Ankle sprains are the commonest injuries among professional soccer players, accounting for more than 1 in 10 total injuries and more than 2,000 missed matches. Those are some of the key findings of a detailed analysis of ankle sprains recorded in English pro soccer over two competitive seasons, carried out by the FA Medical Research Programme.

Player injuries were prospectively recorded from July 1997 to the end of May 1999 inclusive, with a total of 91 clubs from the English soccer leagues committing themselves to the project, using a specially designed questionnaire.

The main findings relating to the clubs that completed injury records for both seasons (87% in the first year and 76% in the second) are stated below:

• Ankle injuries in general accounted for 17% of the 6,030 total injuries sustained over the two seasons;
• Ankle ligament injuries (sprains) were by far the commonest ankle injuries, accounting for 11% of total injuries. This figure is actually lower than has been documented in other studies, but the researchers believe this may have been partly due to the fact that they excluded injuries which caused players to miss training for less than 24 hours;
• Two thirds of ankle sprains were sustained during matches, with player-to-player contact responsible for 59% of these injuries;
• Of the minority of non-contact sprains, more than three quarters were sustained during landing, twisting and turning, and running;
• Over the two seasons, players were absent for 12,138 days and missed a total of 2,033 matches because of ankle sprains, although more than four out of five such injuries required players to miss one month or less;
• Nearly half of ankle sprains were sustained during the last third of both halves of the match, emphasising the importance of endurance training in ankle rehabilitation to avoid fatigue at the end of each half;
• 44% of ankle injuries were sustained during the first three months of the season, emphasising the importance of pre-season conditioning;
• The re-injury rate for ankle sprains was 9% (higher than the average of 7%), suggesting a need for ‘controlled rehabilitation’;
• Of players who sustained ankle sprains, 32% were wearing some form of ankle support, suggesting a history of such injury and/or an inadvisably early return to play following injury.

The researchers conclude: ‘Ankle sprains (especially those involving the lateral ligament) are common injuries in soccer. It is the frequency and risk of reinjury rather than severity (time missed) that makes these injuries problematic. So emphasis is on prevention through the use of functional profiles…, adequate rehabilitation, preseason conditioning of the ankle, and education of coaches and players.’

Br J Sports Med 2003;37:233-238

Isabel Walker