspozycji) niż u mężczyzn (6,9 na 1000 ekspozycji), z najwyższym wskaźnikiem w grupie wiekowej 15-19 lat (7,2 na 1000 osobolat). Wśród sportowców, szczególnie w dyscyplinach takich jak koszykówka żeńska (5,32 na 10 000 ekspozycji), koszykówka męska (5,13 na 10 000 ekspozycji), piłka nożna żeńska (4,96 na 10 000 ekspozycji) oraz futbol amerykański męski (4,55 na 10 000 ekspozycji), skręcenia stanowią znaczący odsetek urazów. Sporty halowe i kortowe cechują się najwyższym wskaźnikiem zachorowalności, sięgającym 7 na 1000 ekspozycji lub 4,9 na 1000 godzin. Nawracające skręcenia, zwłaszcza boczne (80% przypadków), prowadzą do przewlekłej niestabilności stawu skokowego (CAI), która dotyka do 70% pacjentów po urazie i wiąże się z ryzykiem rozwoju pourazowej choroby zwyrodnieniowej stawów.

Epidemiologia skręcenia stawu skokowego

Skręcenie stawu skokowego jest jednym z najczęstszych urazów układu mięśniowo-szkieletowego, stanowiącym istotne wyzwanie diagnostyczne i terapeutyczne, szczególnie u sportowców. Według danych epidemiologicznych, w Stanach Zjednoczonych corocznie dochodzi do około 2 milionów przypadków ostrych skręceń stawu skokowego.¹ Szacuje się, że dziennie w USA dochodzi do około 23 000-30 000 przypadków skręceń stawu skokowego wymagających opieki medycznej, co przekłada się na współczynnik zapadalności wynoszący 1 przypadek na 10 000 osób dziennie.²³

Częstość występowania skręceń stawu skokowego w populacji ogólnej waha się od 2 do 7 przypadków na 1000 osobolat, natomiast częstość występowania złamań stawu skokowego wynosi około 1 na 1000 osobolat.⁴ Inne badania wskazują na współczynnik zachorowalności na poziomie 2,15 na 1000 osobolat w Stanach Zjednoczonych.⁵⁶ Z kolei badania przeprowadzone w Wielkiej Brytanii szacują surowy współczynnik zapadalności na 52,7 na 10 000 osób, który po uwzględnieniu pacjentów bez kodu diagnostycznego wzrasta do 60,9 na 10 000 osób (95% CI 59,4-62,4).⁷

Różnice w epidemiologii według wieku i płci

Metaanaliza 181 prospektywnych badań epidemiologicznych wykazała, że ogólna częstość występowania ostrych skręceń stawu skokowego jest wyższa wśród kobiet niż wśród mężczyzn (13,6 vs 6,9 na 1000 ekspozycji).¹⁸ Istnieją jednak istotne różnice w zależności od wieku:

Szczyt zachorowalności występuje w wieku 15-19 lat (7,2 na 1000 osobolat)⁵⁶
Mężczyźni w wieku 15-24 lat mają znacznie wyższy wskaźnik zachorowalności niż kobiety w tym samym wieku (współczynnik ryzyka 1,53; 95% CI 1,41-1,66)⁵⁹
Kobiety powyżej 30. roku życia mają wyższy wskaźnik zachorowalności niż mężczyźni w tym samym wieku (współczynnik ryzyka 2,03; 95% CI 1,65-2,65)⁵⁹¹⁰
Dzieci mają wyższy wskaźnik zachorowalności (2,85 na 1000 ekspozycji) w porównaniu z nastolatkami (1,94 na 1000 ekspozycji) i dorosłymi (0,72 na 1000 ekspozycji)⁸¹¹

Różnice rasowe w epidemiologii

Badania wykazały również różnice w częstości występowania skręceń stawu skokowego w zależności od rasy. W porównaniu z rasą latynoską, rasy czarna i biała charakteryzują się znacznie wyższym wskaźnikiem skręceń stawu skokowego (współczynnik ryzyka odpowiednio 3,55 [95% CI 1,01-6,09] i 2,49 [95% CI 1,01-3,97]).⁵

Epidemiologia skręceń stawu skokowego w sporcie

Skręcenia stawu skokowego są niezwykle powszechne w sporcie i stanowią około połowy wszystkich urazów sportowych.¹² Około 49,3% wszystkich skręceń stawu skokowego występuje podczas aktywności sportowej, przy czym najczęściej podczas koszykówki (41,1%), futbolu amerykańskiego (9,3%) i piłki nożnej (7,9%).⁵

Wskaźniki zachorowalności w różnych dyscyplinach sportowych

Wśród sportowców na poziomie uniwersyteckim w Stanach Zjednoczonych, ostre skręcenia stawu skokowego są najczęściej zgłaszanym urazem, stanowiącym 15% wszystkich zgłaszanych urazów w tej populacji.¹³ Wskaźnik częstości występowania ostrych skręceń stawu skokowego wśród sportowców w 15 dyscyplinach objętych Narodowym Stowarzyszeniem Sportów Uniwersyteckich (NCAA) wahał się od 0,75 do 0,89 skręceń na 1000 ekspozycji sportowców w latach 1988-1989 do 2003-2004.¹³

Najwyższe współczynniki zapadalności na skręcenia stawu skokowego zaobserwowano w następujących dyscyplinach:

Koszykówka żeńska: 5,32 na 10 000 ekspozycji sportowców¹⁴¹⁵
Koszykówka męska: 5,13 na 10 000 ekspozycji sportowców¹⁴¹⁵
Piłka nożna żeńska: 4,96 na 10 000 ekspozycji sportowców¹⁴¹⁵
Futbol amerykański męski: 4,55 na 10 000 ekspozycji sportowców¹⁴¹⁵

Sporty halowe/na kortach mają najwyższy wskaźnik występowania skręceń stawu skokowego, z łącznym wskaźnikiem zachorowalności wynoszącym 7 na 1000 ekspozycji lub 1,37 na 1000 ekspozycji sportowców i 4,9 na 1000 godzin.¹⁶¹¹ Do sportów o wysokim ryzyku skręceń stawu skokowego należą: koszykówka, siatkówka halowa, piłka ręczna, netball, aeroball oraz wspinaczka ściankowa.¹⁷

