{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T19:59:56Z","timestamp":1790539196946,"version":"4.1.0"},"reference-count":42,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T00:00:00Z","timestamp":1671148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82172416"],"award-info":[{"award-number":["82172416"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["2022A1515010215"],"award-info":[{"award-number":["2022A1515010215"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["82172416"],"award-info":[{"award-number":["82172416"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003453","name":"Natural Science Foundation of Guangdong Province","doi-asserted-by":"publisher","award":["2022A1515010215"],"award-info":[{"award-number":["2022A1515010215"]}],"id":[{"id":"10.13039\/501100003453","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Ankle sprains are one of the most common injuries in athletic populations. Misdiagnosed and untreated ankle sprains will cause chronic ankle instability (CAI), which can significantly affect the performance of athletes. This study aimed to investigate the prevalence and characteristics of CAI in elite athletes of different sports. Method: This cross-sectional study included 198 elite athletes from Guangdong provincial sports teams. All participants answered a questionnaire about ankle sprains and ankle instability. The severity of their ankle instability was evaluated by the Cumberland Ankle Instability Tool (CAIT). Participants further underwent clinical examinations from sports medicine doctors to determine the presence and characteristics of ankle instability. The datasets were analyzed to determine the differences in prevalence between age, gender, sports teams, and sports categories. Results: In 198 athletes, 39.4% (n = 78) had bilateral CAI while 25.3% (n = 50) had unilateral CAI. Female athletes had a higher prevalence of CAI than male athletes in the study (p = 0.01). Prevalence showed differences between sports categories, and were significantly higher in acrobatic athletes than non-contact athletes (p = 0.03). Conclusions: CAI was highly prevalent among elite athletes in this study, with female athletes and athletes in acrobatic sports being associated with a higher risk of developing CAI in their professional careers. Therefore, extra precautions need to be taken into account when applying ankle protections for these athletes.<\/jats:p>","DOI":"10.3390\/jcm11247478","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T08:41:41Z","timestamp":1671439301000},"page":"7478","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["The Prevalence and Characteristics of Chronic Ankle Instability in Elite Athletes of Different Sports: A Cross-Sectional Study"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2268-4832","authenticated-orcid":false,"given":"Congda","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Sun Yat-sen Memorial Hospital, Guangzhou 510130, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sun Yat-sen Memorial Hospital, Guangzhou 510130, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5002-2636","authenticated-orcid":false,"given":"Jingsong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sun Yat-sen Memorial Hospital, Guangzhou 510130, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhengzheng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sun Yat-sen Memorial Hospital, Guangzhou 510130, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chuan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sun Yat-sen Memorial Hospital, Guangzhou 510130, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sun Yat-sen Memorial Hospital, Guangzhou 510130, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianhui","family":"Fang","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Guangdong Sport Hospital, Guangzhou 510105, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juhua","family":"Peng","sequence":"additional","affiliation":[{"name":"Department of Rehabilitation, Guangdong Sport Hospital, Guangzhou 510105, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiping","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sun Yat-sen Memorial Hospital, Guangzhou 510130, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Sun Yat-sen Memorial Hospital, Guangzhou 510130, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,16]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1007\/s40279-013-0102-5","article-title":"The Incidence and Prevalence of Ankle Sprain Injury: A Systematic Review and Meta-Analysis of Prospective Epidemiological Studies","volume":"44","author":"Doherty","year":"2014","journal-title":"Sports Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1177\/0363546516660980","article-title":"The Epidemiology of Lateral Ligament Complex Ankle Sprains in National Collegiate Athletic Association Sports","volume":"45","author":"Roos","year":"2017","journal-title":"Am. J. Sports Med."