Injury characteristics and cost of ankle sprains in amateur soccer (football): a national analysis involving 3 years of Australian insurance data

This national retrospective analytical cross-sectional study investigated the injury characteristics and insurance costs associated with ankle sprains in Australian amateur soccer (football). Three years of insurance records (2018-2020) were analysed to describe claim characteristics, costs, and mechanisms of injury, stratified by sex and age group (junior: 7-17 years; senior: 18-34 years; veteran: 35+ years). Categorical variables were presented as frequencies and percentages and compared using Chi-squared or Fisher's exact tests, while cost data were reported as means ± standard deviation (SD) with 95% confidence intervals (CI). Across three football seasons, 749 ankle sprain claims were reported, with a total insurance cost of AU$1,727,858 and a mean cost of AU$2,307 per claim. Indirect costs (AU$1,117,711) accounted for 65% of total expenditure and were six-fold higher than direct medical costs. Male players were responsible for 80% of total costs, reflecting higher claim numbers, while senior players (18-34 years) contributed 74% of the financial burden. Syndesmosis sprains were uncommon (3%) but had the highest mean cost (AU$7,690). Direct contact (56%) was the most common injury mechanism, although non-contact sprains incurred higher mean costs. No significant sex-based differences were observed in injury characteristics; however, junior players sustained proportionally more tackle-related sprains and fewer non-contact sprains than senior or veteran players. Ankle sprains impose a substantial economic burden within the insurance-covered costs captured in this dataset in amateur football, driven primarily by indirect costs. The disproportionate cost of syndesmosis and non-contact injuries identifies key areas for prevention and provides data for future economic evaluations in football.