Skręcenia stawu skokowego w populacji szkolnej

W latach 2011-2012 do 2018-2019 zgłoszono 9320 skręceń stawu skokowego wśród uczniów szkół średnich w Stanach Zjednoczonych (ogólny wskaźnik = 2,95 na 10 000 ekspozycji sportowców; 95% CI 2,89-3,01).¹⁴¹⁵ W tym okresie wskaźniki skręceń stawu skokowego ogólnie wzrosły. W porównaniu z rokiem akademickim 2011-2012, wskaźniki w roku akademickim 2018-2019 były ogólnie o 22% wyższe; wskaźniki skręceń stawu skokowego związanych z mechanizmem bezkontaktowym i nawrotowym również ogólnie wzrosły, odpowiednio o 91% i 29%.¹⁴¹⁵

Epidemiologia przewlekłej niestabilności stawu skokowego

Przewlekła niestabilność stawu skokowego (Chronic Ankle Instability, CAI) jest częstym następstwem skręcenia stawu skokowego. Ostatnie badania sugerują, że nawet do 70% osób, które doznały ostrego, incydentalnego skręcenia bocznej części stawu skokowego, może rozwinąć CAI w krótkim czasie po początkowym urazie.¹⁸¹⁹

Rozpowszechnienie CAI w populacji

Rozpowszechnienie przewlekłej niestabilności stawu skokowego w populacji ogólnej wynosi około 25%, wahając się od 7% do 53%. Rozpowszechnienie CAI wśród uczestników z historią skręceń stawu skokowego wynosi 46%, wahając się od 9% do 76%.²⁰ Szeroki zakres częstości występowania jest głównie spowodowany kryteriami wykluczenia, wiekiem, dyscypliną sportową i innymi czynnikami.

Między 30% a 40% skręceń stawu skokowego, szczególnie skręceń typu high ankle i lateral ankle, może prowadzić do przewlekłej niestabilności stawu skokowego i ostatecznie wymagać interwencji chirurgicznej.²¹ Badania wskazują, że między 50% a 70% osób, które doznały bocznego skręcenia stawu skokowego, rozwinie przewlekłą niestabilność stawu skokowego, charakteryzującą się utrzymującym się bólem, niestabilnością, nawracającymi urazami i trwałą niepełnosprawnością funkcjonalną.²²

Czynniki ryzyka CAI

Główne czynniki ryzyka rozwoju przewlekłej niestabilności stawu skokowego obejmują:

Nawracające boczne skręcenia stawu skokowego²³
Urazy wielu więzadeł²³
Warianty lub patologie stawu podskokowego²³
Zaburzona propriocepcja lub równowaga postawy²³
Pierwsze skręcenie stawu skokowego w młodszym wieku²³
Samoocena deficytu funkcjonalnego 6 miesięcy po pierwszym skręceniu stawu skokowego²³

Czynniki ryzyka i mechanizmy skręcenia stawu skokowego

Najważniejszym czynnikiem ryzyka skręcenia stawu skokowego jest wcześniejsze skręcenie stawu skokowego.¹³⁶²⁴ Historia bocznego skręcenia stawu skokowego, w szczególności, została opisana jako jeden z najsilniejszych czynników ryzyka przyszłego bocznego skręcenia stawu skokowego.¹³

Czynniki ryzyka związane z pacjentem

Czynniki ryzyka związane z pacjentem obejmują:

Ograniczone zgięcie grzbietowe stopy²⁵
Zmniejszona propriocepcja²⁵
Deficyt równowagi²⁵
Wysokie obcasy¹⁷
Szpotawość tyłostopia¹⁷
Zwiększony wskaźnik masy ciała¹⁷
Zaburzenia propriocepcji¹⁷
Zaburzona równowaga postawy lub deficyty nerwowo-mięśniowe¹⁷
Deficyty siłowe¹⁷

Typy skręceń stawu skokowego

Najczęstszym typem skręcenia stawu skokowego jest skręcenie inwersyjne, gdzie nadmierne zgięcie podeszwowe i supinacja powodują uszkodzenie więzadła strzałkowo-skokowego przedniego. Badania pokazują, że u populacji skandynawskiej skręcenia inwersyjne stawu skokowego stanowiły 85% wszystkich skręceń stawu skokowego.²⁶

Lateralne skręcenia stawu skokowego (LAS) są najczęstszym typem skręcenia stawu skokowego występującym podczas aktywności sportowej. Do 80% LAS to urazy inwersyjne, a 75% prowadzi do nawrotów i niestabilności.¹² Lateralne skręcenia stawu skokowego stanowią 75-80% wszystkich skręceń stawu skokowego.¹⁷

Skręcenia typu high ankle (syndesmotyczne) często występują u osób uprawiających futbol amerykański, narciarstwo zjazdowe i inne sporty terenowe i mogą stanowić do 10% skręceń stawu skokowego w niektórych populacjach.²⁷ Ciężkość tych urazów znacznie się różni, ale często powodują znaczną utratę czasu w pracy lub sporcie (do czterech-pięciu miesięcy).²⁷

Konsekwencje skręceń stawu skokowego

Skręcenia stawu skokowego mogą mieć poważne długoterminowe konsekwencje, szczególnie jeśli nie są odpowiednio leczone. Potencjalnie najbardziej niepokojącym długoterminowym wynikiem urazów skręcenia stawu skokowego jest rozwój pourazowej choroby zwyrodnieniowej stawów.¹⁸

Nawroty i powikłania długoterminowe

Wysoki wskaźnik nawrotów po początkowym skręceniu stawu skokowego jest częściowo spowodowany częstotliwością ponownego urazu po początkowym skręceniu stawu skokowego. Około 70% skręceń stawu skokowego występuje u osób, które wcześniej doznały skręcenia stawu skokowego, z których wiele nie zostało całkowicie zrehabilitowanych.²⁴

Badanie epidemiologiczne dotyczące skręcenia stawu skokowego przeprowadzone w Hongkongu wykazało, że 73% wszystkich sportowców miało nawracające skręcenie stawu skokowego, a 59% tych sportowców miało znaczną niepełnosprawność i utrzymujące się objawy prowadzące do upośledzenia wyników sportowych.²⁸

Ponad połowa pacjentów ma nadal objawy resztkowe między 6 tygodniami a 18 miesiącami, a do 30% zgłasza ból podczas aktywności od 2,5 do 5 lat po ostrym zdarzeniu.²⁹ Do 5% sportowców, którzy doznają skręcenia stawu skokowego, musi zmienić, a do 4% zaprzestać swoich działań sportowych.²⁹ U osób niebędących sportowcami, do 6% nie jest w stanie kontynuować swojego poprzedniego zajęcia, a kolejne 15% potrzebuje dodatkowego wsparcia, aby je kontynuować.²⁹