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"572","DOI":"10.4085\/1062-6050-344-18","article-title":"An Updated Model of Chronic Ankle Instability","volume":"54","author":"Hertel","year":"2019","journal-title":"J. Athl. Train."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1136\/bjsports-2013-093175","article-title":"Selection criteria for patients with chronic ankle instability in controlled research: A position statement of the International Ankle Consortium","volume":"48","author":"Gribble","year":"2014","journal-title":"Br. J. Sports Med."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lin, C.-I., Mayer, F., and Wippert, P.-M. (2022). The prevalence of chronic ankle instability in basketball athletes: A cross-sectional study. BMC Sports Sci. Med. Rehabil., 14.","DOI":"10.1186\/s13102-022-00418-0"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"612","DOI":"10.1177\/0363546505281813","article-title":"Ligamentous Posttraumatic Ankle Osteoarthritis","volume":"34","author":"Valderrabano","year":"2006","journal-title":"Am. J. Sports Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1800","DOI":"10.1007\/s11999-008-0543-6","article-title":"Etiology of Ankle Osteoarthritis","volume":"467","author":"Valderrabano","year":"2008","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1496","DOI":"10.1136\/bjsports-2016-096189","article-title":"Evidence review for the 2016 International Ankle Consortium consensus statement on the prevalence, impact and long-term consequences of lateral ankle sprains","volume":"50","author":"Gribble","year":"2016","journal-title":"Br. J. Sports Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4085\/1062-6050-46.2.133","article-title":"Chronic Ankle Instability: Evolution of the Model","volume":"46","author":"Hiller","year":"2011","journal-title":"J. Athl. Train."},{"key":"ref_10","first-page":"364","article-title":"Functional Anatomy, Pathomechanics, and Pathophysiology of Lateral Ankle Instability","volume":"37","author":"Hertel","year":"2002","journal-title":"J. Athl. Train."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"463","DOI":"10.1136\/bjsports-2020-103311","article-title":"Understanding chronic ankle instability: Model rich, data poor","volume":"55","author":"Bleakley","year":"2021","journal-title":"Br. J. Sports Med."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Donovan, L., Hetzel, S., Laufenberg, C.R., and McGuine, T.A. (2020). Prevalence and Impact of Chronic Ankle Instability in Adolescent Athletes. Orthop. J. Sports Med., 8.","DOI":"10.1177\/2325967119900962"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1016\/j.ptsp.2020.05.014","article-title":"Prevalence and characteristics of chronic ankle instability and copers identified by the criteria for research and clinical practice in collegiate athletes","volume":"45","author":"Koshino","year":"2020","journal-title":"Phys. Ther. Sport"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1545","DOI":"10.1007\/s40279-014-0218-2","article-title":"Chronic Ankle Instability in Sporting Populations","volume":"44","author":"Attenborough","year":"2014","journal-title":"Sports Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1016\/j.apmr.2006.05.022","article-title":"The Cumberland Ankle Instability Tool: A Report of Validity and Reliability Testing","volume":"87","author":"Hiller","year":"2006","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1186\/1757-1146-1-3","article-title":"Arch height change during sit-to-stand: An alternative for the navicular drop test","volume":"1","author":"McPoil","year":"2008","journal-title":"J. Foot Ankle Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.ptsp.2016.06.010","article-title":"Intra-rater reliability and agreement of various methods of measurement to assess dorsiflexion in the Weight Bearing Dorsiflexion Lunge Test (WBLT) among female athletes","volume":"23","author":"Emparanza","year":"2017","journal-title":"Phys. Ther. Sport"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e14","DOI":"10.1136\/bjsm.2004.011676","article-title":"Long term outcomes of inversion ankle injuries * Commentary","volume":"39","author":"Anandacoomarasamy","year":"2005","journal-title":"Br. J. Sports Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"653","DOI":"10.1177\/107110079801901002","article-title":"Persistent disability associated with ankle sprains: A prospective examination of an athletic population","volume":"19","author":"Gerber","year":"1998","journal-title":"Foot Ankle Int."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1177\/1938640013509670","article-title":"Prevalence of Chronic Ankle Instability in High School and Division I Athletes","volume":"7","author":"Tanen","year":"2014","journal-title":"Foot Ankle Sp\u00e9c."