What causes ankle sprains?

Updated: Jan 14, 2019
  • Author: Craig C Young, MD; Chief Editor: Sherwin SW Ho, MD  more...
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Mechanical forces exceeding the tensile limits of the ankle joint capsule and supportive ligaments cause ankle sprains.

There are a number of contributing factors, which can be classified as either predisposing or provocative, as follows:

  • Predisposing factors can result from a lack of physical conditioning; they include poor muscle tone and shortened and/or contracted joint capsule or tendons. Poor proprioception can also be a factor, as can inadequate training or experience with the physical activity being performed.

  • Provocative factors include accidents and other unforeseen circumstances that result in mechanical stresses that exceed the tensile limits of the ankle joint capsule and ligaments. Obesity can contribute to sprains by increasing kinetic energy to a point that exceeds joint-design stress limits.

A cohort study analyzed risk factors in ankle injuries from the Cadet Illness and Injury Tracking System (CIITS) database at the United States Military Academy (USMA) from 2005-2009. The results found higher risk of syndesmotic ankle sprains in males who performed at a higher level of athletic competition; male athletes were 3 times more likely to experience medial ankle sprains than female athletes. [15]

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