Wpływ socjoekonomiczny

Skręcenia stawu skokowego mają znaczący wpływ socjoekonomiczny. W Wielkiej Brytanii skręcenia stawu skokowego stanowią 3-5% wszystkich wizyt na oddziałach ratunkowych, a w USA 10% wszystkich wizyt związanych z urazami.⁴ Szacuje się, że około 14% skręceń stawu skokowego zgłaszających się na oddziały ratunkowe jest klasyfikowanych jako ciężkie, co przekładałoby się na 42 000 ciężkich skręceń stawu skokowego rocznie w Wielkiej Brytanii.⁷

Badanie przeprowadzone w Kingston w Ontario w Kanadzie wykazało, że 11% (95% CI, 8-15%) uczestników odwiedziło lekarza po początkowej wizycie na oddziale ratunkowym. Prawie wszyscy (95%; 95% CI, 92-97%) uczestnicy stosowali leki lub leczenie wspomagające, a 55% (95% CI, 50-61%) zgłosiło wzięcie wolnego od pracy, szkoły lub prac domowych. Korzystanie z nieodpłatnej pomocy zgłosiło 56% (95% CI, 50-62%).³⁰

Strategie profilaktyczne i interwencyjne

Zrozumienie epidemiologii skręceń stawu skokowego jest ważne dla poprawy zdrowia mięśniowo-szkieletowego pacjentów i zmniejszenia obciążenia chorobami mięśniowo-szkieletowymi kończyn dolnych.¹

Profilaktyka skręceń stawu skokowego

Strategie profilaktyczne koncentrują się na rozwiązywaniu specyficznych czynników etiologicznych, w tym:

Łagodzenie nielegalnego kontaktu poprzez zmiany zasad i ich egzekwowanie³¹
Stosowanie ortez i programów treningowych proprioceptywnych i równoważnych³¹
Utrzymywanie dobrej siły mięśniowej, równowagi i elastyczności³²³³
Stosowanie wsporników powietrznych i zapięć sznurowadeł w sportach wysokiego ryzyka²⁷

Interwencje i rehabilitacja

Odpowiednie leczenie i rehabilitacja są kluczowe dla zapobiegania przewlekłym problemom związanym z kostką. Niepełna rehabilitacja jest najczęstszą przyczyną przewlekłej niestabilności stawu skokowego po skręceniu.³²

Ćwiczenia są niezbędną częścią rehabilitacji po skręceniu stawu skokowego.³⁴ Istnieją znaczące dowody na to, że włączenie tych ćwiczeń jest skuteczne w zmniejszaniu przyszłych urazów stawu skokowego, a także urazów kolana, ścięgien udowych i innych urazów kończyn dolnych u sportowców.²⁷

Ryzyko ponownego urazu utrzymuje się do 12 miesięcy, nawet po pełnej rehabilitacji. Zewnętrzne wsparcie stawu skokowego i trening nerwowo-mięśniowy mogą zmniejszyć to ryzyko i są ważnym aspektem bezpiecznego powrotu do gry.²⁴

Wnioski i przyszłe kierunki badań

Dalsze monitorowanie wskaźników i rozkładów skręceń stawu skokowego jest potrzebne do oceny wzorców czasowych i oceny, jak zmiany w zachorowalności mogą być związane z wysiłkami profilaktycznymi.¹⁴¹⁵

Kontynuowane badania związku między incydentem skręcenia stawu skokowego a przewlekłą niestabilnością stawu skokowego i rozwojem pourazowej choroby zwyrodnieniowej stawów są potrzebne.³⁵

Przyszłe inicjatywy zapobiegania urazom muszą nadal uwzględniać ryzyko kolejnego urazu po początkowym skręceniu stawu skokowego, CAI i rozwoju pourazowej choroby zwyrodnieniowej stawów w celu zmniejszenia obciążenia tymi urazami w całej populacji.¹⁸

Lepsze zrozumienie różnic w częstości występowania i wzorców urazów skręcenia stawu skokowego w różnych środowiskach klinicznych może pomóc klinicystom w lepszym rozpoznawaniu i leczeniu urazów stawu skokowego, które najprawdopodobniej pojawią się w ich środowisku klinicznym, zmniejszając w ten sposób możliwość wystąpienia przewlekłych problemów z kostką.³⁶

Potrzeba dalszych badań

Istnieje potrzeba dodatkowych badań nad metodami zapobiegania i programami rehabilitacji skręceń stawu skokowego w populacji wojskowej, ponieważ wskaźnik skręceń stawu skokowego w tej populacji przekracza wskaźnik w populacjach o mniej wymagającym fizycznie stylu życia. W konsekwencji, strategie zapobiegania o niskich kosztach mogłyby przynieść znaczne korzyści.³⁷

Potrzebne są bardziej prospektywne badania w celu lepszego rozpoznania wewnętrznych czynników ryzyka urazów stawu skokowego.³⁸ Czynniki wpływające na częstość występowania przewlekłej niestabilności stawu skokowego powinny być badane i jasno opisane.²⁰

Czynnik demograficzny	Wskaźnik zapadalności	Uwagi
Populacja ogólna	2,15 na 1000 osobolat	Szacunki dla USA
Nastolatki (15-19 lat)	7,2 na 1000 osobolat	Najwyższy wskaźnik w ogólnej populacji
Kobiety	13,6 na 1000 ekspozycji	Wyższy wskaźnik niż u mężczyzn ogólnie
Mężczyźni	6,94 na 1000 ekspozycji	Niższy wskaźnik niż u kobiet ogólnie
Mężczyźni (15-24 lat)	Wyższy niż u kobiet w tym samym wieku	Współczynnik ryzyka 1,53 (95% CI 1,41-1,66)
Kobiety (powyżej 30 lat)	Wyższy niż u mężczyzn w tym samym wieku	Współczynnik ryzyka 2,03 (95% CI 1,65-2,65)
Dzieci	2,85 na 1000 ekspozycji	Wyższy wskaźnik niż u nastolatków i dorosłych
Nastolatki	1,94 na 1000 ekspozycji	Wyższy wskaźnik niż u dorosłych
Dorośli	0,72 na 1000 ekspozycji	Najniższy wskaźnik wśród grup wiekowych
Koszykówka żeńska	5,32 na 10 000 ekspozycji sportowców	Najwyższy wskaźnik wśród sportów
Koszykówka męska	5,13 na 10 000 ekspozycji sportowców	Drugi najwyższy wskaźnik wśród sportów
Piłka nożna żeńska	4,96 na 10 000 ekspozycji sportowców	Trzeci najwyższy wskaźnik wśród sportów
Futbol amerykański męski	4,55 na 10 000 ekspozycji sportowców	Czwarty najwyższy wskaźnik wśród sportów
Sporty halowe/na kortach	7 na 1000 ekspozycji lub 4,9 na 1000 godzin	Najwyższy wskaźnik wśród kategorii sportowych
Rugby męskie na poziomie uniwersyteckim	1,21 urazów na 1000 zawodnikogodzin	Ryzyko podczas meczów 25,6 razy wyższe niż podczas treningów

