As many as one quarther of all ankle injuries involve the ankle syndesmosis and factors that increase risk have yet to be investigated prospectively. This study aimed to identify predictors of ankle syndesmosis injury in football players. Rugby Union and Australian Football League players were recruited during 2010. Rugby League and different Rugby Union players were recruited during 2011. Baseline data collection was comprised of age, body size, flexibility, strength and balance. Bivariate correlations were performed between all predictors. Variables with r≥0.7 had only one variable entered in further analysis. Remaining predictor variables were analysed for association with the presence/absence of ankle syndesmosis injury. Variables with non-significant association with injury (p>0.2) were included in a backward step-wise Cox regression model. 202 male participants aged 21±3.3 years (mean±SD) were recruited of whom 12 (5.9%) suffered an ankle syndesmosis injury. The overall incidence rate was 0.59/1000h sport participation for Rugby Union and Rugby League. Australian Football League training data was not available. No significant predictors were identified; however, participants who sustained an injury during the season performed a higher vertical jump (63.6±8.2cm) and greater Star Excursion Balance Test reach (80.5±5.3cm), than participants who did not sustain an injury: 59.1±7.8cm for Vertical Jump and 77.9±6.1cm for Star Excursion Balance Test. This was normalised for height.
Variables such as age, body size, foot posture, flexibility and muscle strength didn’t increase risk of ankle syndesmosis injury. Jump height and balance performance could contribute to predicting ankle syndesmosis sprains.