Athletic Training Service Characteristics for Patients With Ankle Sprains Sustained During High School Athletics

Abstract

Context Limited information exists on the amount and type of care provided by athletic trainers (ATs) treating athletes who sustained ankle sprains in the high school setting. Objective To describe AT services provided for patients with ankle sprains injured in high school athletics. Design Descriptive epidemiology study. Setting Athletic training facility (ATF) visits and AT services collected from 147 high schools in 26 states. Patients or Other Participants High school student-athletes participating in 13 boys' and 14 girls' sports who sustained a diagnosed ankle sprain during the 2011−2012 through 2013−2014 academic years. The ATs documented 3213 ankle sprains. Main Outcome Measure(s) Number of ATF visits and individual AT services and mean ATF visits (per injury) and AT services (per injury) were calculated by sport and for time-loss injuries (participation-restriction time of at least 24 hours) and non–time-loss injuries (participation-restriction time <24 hours). Results During the 3-year period, 19 925 ATF visits were reported, with an average of 6 (interquartile range = 1−7) ATF visits per ankle sprain. Most ATF visits were for non–time-loss injuries (65.1%). Football accounted for the largest proportions of ankle sprains (27.3%) and ATF visits (35.0%). In total, 71 404 AT services were provided for ankle sprains. Therapeutic activities or exercise were the most common AT services (47.4%), followed by neuromuscular reeducation (16.6%), strapping (14.2%), and modalities (11.5%). An average of 22 (interquartile range = 4−28) AT services were reported per ankle sprain. The average number of AT services per injury was higher among patients with time-loss than non–time-loss injuries (35 versus 19; P < .001). Conclusions The ATs provided a variety of services to treat high school athletes who had sustained ankle sprains, including therapeutic exercises and neuromuscular reeducation, which were supported by research. However, ATs should consider using manual therapy (use supported by grade B evidence) and therapeutic exercise more (use supported by grade A evidence).