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Materiały źródłowe

#1 Epidemiology of Ankle Sprains and Chronic Ankle Instability
https://pmc.ncbi.nlm.nih.gov/articles/PMC6602402/
To provide a focused overview of the existing literature on the epidemiology of acute ankle sprains (lateral, medial, and high/syndesmotic) with an emphasis on incidence studies from the United States. […] Acute ankle sprains are one of the most common musculoskeletal injuries, with a high incidence among physically active individuals. […] Understanding the epidemiology of these injuries is important for improving patients’ musculoskeletal health and reducing the burden of lower limb musculoskeletal conditions. […] In the United States, approximately 2 million acute ankle sprains occur annually. […] A meta-analysis of 181 prospective epidemiology studies of ankle sprains among various populations and from various data sources showed that, overall, the incidence of acute ankle sprains was higher among females than among males (13.6 versus 6.9/1000 exposures).
#2 Ankle Sprain: Practice Essentials, Background, Anatomy
https://emedicine.medscape.com/article/85526-overview
Most ankle sprains are probably self-treated and are never reported to a health care provider; therefore, many ankle sprains are not documented. Sprained ankles have been estimated to constitute up to 30% of injuries seen in sports medicine clinics and are the most frequently seen musculoskeletal injury seen by primary care providers. More than 23,000 people per day in the United States, including athletes and nonathletes, require medical care for ankle sprains. Stated another way, incident cases have been estimated at 1 case per 10,000 persons per day. A US Army study found that ankle sprains are the most common foot and ankle injury in active-duty Army personnel with a rate of 103 sprains per 1000 persons per year. […] Female athletes are 25% more likely to sustain ankle injuries than male athletes. Female basketball players are at a higher risk of a first-time inversion injury than those participating in other sports. Soccer and volleyball are other leading causes of ankle sprains in high school and college female athletes. Some studies attribute a higher incidence of ankle injuries in high school football, basketball, and soccer players. Other studies conclude that in college men, the risk of suffering an ankle sprain appears to be similar with basketball, soccer, and football.
#3 Ankle Sprains by the Numbers [Infographic] Everything Ankle Sprains
https://www.donjoystore.com/ankle-sprains-by-the-numbers-infographic?srsltid=AfmBOoq53RGUV31juw_ywtmwQoQDkNpghx69uS50iRbywBfTPIciamDn
Whether running, jumping, kicking or even walking, one wrong step or slip can cause serious ankle pain. Ankle sprains happen. In fact, about 25,000 ankle sprains occur per day, according to The American Orthopaedic Foot Ankle Society (AOFAS). […] Athletes, parents and coaches should understand the severity of an ankle sprain and know what needs to be done to keep pain at a minimum. […] Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med. 1977;5:241242.
#4 P1-94âThe epidemiology and costs of ankle injuries: a review of the literature | Journal of Epidemiology & Community Health
https://jech.bmj.com/content/65/Suppl_1/A93.1
Ankle sprains are one of the most common injuries presenting to emergency departments, representing 3% to 5% of all visits in the UK, and 10% of all injury-related visits in the USA. […] To describe the epidemiology of ankle sprains and fractures among the general population; and to determine the direct and indirect costs related to the diagnosis and treatment of ankle injuries. […] The incidence of ankle sprains was 2 to 7 per 1000 person-years, while the incidence of ankle fractures was 1 per 1000 person-years. […] Information on the epidemiology of ankle sprains and fractures may help plan for health policy and the provision of health services.
#5
https://journals.lww.com/jbjsjournal/fulltext/2010/10060/the_epidemiology_of_ankle_sprains_in_the_united.3.aspx
Ankle sprain has been studied in athletic cohorts, but little is known of its epidemiology in the general population. A longitudinal, prospective epidemiological database was used to determine the incidence and demographic risk factors for ankle sprains presenting to emergency departments in the United States. It was our hypothesis that ankle sprain is influenced by sex, race, age, and involvement in athletics. […] During the study period, an estimated 3,140,132 ankle sprains occurred among an at-risk population of 1,461,379,599 person-years for an incidence rate of 2.15 per 1000 person-years in the United States. The peak incidence of ankle sprain occurred between fifteen and nineteen years of age (7.2 per 1000 person-years). Males, compared with females, did not demonstrate an overall increased incidence rate ratio for ankle sprain (incidence rate ratio, 1.04; 95% confidence interval, 1.00 to 1.09). However, males between fifteen and twenty-four years old had a substantially higher incidence of ankle sprain than their female counterparts (incidence rate ratio, 1.53; 95% confidence interval, 1.41 to 1.66), whereas females over thirty years old had a higher incidence compared with their male counterparts (incidence rate ratio, 2.03; 95% confidence interval, 1.65 to 2.65). Compared with the Hispanic race, the black and white races were associated with substantially higher rates of ankle sprain (incidence rate ratio, 3.55 [95% confidence interval, 1.01 to 6.09] and 2.49 [95% confidence interval, 1.01 to 3.97], respectively). Nearly half of all ankle sprains (49.3%) occurred during athletic activity, with basketball (41.1%), football (9.3%), and soccer (7.9%) being associated with the highest percentage of ankle sprains during athletics.
#6 Update on Acute Ankle Sprains | AAFP
https://www.aafp.org/pubs/afp/issues/2012/0615/p1170.html
Ankle sprains are a common problem seen by primary care physicians, especially among teenagers and young adults. […] Acute ankle sprain is one of the most common reasons for primary care office and emergency department visits in the United States, with an overall incidence of 2.15 per 1,000 person-years. Teenagers and young adults have the highest rates of ankle sprain, with a peak incidence of 7.2 per 1,000 person-years for those 15 to 19 years of age. […] The greatest risk factor for ankle sprain is a previous ankle sprain, which underscores the importance of proper treatment and effective prevention strategies. […] Ankle sprains should be evaluated using the Ottawa ankle rules, which are well-established clinical guidelines used to determine the need for radiography. […] Multiple studies have demonstrated that the Ottawa ankle rules are nearly 100 percent sensitive for detecting fractures in adults and children as young as five years.
#7 Population based epidemiology of ankle sprains attending accident and emergency units in the West Midlands of England, and a survey of UK practice for severe ankle sprains | Emergency Medicine Journal
https://emj.bmj.com/content/20/6/508
Population based epidemiology of ankle sprains attending accident and emergency units in the West Midlands of England, and a survey of UK practice for severe ankle sprains […] To estimate the incidence of ankle sprains and severe ankle sprains attending accident and emergency (AE) units; to describe current practice for severe ankle sprains in AE units in the United Kingdom. […] The estimate of the crude incidence rate of ankle sprains was a minimum of 52.7 per 10 000, rising to 60.9 (95% CI 59.4 to 62.4) when figures were adjusted for the proportion of patients without a diagnostic code (13.7%). […] As 14% of ankle sprains attending AE were classed as severe, this would equate to 42 000 severe ankle sprains per year in the UK. […] While there is considerable variation in severe ankle sprain management in UK AE units, most are treated with the minimal mechanical support of Tubigrip.
