Predictive factors for ankle syndesmosis injury in football players: a prospective study.
OBJECTIVE
Up to 25% of all ankle injuries involve the ankle syndesmosis and factors that increase risk have yet to be investigated prospectively. This study aimed to identify predictors of ankle syndesmosis injury in football players.


METHODS
A prospective study.


METHODS
Rugby Union and Australian Football League players were recruited during 2010. Rugby League and different Rugby Union players were recruited during 2011. Baseline data collection included: age, body size, flexibility, strength and balance. Bivariate correlations were performed between all predictors. Variables with r ≥ 0.7 had only one variable entered in further analysis. Remaining predictor variables were analysed for association with the presence/absence of ankle syndesmosis injury. Variables with non-significant association with injury (p>0.2) were included in a backward step-wise Cox regression model.


RESULTS
202 male participants aged 21 ± 3.3 years (mean ± SD) were recruited of whom 12 (5.9%) sustained an ankle syndesmosis injury. The overall incidence rate was 0.59/1000 h sport participation for Rugby Union and Rugby League. Australian Football League training data was not available. No significant predictors were identified; however, participants who sustained an injury during the season performed a higher vertical jump (63.6 ± 8.2 cm) and greater Star Excursion Balance Test reach (80.5 ± 5.3 cm), than participants who did not sustain an injury: 59.1 ± 7.8 cm for Vertical Jump and 77.9 ± 6.1 cm for Star Excursion Balance Test. This was normalised for height.


CONCLUSIONS
Variables such as age, body size, foot posture, flexibility and muscle strength did not increase risk of ankle syndesmosis injury. Jump height and balance performance may play a role in predicting ankle syndesmosis sprains.
Faculty of Health Sciences, University of Sydney, Australia. Electronic address: amy.sman@sydney.edu.au.
Amy D
AD
Sman
Faculty of Health Sciences, University of Sydney, Australia.
Claire E
CE
Hiller
Sports Clinic, University of Sydney, Australia.
Katherine
K
Rae
Castlereagh Imaging, Australia.
James
J
Linklater
Department of Orthopaedic Surgery, University of Ottawa, Canada.
John
J
Morellato
Department of Physiotherapy, North Shore Private Hospital, Australia.
Nathan
N
Trist
Faculty of Health Sciences, University of Sydney, Australia.
Leslie L
LL
Nicholson
Faculty of Health Sciences, University of Sydney, Australia.
Deborah A
DA
Black
Faculty of Health Sciences, University of Sydney, Australia.
Kathryn M
KM
Refshauge
D000293:Adolescent; D016512:Ankle Injuries / Q000453:epidemiology*; D001265:Athletic Injuries / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D005538:Football / Q000293:injuries*; D006801:Humans; D008297:Male; D011446:Prospective Studies; D055815:Young Adult
Ankle; Ankle injuries; Lateral ligament; Risk factors; Sports injury; Sprain