Article Text

Download PDFPDF

9 The noncontact ankle sprain is not always the result of a “bad landing”: a systematic video-analysis of 145 non-consecutive cases
  1. Timo Bagehorn1,
  2. Mark de Zee1,
  3. Daniel Fong2,
  4. Kristian Thorborg3,
  5. Uwe G Kersting1,4,
  6. Filip Gertz Lysdal1,5
  1. 1Department of Health Science and Technology, Aalborg University, Denmark
  2. 2School of Sport, Exercise and Health Sciences, Loughborough University, UK
  3. 3Department of Orthopedic Surgery, Sports Orthopedic Research Center—Copenhagen, Amager-Hvidovre Hospital, Copenhagen University, Denmark
  4. 4Institute of Biomechanics and Orthopaedics, German Sport University Cologne, Germany
  5. 5Faculty of Sport, Allied Health and Performance Science, St Mary’s University, UK


Introduction The noncontact lateral ankle sprain is the most common injury in indoor and court sports. Here, it is predominantly described as occurring via a mechanism that typically incites from an initial “bad landing” – with the foot in inverted position. Descriptions of the actual foot landing posture prior to injury has, however, only been documented in few quantitative cases, or simply retrospectively reported by the incurring athletes during prospective trials. Therefore, we aimed to determine the initial foot landing posture using video-recorded injuries.

Materials and Methods In this explorative, observational, non-consecutive, case-series study, two independent, blinded, analysists systematically retrieved and analysed 585 video-recorded lateral ankle sprain injuries.

Results 445 injuries remained after 79 duplicates, and 61 videos with no clear view or non-lateral joint excursion, had been excluded. Of these, 113 (25%) were noncontact and 32 (7%) were indirect-contact injuries. Among the 113 noncontact injuries, 18 (16%) were characterised by initial contact on the lateral side, while 95 (84%) had a medial- or flat landing posture prior to injury. Among the 32 indirect-contact injuries, 9 (28%) injuries had initial contact on the lateral side, while 23 (72%) had a medial- or flat landing posture.

Conclusion Contrary to our expectations, most noncontact injuries were not caused by an initial “bad landing” with the foot in an initially inverted position. It is important to concede that the noncontact lateral ankle sprain can indeed occur and progress irrespective of initial foot landing posture. Joint stiffness might be more important than joint position.

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See:

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.