#8
https://link.springer.com/article/10.1007/s40279-013-0102-5
Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. […] Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. […] The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures). […] Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. […] Studies at a greater risk of bias were more likely to underestimate the risk of ankle sprain. […] Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains. […] The epidemiology of ankle sprains in the United States.
#9 Sprained ankle and therapeutic approach through the tecar
https://www.wintecare.ch/en/news/ankle-sprain-epidemiological-data-and-therapeutic-approach-with-tecar-t-plus-device/
Injuries related to ankle sprain are common and often, if neglected or not treated with the correct therapeutic approach, can generate long-term repercussions especially for those who practice sports. […] As it happens for almost all epidemiological analysis of injures, the statistical numbers about the ankle joints vary according to the sources referred to. […] At epidemiological level: 16% of sports injuries involve the ankle area (1). […] 84% of ankle injuries are sprained (1). […] The right ankle is more commonly injured (58%) than the left one (42%) (3). […] The higher prevalence of cases of ankle sprain is recorded between the ages of 10 and 19 (4). […] Males between the ages of 15 and 24 have higher rates of ankle sprains than their female counterparts (4). […] Women over the age of 35 have higher rates of ankle sprains than their male counterparts (4).
#10 Ankle Sprain and Strain Risk Factors
https://www.sports-health.com/sports-injuries/ankle-and-foot-injuries/ankle-sprain-and-strain-risk-factors
Some people have a higher risk of developing ankle sprains and strains than others. […] Risk factors for developing ankle sprains and strains include, but are not limited to: […] Female gender in athletes over 30 (ankle sprains only). Several studies have indicated that females over age 30 are at a significantly higher risk of developing ankle sprains than males in that age group, independent of their body mass index. […] Male gender in young athletes, age 15-24 (ankle sprains only). In teenage and young adult athletes, males appear to have a higher incidence of ankle sprain than their female counterparts in the same age group. […] Prior history of sprains or strains. Persons who have had sprains or strains in the past have a higher risk of undergoing the same injury again than persons who have never had an ankle sprain or strain. […] Patients with one or more of the above risk factors are advised to seek prompt medical attention if they suspect an ankle sprain or strain, especially if they have a history of repeated ankle injuries.
#11 The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies
https://www.lenus.ie/handle/10147/639538?show=full
The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies […] Ankle sprain is one of the most common musculoskeletal injuries, yet a contemporary review and meta-analysis of prospective epidemiological studies investigating ankle sprain does not exist. […] Our aim is to provide an up-to-date account of the incidence rate and prevalence period of ankle sprain injury unlimited by timeframe or context activity. […] One-hundred and eighty-one prospective epidemiology studies from 144 separate papers were included. […] The main findings of the meta-analysis demonstrated a higher incidence of ankle sprain in females compared with males (13.6 vs 6.94 per 1,000 exposures), in children compared with adolescents (2.85 vs 1.94 per 1,000 exposures) and adolescents compared with adults (1.94 vs 0.72 per 1,000 exposures).
#11 The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies
https://www.lenus.ie/handle/10147/639538?show=full
The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. […] Ankle sprain prevalence period estimates were similar across sub-groups. […] Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. […] Participants were at a significantly higher risk of sustaining a lateral ankle sprain compared with syndesmotic and medial ankle sprains.
#12 The epidemiology, evaluation, and assessment of lateral ankle sprains in athletes
https://scholarworks.utrgv.edu/som_pub/369/
Approximately 30,000 ankle injuries occur every day in the United States. With the incidence estimated at more than 3 million a year and at a rate of 2.15/1,000 in the U.S. alone, medical specialists and other healthcare providers caring for the foot and ankle must take notice. […] Ankle sprains account for half of all sports injuries and remains a difficult diagnostic and therapeutic challenge in the athlete. […] The Lateral Ankle Sprain (LAS) is among the most common type of ankle sprains suffered during athletic activities. Up to 80% of LAS are of the inversion type, and 75% lead to recurrence and instability. […] The purpose of this review is to highlight the epidemiology, pathoetiology, pathoanatomy, and biomechanics of the LAS, enabling sports physicians to implement the best practice guidelines and protocols to manage this common enigma.
#13 Epidemiology of Ankle Sprains and Chronic Ankle Instability
https://pmc.ncbi.nlm.nih.gov/articles/PMC6602402/
Among collegiate athletes in the United States, acute ankle sprains are the most commonly reported injury, representing 15% of all injuries reported in this population. […] The incidence rate of acute ankle sprains among athletes in 15 National Collegiate Athletic Association sports ranged from 0.75 to 0.89 sprains/1000 AEs from 1988-1989 through 2003-2004. […] The high incidence rate of acute ankle sprains is due in part to the frequency of reinjury after an initial ankle sprain. […] A history of lateral ankle sprain, in particular, has been described as one of the strongest risk factors for a future lateral ankle sprain. […] Chronic ankle instability can develop after an initial ankle sprain, from multiple injuries to the same structure, or from other mechanisms, ultimately leading to insufficiency of the lateral ankle ligament complex.
#14 The Epidemiology of Ankle Sprains in US High School Sports, 2011-2012 to 2018-2019 Academic Years – PubMed
https://pubmed.ncbi.nlm.nih.gov/35271730/
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. […] To describe the epidemiology of ankle sprains in 16 US high school sports during the 2011-2012 to 2018-2019 school years. […] 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). […] 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.
#15 The Epidemiology of Ankle Sprains In United States High School Sports, 2011/12-2018/19 Academic Years
https://aquila.usm.edu/fac_pubs/20468/
