Time‐loss and recurrence of lateral ligament ankle sprains in male elite football: A systematic review and meta‐analysis

Abstract

A literature search was conducted to systematically review and meta‐analyze time‐loss and recurrence rate of lateral ankle sprains (LAS) in male professional football players. Six electronic databases (PubMed, Scopus, Web of Science, PEDRO, CINAHL, and Cochrane) were searched independently, separately both for time‐loss and recurrence from inception until April 30, 2021. In addition, reference lists were screened manually to find additional literature. Cohort studies, case reports, case–control studies and RCT in English language of male professional football players (aged more than 16 years) for which data on time‐loss or recurrence rates of LAS were available were included. A total of 13 (recurrence) and 12 (time‐loss) studies met the inclusion criteria. The total sample size of the recurrence studies was 36,201 participants (44,404 overall initial injuries; 7944 initial ankle sprain [AS] injuries, 1193 recurrent AS injuries). 16,442 professional football players (4893 initial AS injuries; 748 recurrent AS injuries) were meta‐analyzed. A recurrence rate of 17.11% (95% CI: 13.31–20.92%; df = 12; Q = 19.53; I2 = 38.57%) based on the random‐effects model was determined. A total of 7736 participants were part of the time‐loss studies (35,888 total injuries; 4848 total ankle injuries; 3370 AS injuries). Out of the 7736 participants, 7337 participants met the inclusion criteria with a total of 3346 AS injuries. The average time‐loss was 15 days (weighted mean: 15.92; median: 14.95; min: 9.55; max: 52.9). We determined a priori considerable heterogeneity (CI: 18.15–22.08; df = 11; Q = 158; I2 = 93%), so that the data on time‐loss are only presented descriptively. There is an average time‐loss of 15 days per LAS and a recurrence rate of 17%. LAS is one of the most common types of injury with higher recurrence rates than ACL injuries (9%–12%) in professional football players. Nevertheless, the focus of research in recent years has been mostly on ACL injuries. However, the high recurrence rates and long‐term consequences show the necessity for research in the field of LAS in elite football. Yet, heterogeneous data lead to difficulties concerning the aspect of comparability.

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“…However, during the COVID-19 pandemic, lower-injury research has seen an increase in topics and a more granular focus, including studies of specific injury triggers and interventions for recovery. The injury sites studied were the hip, pelvis, hamstring, ankle, and knee, and the research covered a variety of topics, including injury triggers, repetitive injuries to the same site, injury prevention, and rehabilitation ( Fernandez-Baeza et al, 2022 ; Flore et al, 2022 ; Mendez-Villanueva et al, 2022 ; Mohammad and Elsais, 2022 ; Roughead et al, 2022 ).…”

A Rehabilitation Algorithm After Lateral Ankle Sprains in Professional Football (Soccer): An Approach Based on Clinical Practice Guidelines

“… 13 The average time-loss after LAS in elite football players is 15 days and is thus often below the recovery time required for physiological ligament healing. 20,21 This means that elite football players may return to competition too soon with incompletely healed ligaments. 22 Premature RTC is considered to be one of the highest risk factors for re-injury.…”

“… 16 The recurrence rate after LAS in elite football players averages 17%. 20 which is one of the highest recurrence rates of all sports injuries. 13,16 The short time-loss (15 days) and high recurrence rate (17%) raise the question of trivialization of LAS injuries in elite footballers.…”

Comparative Efficacy of Micro-Needle-Knife Therapy and Acupuncture in Acute Ankle Sprains: A Randomized Controlled Trial

“…However, systematic reviews [ 15 ] incorporating analyses from 11 studies indicate that most patients require additional supervision to ensure compliance. Surveys [ 16 ] have also highlighted that 78% of physicians believe patient expectations influence the adherence to rehabilitation guidelines, hence affecting recovery outcomes and potentially leading to chronic ankle sprains [ 17 , 18 ]. Patients often prefer more physician-led interventions to self-administered management approaches [ 19 – 21 ].…”