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Understanding the Ins and Outs of Ankle Sprains in the United States

Posted on: 11/17/2010
Ever twist your ankle (or sprain it) badly enough to go to the emergency department? Every year two million Americans suffer an acute ankle sprain. About half of those people hurt themselves during an athletic event -- but not everyone. The other half were men and women like you and me.

Why does it even matter how many people sprain their ankles? As the authors of this epidemiological study point out, the economic (health care) cost of ankle sprains each year in the United States is two billion dollars! And that doesn't even include the cost of time lost at work, loss of productivity on-the-job, or the cost of long-term disability.

Long-term disability for an ankle sprain? Yup -- as the results of this study show, up to 60 per cent of the folks who go to the emergency department have an ankle sprain severe enough to alter their function for the rest of their lives.

And these figures don't even represent the numbers of teens and adults who see their primary care physician for an ankle sprain. And they certainly don't represent the numbers of people who don't see anyone but just try and treat it themselves.

By the way, an epidemiological study is one that looks at the patterns of health and illness. By looking at who sprains their ankle, it is possible to identify associated risk factors with the idea of preventing the problem.

Understanding who sprains their ankles and why this happens also helps health care professional determine optimal treatment approaches for these patients. Reducing the costs associated with ankle sprains and especially preventing long-term disability are two important goals of a study like this one.

So what do we know now from a study like this one? From examining the records of emergency departments, it was possible to see that overall, men and women sprain their ankles in equal numbers. Some specific age patterns are evident: there is a peak incidence of ankle sprains in women over 30 and men between the ages of 15 and 24.

Ankle sprains occur most often during athletic activities, in particular, during basketball, football, and soccer (in that order). Athletes involved in other sports such as gymnastics, volleyball, and running are also at increased risk of ankle sprains.

Not too surprising is the fact that the peak of sprains occurs in children between ages 10 and 19 as a result of sports, athletics, or other physical activity. But half of all ankle sprains occur while people are at home from falls on stairs or a stumble on a ground-level surface.

What are the conclusions about ankle sprains in the general population from an epidemiologic study like this? Well, first there is a definite association with sports and athletic activates. With more and more young people participating in school sports, competitive physical activities, and recreational events, the likelihood of this injury occurring may increase.

That means it may be a good idea to find cost-effective ways to prevent the problem. Finding the right solution(s) will be the focus of future studies. Some ideas presented included: identifying high-risk individuals, weight control programs, or offering a training program of strengthening and proprioceptive activities to those individuals involved in high-risk sports.

And future studies to investigate other important factors may be a good idea, too. The role of race, obesity, anatomy, nutrition, and preventive ankle bracing are just a few factors that remain to be evaluated.

Captain Brian R. Waterman, MD, et al. The Epidemiology of Ankle Sprains in the United States. In The Journal of Bone and Joint Surgery. October 2010. Vol. 92. No. 13. Pp. 2279-2284.

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