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. […] Describe the epidemiology of ankle sprains in 15 high school sports during the 2011/122018/19 school years. […] Overall, 9,320 ankle sprains were reported (overall rate=2.95/10,000AE; 95%CI: 2.893.01). The highest sport-specific rates were reported in girls’ basketball (5.32/10,000AE), boys’ basketball (5.13/10,000AE), girls’ soccer (4.96/10,000AE), and boys’ football (4.55/10,000AE). […] Across the included academic years, ankle sprain rates generally increased. Compared to the 2011/12 academic year, rates in the 2018/19 academic year overall were 22% higher; non-contact-related and recurrent ankle sprain rates also generally increased, with 91% and 29% increases, respectively. […] Time trends suggest ankle sprain rates have increased across the past decade, particularly among those with non-contact-related mechanisms; this contrasts previous research suggesting decreases in incidence. Findings may pinpoint specific etiological factors that should direct prevention efforts.
#16 Reviewing the Prevalence of Ankle Sprain Injuries – Training & Conditioning
https://training-conditioning.com/news/reviewing-the-prevalence-of-ankle-sprain-injuries/
Everyone suffers an ankle sprain at one point or another. […] The study, entitled The Incidence Prevalence of Ankle Sprain Injury: A Systematic Review Meta-Analysis of Prospective Epidemiological Studies, published the findings of its theory in the journal Sports Medicine. […] The sport category with the highest incidence of ankle sprain was indoor/court sports, with a cumulative incidence rate of 7 per 1,000 exposures or 1.37 per 1,000 athlete exposures and 4.9 per 1,000 h. […] However, the study further stated, Females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity. […] Strong evidence from studies suggests once people sprain their ankle, they are more likely to re-sprain it.
#17 Lateral ankle sprain | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/lateral-ankle-sprain?lang=us
Lateral ankle sprains are the most common ankle injuries with an estimated incidence of 0.2% per year. About half of lateral ankle sprains are due to sports injuries, and they account for many athletic injuries 1-5. The most common ankle injury is ankle sprain and of ankle sprains, a lateral ankle sprain is by far the most common, accounting for up 75-80% of ankle sprains 1. There is a higher incidence in children and adolescents than in adults 2,3. Women are thought to be more frequently affected 2,4. […] The following team sports have an increased incidence in lateral ankle sprain 1-4: basketball, volleyball (indoor), handball, netball, aero ball; field hockey, cricket; football (soccer), Gaelic football; rugby, Australian football. […] Further non-sports-related risk factors are 3-5: high-heeled shoes, previous ankle sprain, hindfoot varus, increased body mass index, impaired proprioception, impaired postural balance or neuromuscular deficits, strength deficits.
#18 Epidemiology of Ankle Sprains and Chronic Ankle Instability
https://pmc.ncbi.nlm.nih.gov/articles/PMC6602402/
A recent review of CAI prevalence suggested that up to 70% of individuals who sustain an acute, incident lateral ankle sprain may develop CAI over a short time period after the initial injury. […] Potentially the most concerning long-term outcome of ankle-sprain injuries is the development of posttraumatic osteoarthritis. […] Future injury-prevention initiatives must continue to take into account the risk for subsequent injury after an initial ankle sprain, CAI, and the development of posttraumatic osteoarthritis in an effort to reduce the burden of these injuries across the population.
#19 Journal of Athletic Training Releases Special Thematic Issue Focused on Ankle Sprains and Instability | NATA
https://www.nata.org/press-release/090719/journal-athletic-training-releases-special-thematic-issue-focused-ankle-sprains
DALLAS, TX A special thematic issue of the Journal of Athletic Training, the National Athletic Trainers Associations scientific publication, was recently released. The themed issue focuses on ankle sprains and instability as ankle sprains are the most common injury experienced by athletes and others who engage in physical activity. […] Additionally, the research reveals that a large number of those who sprain their ankle also develop disorders, such as recurrent ankle sprains, chronic ankle instability and osteoarthritis. […] Acute ankle sprains are among the most common musculoskeletal injuries and up to 70% of individuals who sustain an acute ankle sprain may develop residual physical disability, which may include chronic ankle instability. […] Acute ankle sprains occur at high rates across all levels of sports participation and among other active populations, such as active duty military personnel; however, half of all ankle sprains treated in U.S. emergency departments reportedly did not occur during sport activity.
#20 The epidemiology of chronic ankle instability with perceived ankle instability- a systematic review | Journal of Foot and Ankle Research | Full Text
https://jfootankleres.biomedcentral.com/articles/10.1186/s13047-021-00480-w
Chronic ankle instability, developing from ankle sprain, is one of the most common sports injuries. Investigating the epidemiology of chronic ankle instability is an essential step to develop an adequate injury prevention strategy. However, the epidemiology of chronic ankle instability remains unknown. The prevalence of chronic ankle instability was 25%, ranging between 7 and 53%. The prevalence of chronic ankle instability within participants with a history of ankle sprains was 46%, ranging between 9 and 76%. The prevalence of CAI was 25%, ranging from 7 to 53% and the prevalence of CAI within participants with a history of ankle sprains was 46%, ranging from 9 to 76%. The wide range of the prevalence was mainly caused by exclusion criteria, age, sports discipline, and other factors. To develop a prevention strategy, the clarification of epidemiological data is essential. Factors affecting the prevalence of chronic ankle instability should be investigated and clearly described.
#21 Ankle Sprain | PM&R KnowledgeNow
https://now.aapmr.org/ankle-sprain/
Risk factors and primary prevention strategies address poor ankle proprioception, weak ankle dorsiflexors and invertors, and poor flexibility. Additionally, body mass index, slow eccentric inversion strength, fast concentric plantar flexion strength, passive inversion joint position sense, and peroneus brevis reaction time correlated with lateral ankle sprains. Thirty to forty percent of ankle sprains, especially high ankle and lateral ankle sprains, can result in chronic ankle instability and may ultimately require surgery.
#22 Ankle Injuries and Sprains (Assessment, Symptoms, and Treatment)
https://patient.info/doctor/ankle-injuries-pro
Ankle sprains and injuries are common in primary care, AE and sports medicine. Most are inversion and plantar flexion injuries that lead to damage to the lateral ligaments. […] Between 50% and 70% of people who sustain a lateral ankle sprain will develop chronic ankle instability, which is characterised by lingering pain, instability, injury recurrence, and persistent functional disability. […] Ankle sprains are classified from grade I to grade III depending on their severity. […] Chronic ankle instability may follow an acute lateral ankle sprain. Initial treatment involves bracing or neuromuscular training. However, if symptoms persist, surgery may be considered. […] After a sprain, persistent symptoms remain in up to 30% of individuals. […] Prevention of ankle sprains may be facilitated by wearing walking boots that protect the ankle when hiking over hills or uneven ground, or for manual labour.
#23 Chronic ankle instability | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/chronic-ankle-instability?lang=us
