The ‘netballer's ankle’: An international survey of the negative sequelae associated with lateral ankle ligament sprains in netball

OBJECTIVES: To determine when netballers first sustain a lateral ankle ligament sprain and describe the prevalence of persistent symptoms, recurrent sprains, and perceived instability. DESIGN: Cross-sectional survey. SETTING: An online survey was distributed across Australia, United Kingdom, and New Zealand. were recruited and asked about their ankle sprain history. PARTICIPANTS: Netballers aged ≥14 years. MAIN OUTCOME MEASURES: History of lateral ankle ligament sprains, persistent symptoms, perceived instability using the Cumberland Ankle Instability Tool (CAIT) and ankle-related disability using the Foot and Ankle Ability Measure (FAAM). RESULTS: The survey received 2144 responses from Australia (52%, n = 1123), United Kingdom (29%, n = 627), and New Zealand (18%, n = 394). Most respondents (87%, n = 1872) reported a history of lateral ankle ligament sprain. Over half (54%, n = 1005) reported their first sprain before age fifteen, and most (89%, n = 1660) experienced persistent symptoms, including fear of re-injury (63%, n = 1172), pain (58%, n = 1080), and stiffness (52%, n = 965). Two-thirds (66%, n = 1423) suffered recurrent sprains, including almost half (42%, n = 897) with bilateral recurrences. Three-quarters (75%, n = 1397) had perceived ankle instability, but ankle disability was less frequent (35%, n = 647). CONCLUSION: Most netballers experience lateral ankle ligament sprains before age fifteen, and an extremely high proportion continue to suffer long-term symptoms and instability.