The Epidemiology Of Ankle Sprains In Youth, High School, And College Lacrosse

Abstract

Understanding how ankle sprain injury incidence varies by level of play in male and female lacrosse players is important in informing level- and sport-specific injury prevention strategies. PURPOSE: Describe the epidemiology of ankle sprains in youth, high school (HS), and college lacrosse in the 2014/15-2016/17 seasons. METHODS: Youth data originated from 10 leagues in 5 states (21 boys’ and 21 girls’ team-seasons). HS data originated from the National Athletic Treatment, Injury and Outcomes Network (22 boys’ and 15 girls’ team-seasons). College data originated from the National Collegiate Athletic Association Injury Surveillance Program; 20 men’s and 47 women’s team-seasons). Athletic trainers (ATs) reported athlete-exposure (AE) and injury data from practices and competitions. Injury rate ratios (IRR) compared injury rates by level of play. Sex differences were not examined as these sports have different rules. IRRs with 95% confidence intervals (CI) excluding 1.00 were considered significant. We calculated the proportions of time loss (TL) injuries (resulting in participation restriction time ≥24 hours) and injury mechanism distributions. RESULTS: Ankle sprain rates per 1000AE were 0.77 (n=20), 0.36 (n=13), and 0.54 (n=62) in youth, HS, and collegiate male players, respectively, and 1.20 (n=11), 0.90 (n=20), and 0.56 (n=55) in youth, HS, and collegiate female players, respectively. Ankle sprain rates were higher in youth girls versus college women (IRR=2.15, 95%CI: 1.12-4.11), and youth boys versus HS boys (IRR=2.14, 95%CI: 1.07-4.31). Overall, 50% of ankle sprains in female lacrosse players were TL injuries; proportions of TL injuries in male lacrosse players increased with level of play (40.0%, 62.9% and 71.2%, respectively). Also, 56.2% of male ankle sprains and 39.2% of female ankle sprains were due to non-contact mechanisms. Overall, proportions of player contact-related ankle sprains increased with level of play (6.5%, 18.2%, and 29.1%, respectively). CONCLUSIONS: Ankle sprain rates varied by level of play in male and female lacrosse players. Variations associated with TL injuries and player contact-related injuries may highlight the need for level-specific injury prevention strategies. Future research should target reducing the incidence of non-contact ankle sprains.