Ankle injuries are common and not only in the context of sports injuries. They have a high recurrence rate and the risk of developing chronic ankle instability after estimates sustaining a first-time ankle sprain are considered as high as up to 40%. […] Risk factors for developing chronic ankle instability include the following: recurrent lateral ankle sprains, multi-ligament injuries, subtalar joint variants or pathologies, impaired proprioception or postural balance, first-time ankle sprain at a younger age, self-reported functional deficit 6 months after the first ankle sprain. […] Chronic ankle instability is associated with the following clinical conditions: pathologic ligament laxity, tibiotalar joint pathologies, subtalar joint pathologies, decelerated proprioception, neuromuscular, postural and strength deficiencies.
#24 5 QUESTIONS TO ASK ABOUT ANKLE SPRAINS | Sports Medicine Today
https://www.sportsmedtoday.com/5-questions-to-ask-about-ankle-sprains-van-23.htm
Ankle sprains are very common. In fact, approximately 2-million ankle injuries occur in the United States every year. Unfortunately, over 70% of ankle sprains occur among individuals with previous ankle sprains, many of which were not completely rehabilitated. The most important risk factor for ankle sprains is a previous ankle sprain. Therefore, individuals should seek medical guidance and possibly formal rehabilitation to prevent recurrent and chronic ankle issues. Completing all phases of rehabilitation allows one to confidently return to sport and lessens the likelihood of chronic ankle issues. The risk of re-injury persists for up to 12 months, even after full rehabilitation. External ankle support and neuromuscular training can reduce this risk and are an important aspect of returning to play safely. The epidemiology of ankle sprains in the United States.
#25
https://www.orthobullets.com/foot-and-ankle/7028/ankle-sprain
Ankle sprains are the most common reason for missed athletic participation. […] Epidemiology: ankle sprains are the most common reason for missed athletic participation. […] Demographics: most common injury in dancers. […] Risk factors: patient-related: limited dorsiflexion, decreased proprioception, balance deficiency. […] Environmental-related: indoor-court sports have the highest risk (basketball, volleyball).
#26 Sprained ankle – Wikipedia
https://en.wikipedia.org/wiki/Sprained_ankle
Ankle sprains can occur through either sports or activities of daily living, and individuals can be at higher or lower risk depending on a variety of circumstances including their homeland, race, age, sex, or profession. […] Overall, the most common type of ankle sprain to occur is an inversion ankle sprain, where excessive plantar flexion and supination cause the anterior talofibular ligament to be affected. A study showed that for a population of Scandinavians, inversion ankle sprains accounted for 85% of all ankle sprains. […] The rate of recurrence is particularly high for athletes in high-risk sports. […] In a study comparing the prevalence of ankle sprains between age, race, and sex, individuals who were aged 10-19 years old had highest instances of ankle sprains. […] Moreover, average ankle sprains for the general U.S. population are estimated at 57 ankle sprains for every 1000 person-years; however, a study showed that for military cadets, instances for ankle sprains were about 10 times those of the general population. […] Another study comparing sex influences on ankle sprains found that male and female counterparts had similar incidence rates of ankle sprains. However, at a specific age range of 19-25 years old, males were found to have a substantially greater rate of ankle sprains than females.
#27 Update on Acute Ankle Sprains | AAFP
https://www.aafp.org/pubs/afp/issues/2012/0615/p1170.html
High ankle sprains often occur in persons participating in football, downhill skiing, and other field sports, and may represent up to 10 percent of ankle sprains in some populations. […] The severity of these injuries varies widely, but cases often result in significant time lost from work or sports (up to four to five months). […] Because a previous ankle sprain is the greatest risk factor for recurrent injuries, a more aggressive approach to follow-up is indicated. […] Patients with significant ankle sprains should be examined four to six weeks after the injury to assess for symptoms or physical findings of ligamentous instability. […] There is substantial evidence that incorporating these exercises is effective at reducing future ankle injuries as well as knee, hamstring, and other lower limb injuries in athletes. […] Substantial evidence supports the effectiveness of air stirrup braces and lace-up supports in protecting against ankle sprains in high-risk sports.
#28 Sprained ankle and therapeutic approach through the tecar
https://www.wintecare.ch/en/news/ankle-sprain-epidemiological-data-and-therapeutic-approach-with-tecar-t-plus-device/
About half of all ankle sprains occur during sports (4). […] In an epidemiological investigation of ankle sprain conducted in Hong Kong (5): 73% of all athletes had a recurrent ankle sprain. […] 59% of these athletes had significant disability and residual symptoms leading to impaired athletic performance. […] From a first analysis it could be said that instability, demographic and environmental factors contribute to increasing the risk of ankle injury. […] The rehabilitation process of post-injury ankle sprain plays a fundamental role in determining any post-traumatic repercussions and recovery times are fundamental. Shorter recovery time is typically related to a lower risk of long-term repercussions.
#29 Lateral ankle sprain | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/lateral-ankle-sprain?lang=us
A major sequel of lateral ankle sprains in particular if repetitive is chronic ankle instability 1-3. More than half of the patients have still residual symptoms between 6 weeks and 18 months 5,10 and up to 30% report pain on activity 2.5 to 5 years after the acute event 9. Up to 5% of athletes sustaining an ankle sprain have to change and up to 4% to stop their sportive activities 3. In non-athletes, up to 6% are not able to continue their previous occupation and a further 15% need additional support to continue it 1. Short-term prognostic factors include weight-bearing status and injury grade, medium-term pain, weight-bearing and a functional activity score 6. There are also reports, which found that MRI is an independent predictor 9.
#30 Health Care Resource Utilization after Acute Ankle Sprains
https://ejournals.eu/czasopismo/zdrowie-publiczne-i-zarzadzanie/artykul/health-care-resource-utilization-after-acute-ankle-sprains
Health Care Resource Utilization after Acute Ankle Sprains […] Ankle sprains are common soft-tissue injuries that are often treated in emergency departments. These injuries can have significant consequences for the patient, including long-term morbidity and loss of productivity. The objective of this study was to examine the direct and indirect health resource utilization associated with ankle sprains. 296 adult patients with acute ankle sprains participated in the study in Kingston, Ontario, Canada. Data were collected using a one-month productivity questionnaire. Overall, 11% (95% CI, 8-15%) of the participants visited a physician following the initial emergency department visit. Almost all (95%; 95% CI, 92-97%) of the participants used medications or supportive treatments and 55% (95% CI, 50-61%) reported taking time off from work, school, or housework. The use of unpaid assistance was indicated by 56% (95% CI, 50-62%). Findings from this analysis highlight the significant patient-related and health care system burden of acute ankle sprains. […] […] Waterman B.R., Owens B.D., Davey S., Zacchilli M.A., Belmont P.J., The epidemiology of ankle sprains in the United States. The Journal of Bone and Joint Surgery (American) 2010; 92(13): 2279-2284.
