Study Design Prospective cohort study.

Objectives Determine the ability of clinical outcomes and anthropometrics to predict recurrent injuries in athletes during the same competitive season following return-to-play (RTP) from an ankle sprain.

Background Prediction of recurrent injury may be a valuable step towards minimising long-term consequences of ankle sprains. Limited investigation has predicted single-season recurrent ankle sprains in competitive athletes.

Methods and Measures We evaluated 60 high school and collegiate athletes at RTP following an ankle sprain (F:17, M:43; 17.9±3.3 years; 178.6±10.8 cm; 85.0±24.8 kg). Clinical outcomes included pain (100 mm visual analogue scale), swelling (figure-of-eight girth measurement), dorsiflexion ROM (weight-bearing lunge test), ligamentous laxity (anterior drawer and talar tilt tests), and the Foot and Ankle Ability Measure activity of daily living (FAAM-ADL) and sport (FAAM-S) subscales. Anthropometric outcomes included height, mass, and body mass index (BMI). After RTP, athletic trainers documented recurrent ankle sprains during the same competitive season.

Results Patients with (n=8) and without (n=52) recurrent ankle sprains did not differ in involved-limb pain (12.8±16.1 vs 9.8±13.7, p=0.58), swelling (56.7±4.1 vs 54.4±5.1 cm, p=0.23), dorsiflexion ROM (7.6±4.1 vs 6.9±3.6 cm, p=0.58), FAAM-ADL (85.1±9.1 vs 86.4%±10.8%, p=0.73), and FAAM-S (70.3±10.0 vs 64.8%±19.8%, p=0.44) at RTP. Anterior drawer (p=0.64) and talar tilt (p=0.25) laxity (+/-) was not associated with recurrent injury status. Patients with recurrent ankle sprains had greater height (185.7±9.9 vs 177.5±10.6 cm, p=0.04), mass (104.7±29.7 vs 81.9±22.8 kg, p=0.01), and BMI (30.1±6.7 vs 25.7±5.5 kg/m², p=0.05) than patients without recurrent ankle sprains. Area under receiver operating characteristic curves (AUROC) and diagnostic odds ratios (DOR) exhibited predictive value for height (AUROC=0.71, DOR=4.93), mass (AUROC=0.75, DOR=12.21) and BMI (AUROC=0.71, DOR=9.48).

Conclusions Athletic patients with greater height, mass, and BMI demonstrated greater odds of recurrent ankle sprains in the same competitive season following RTP. Taller and heavier patients may benefit from weight-management education before RTP to prevent recurrent ankle sprains.