{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T18:42:46Z","timestamp":1793558566506,"version":"4.5.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2025,4,10]],"date-time":"2025-04-10T00:00:00Z","timestamp":1744243200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100019115","name":"National Football League Players Association","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019115","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006425","name":"National Football League Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006425","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Ankle sprains in American football resulting from external rotation and eversion (EE) mechanisms remain a persistent injury that often involves player-to-player contact. Currently, there is little research that describes the frequency or source of this contact in American football and what scenarios are responsible for these injuries across different player positions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To identify injury scenarios of ankle sprains that result from EE mechanisms in the National Football League (NFL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Descriptive epidemiology study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Ankle sprains reported during NFL games over 4 consecutive seasons (2017-2020) were identified through a query of the NFL Electronic Medical Record by an independent epidemiological company based on a set of clinical impression codes. Injuries with available video to view the injury enabled the identification of ankle sprains that resulted from EE mechanisms. Standardized terminology was developed to systematically describe and categorize each injury.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 257 ankle sprains resulting from EE mechanisms were identified from a review of 670 ankle sprains and grouped into 8 standardized injury scenarios. Direct contact to the injured player\u2019s foot, ankle, or leg from a large external mass, such as an opponent\u2019s pelvis, accounted for 79% of reviewed injuries. Direct contact from a large external mass was the most common scenario for all positions except safeties, and 83% of running back injuries were the result of a tackle. Only 15% of injuries reviewed resulted from injury scenarios in which injurious loading was transmitted solely through the cleat-surface interaction. Safeties and cornerbacks were more commonly involved in these nondirect injury scenarios, such as change of direction, where current interventions may prove more effective.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>EE ankle sprains were observed to occur from 8 different injury scenarios that varied by player position. Interventions through training, bracing, or changing cleat-surface interaction may not be effective for all injury scenarios. Tackling technique may be a unique intervention for running backs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03635465251329181","type":"journal-article","created":{"date-parts":[[2025,4,11]],"date-time":"2025-04-11T02:54:47Z","timestamp":1744340087000},"page":"1281-1290","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Injury Scenarios of Ankle Sprains in the National Football League: External Rotation and Eversion Mechanisms"],"prefix":"10.1177","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1519-9342","authenticated-orcid":false,"given":"Cody M.","family":"O\u2019Cain","sequence":"first","affiliation":[{"name":"Biomechanics Consulting and Research, LLC, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. Meade","family":"Spratley","sequence":"additional","affiliation":[{"name":"Biomechanics Consulting and Research, LLC, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1694-4562","authenticated-orcid":false,"given":"Kristy B.","family":"Arbogast","sequence":"additional","affiliation":[{"name":"Center for Injury Research and Prevention, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J.","family":"Lessley","sequence":"additional","affiliation":[{"name":"Biomechanics Consulting and Research, LLC, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. Britt","family":"Evans","sequence":"additional","affiliation":[{"name":"Biomechanics Consulting and Research, LLC, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe M.","family":"Cormier","sequence":"additional","affiliation":[{"name":"Biomechanics Consulting and Research, LLC, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mackenzie M.","family":"Herzog","sequence":"additional","affiliation":[{"name":"IQVIA, Durham, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nate","family":"Weir","sequence":"additional","affiliation":[{"name":"Green Bay Packers, Green Bay, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff R.","family":"Crandall","sequence":"additional","affiliation":[{"name":"Biomechanics Consulting and Research, LLC, Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Coughlin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, University of California \u2013 San Francisco, San Francisco, California, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert B.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Bellin Health Titletown Sports Medicine and Orthopedics, Green Bay, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,4,10]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546503262023"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.26603\/ijspt20180379"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354659101900315"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516667914"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.2021.1924046"},{"issue":"1","key":"e_1_3_2_7_2","first-page":"15","article-title":"Syndesmotic ankle sprains in football: a survey of National Football League athletic trainers","volume":"34","author":"Doughtie M.","year":"1999","unstructured":"Doughtie M. Syndesmotic ankle sprains in football: a survey of National Football League athletic trainers. J Athl Train. 1999;34(1):15.","journal-title":"J Athl Train"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738119854759"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658301100302"},{"issue":"5","key":"e_1_3_2_10_2","article-title":"Traction forces generated during studded boot-surface interactions on third-generation artificial turf: a novel mechanistic perspective","volume":"1","author":"Forrester S","year":"2019","unstructured":"Forrester S, Fleming P. Traction forces generated during studded boot-surface interactions on third-generation artificial turf: a novel mechanistic perspective. Eng Rep. 2019;1(5):e12066.","journal-title":"Eng Rep"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1177\/1098214011426594"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-010-1100-x"},{"issue":"4","key":"e_1_3_2_13_2","first-page":"364","article-title":"Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability","volume":"37","author":"Hertel J.","year":"2002","unstructured":"Hertel J. Functional anatomy, pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train. 2002;37(4):364.","journal-title":"J Athl Train"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518756328"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2011.07.014"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518804498"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967115581593"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000711"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546520922547"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1177\/2325967118781333"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546511422332"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.11613\/BM.2012.031"},{"issue":"1","key":"e_1_3_2_23_2","first-page":"68","article-title":"The anatomy and mechanisms of syndesmotic ankle sprains","volume":"36","author":"Norkus SA","year":"2001","unstructured":"Norkus SA, Floyd RT. The anatomy and mechanisms of syndesmotic ankle sprains. J Athl Train. 2001;36(1):68.","journal-title":"J Athl Train"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465010290011001"},{"issue":"1","key":"e_1_3_2_25_2","first-page":"29","article-title":"The effects of spatting and ankle taping on inversion before and after exercise","volume":"32","author":"Pederson TS","year":"1997","unstructured":"Pederson TS, Ricard MD, Merrill G, Schulthies SS, Allsen PE. The effects of spatting and ankle taping on inversion before and after exercise. J Athl Train. 1997;32(1):29-33.","journal-title":"J Athl Train"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546514529643"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1177\/03635465990270061201"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1177\/036354658501300408"},{"key":"e_1_3_2_29_2","first-page":"40","article-title":"Incidence and variance of foot and ankle injuries in elite college football players","volume":"40","author":"West R","year":"2011","unstructured":"West R, Bradley JP. Incidence and variance of foot and ankle injuries in elite college football players. Am J Orthop. 2011;40:40-44.","journal-title":"Am J Orthop"},{"issue":"1","key":"e_1_3_2_30_2","first-page":"93","article-title":"Management of ankle sprains","volume":"63","author":"Wolfe MW","year":"2001","unstructured":"Wolfe MW, Uhl TL, Mattacola CG, McCluskey LC. Management of ankle sprains. Am Fam Physician. 2001;63(1):93-104.","journal-title":"Am Fam Physician"}],"container-title":["The American Journal of Sports Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03635465251329181","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03635465251329181","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03635465251329181","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T09:20:28Z","timestamp":1779268828000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03635465251329181"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,10]]},"references-count":29,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["10.1177\/03635465251329181"],"URL":"https:\/\/doi.org\/10.1177\/03635465251329181","relation":{},"ISSN":["0363-5465","1552-3365"],"issn-type":[{"value":"0363-5465","type":"print"},{"value":"1552-3365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,10]]}}}