#31 The Epidemiology of Ankle Sprains in US High School Sports, 2011-2012 to 2018-2019 Academic Years – PubMed
https://pubmed.ncbi.nlm.nih.gov/35271730/
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.
#32 Sprained Ankle – OrthoInfo – AAOS
https://orthoinfo.aaos.org/en/diseases–conditions/sprained-ankle/
An ankle sprain is largely a clinical diagnosis based on how the injury happened, symptoms, and examination by a medical professional. […] Surgical treatment for ankle sprains is rare. […] Outcomes for ankle sprains are generally quite good. With proper treatment and rehabilitation, most patients are able to resume their day-to-day activities after a period of time. Successful outcomes and return to activity depend on: the grade of the sprain, whether there are other injuries, and the patient’s commitment to rehabilitation exercises. Incomplete rehabilitation is the most common cause of chronic ankle instability after a sprain. […] Once you have sprained your ankle, you may continue to sprain it if the ligaments do not have time to completely heal. This can happen if you return to work, sports, or other activities before your ankle heals and is rehabilitated. […] The best way to prevent ankle sprains is to maintain good muscle strength, balance, and flexibility.
#33 Ankle Sprain | UConn Musculoskeletal Institute
https://health.uconn.edu/msi/clinical-services/orthopaedic-surgery/foot-ankle-and-podiatry/ankle-sprain/
The best way to prevent ankle sprains is to maintain good strength, muscle balance and flexibility. […] If you have sprained your ankle in the past, you may continue to sprain it if the ligaments did not have time to completely heal. If the sprain happens frequently and pain continues for more than four weeks to six weeks, you may have a chronic ankle sprain. Activities that tend to make an already sprained ankle worse include stepping on uneven surfaces, cutting actions and sports that require rolling or twisting of the foot, such as trail running, basketball, tennis, football and soccer. […] Surgical treatment for ankle sprains is rare. Surgery is reserved for injuries that fail to respond to non-surgical treatment, and for persistent instability after months of rehabilitation and non-surgical treatment.
#34 Ankle sprains: 10 things you should know
https://www.nps.org.au/consumers/ankle-sprains-10-things-you-should-know
You dont need an ultrasound to diagnose your ankle sprain. However, making an accurate diagnosis can sometimes be a challenge. Damage to different structures can cause similar symptoms such as pain, swelling, bruising and difficulty walking and running. […] Even though your ankle hurts, it doesnt mean you need an X-ray. X-rays can make an accurate diagnosis of a bone fracture (break). They are poor, however, at finding a damaged ligament due to an ankle sprain. […] There are 3 grades of ankle sprain. The amount of fibres that are torn (how severe your ankle sprain is) can be defined as one of three grades: Grade I: only a few tissue fibres torn, Grade II: considerable proportion of tissue torn, Grade III: complete tear of the ligament. […] You can help with treatment in the first few days after injury. If your health professional has decided (following a history and physical examination) that your injury will settle with simple treatment such as rest and ice, you can manage your injury yourself under their supervision in the first few days. […] Exercises help you achieve the best recovery. Exercises are an essential part of recovery after an ankle sprain. […] You may need to see your health professional again. Your health professional may ask you to return in a few days once the swelling has gone down, so they can check your progress.
#35 Journal of Athletic Training Releases Special Thematic Issue Focused on Ankle Sprains and Instability | NATA
https://www.nata.org/press-release/090719/journal-athletic-training-releases-special-thematic-issue-focused-ankle-sprains
Evidence suggests a strong link between a prior ankle sprain and an increased risk for a future ankle sprain. […] Continued investigation into the link between the ankle sprain incident and chronic ankle instability and the development of posttraumatic osteoarthritis is needed. […] The majority of participants in this study did not seek medical treatment for their initial lateral ankle sprains. […] Those who did not seek medical treatment for their initial ankle sprain scored worse on the Foot and Ankle Ability Measure. […] Those who did not seek medical treatment for their initial ankle sprain suffered more recurrent ankle sprains. […] The public needs to be educated on the significance of an ankle sprain and the need for proper treatment and management to prevent long-term joint dysfunction.
#36 Epidemiologic comparison of ankle injuries presenting to US emergency departments versus high school and collegiate athletic training settings | Injury Epidemiology | Full Text
https://injepijournal.biomedcentral.com/articles/10.1186/s40621-018-0163-x
The rate of ankle injuries presenting to US EDs is reported as 2.15 per 1000 person-years. ED studies reported ankle injuries represented 22% to 50% of all sports-related injuries. […] A recent study that evaluated all soccer injuries across multiple settings and age groups demonstrated that more severe injuries, with longer recovery times, presented to the ED setting. […] Several studies have reported prevalence and incidence of ankle sprains are higher in collegiate athletic than high school athletes and higher in females than males. […] Understanding the epidemiology of ankle injuries across various clinical settings may help clinicians better recognize and manage ankle injuries most likely to present to their clinical setting, thus reducing the potential for chronic ankle problems.
#37
https://journals.lww.com/jbjsreviews/fulltext/2022/06000/epidemiology_of_ankle_sprain_in_the_active_duty.2.aspx
Ankle sprain is one of the most prevalent injuries within the military population, resulting in health-care costs, time away from active duty, and negative impacts on overall readiness. […] Female service members appear to be more likely to sustain ankle sprains than male service members. […] There is a need for additional research on prevention methods and rehabilitation programs for ankle sprains in the military population because the rate of ankle sprain in this population exceeds that in populations with less physically demanding lifestyles. Consequently, low-cost prevention strategies could yield substantial benefits.
#38 The Prevalence of Selected Intrinsic Risk Factors for Ankle Sprain Among Elite Football and Basketball Players
https://brieflands.com/articles/asjsm-21709
Therefore, the recognition of factors which may be related to lateral ankle sprain seem to be the cornerstone of an effective ankle sprain prevention program. […] This study showed that some intrinsic risk factors including ankle joint laxity, impaired Single Leg balance test and decreased ankle plantarflexion are more prevalent in athletes with history of acute or recurrent LAS. […] More prospective studies are required for better recognition of intrinsic risk factors of ankle injuries.