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.