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.apmr.2016.08.474","article-title":"Correlates of Perceived Ankle Instability in Healthy Individuals Aged 8 to 101 Years","volume":"98","author":"Baldwin","year":"2017","journal-title":"Arch. Phys. Med. Rehabil."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"162","DOI":"10.1016\/j.ptsp.2020.09.002","article-title":"The prevalence of chronic ankle instability and its relationship to foot arch characteristics in female collegiate athletes","volume":"46","author":"Kobayashi","year":"2020","journal-title":"Phys. Ther. Sport"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/j.jsams.2015.04.010","article-title":"A snapshot of chronic ankle instability in a cohort of netball players","volume":"19","author":"Attenborough","year":"2015","journal-title":"J. Sci. Med. Sport"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1055\/a-1236-3654","article-title":"Neuromuscular Control of Ankle-stabilizing Muscles-specific Effects of Sex and Menstrual Cycle","volume":"42","author":"Khowailed","year":"2021","journal-title":"Int. J. Sports Med."},{"key":"ref_25","first-page":"46","article-title":"Differences in men\u2019s and women\u2019s mean ankle ligamentous laxity","volume":"20","author":"Wilkerson","year":"2000","journal-title":"Iowa Orthop. J."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"143","DOI":"10.4085\/1062-6050-47.2.143","article-title":"Sex differences, hormone fluctuations, ankle stability, and dynamic postural control","volume":"47","author":"Ericksen","year":"2012","journal-title":"J. Athl. Train."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/S0736-0266(00)90004-4","article-title":"Ankle ligament injury risk factors: A prospective study of college athletes","volume":"19","author":"Beynnon","year":"2001","journal-title":"J. Orthop. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"126","DOI":"10.1007\/s00167-006-0143-5","article-title":"Effects of menstrual-cycle hormone fluctuations on musculotendinous stiffness and knee joint laxity","volume":"15","author":"Eiling","year":"2007","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"672","DOI":"10.1016\/j.jmpt.2018.04.001","article-title":"Medial Longitudinal Arch: Accuracy, Reliability, and Correlation Between Navicular Drop Test and Footprint Parameters","volume":"41","year":"2018","journal-title":"J. Manip. Physiol. Ther."},{"key":"ref_30","first-page":"21","article-title":"Prevalence of Flat Foot and High Arch Foot among undergraduate Physical Therapy students by using Navicular Drop Test","volume":"6","author":"Ashraf","year":"2017","journal-title":"IJART"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"A1","DOI":"10.2519\/jospt.2013.0305","article-title":"Ankle Stability and Movement Coordination Impairments: Ankle Ligament Sprains","volume":"43","author":"Martin","year":"2013","journal-title":"J. Orthop. Sports Phys. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1080\/00913847.2021.1895693","article-title":"Lower extremity injuries in U.S. national fencing team members and U.S. fencing Olympians","volume":"50","author":"Thompson","year":"2022","journal-title":"Physician Sport."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"73","DOI":"10.2165\/00007256-200737010-00006","article-title":"A Systematic Review on Ankle Injury and Ankle Sprain in Sports","volume":"37","author":"Fong","year":"2007","journal-title":"Sports Med."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1886","DOI":"10.1080\/10255842.2015.1069555","article-title":"Spring jumpers vs power jumpers: Ankle joint behavior in elite wushu athletes and implications for performance and injury risk","volume":"18","author":"Benouaich","year":"2015","journal-title":"Comput. Methods Biomech. Biomed. Eng."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.ptsp.2020.12.021","article-title":"Applicability of cutoff scores of Chinese Cumberland Ankle Instability Tool and Foot and Ankle Ability Measure as inclusion criteria for study of chronic ankle instability in Chinese individuals","volume":"48","author":"Li","year":"2021","journal-title":"Phys. Ther. Sport"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"9747","DOI":"10.1038\/s41598-021-87848-x","article-title":"Development of a valid Chinese version of the Cumberland Ankle Instability Tool in Chinese-speaking patients with chronic ankle instability disorders","volume":"11","author":"Wang","year":"2021","journal-title":"Sci. Rep."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"330","DOI":"10.1177\/1938640008327516","article-title":"Effect of foot orthotics on single- and double-limb dynamic balance tasks in patients with chronic ankle instability","volume":"1","author":"Sesma","year":"2008","journal-title":"Foot Ankle Spec"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1249\/MSS.0b013e3180337371","article-title":"The Placebo Effect of Ankle Taping in Ankle Instability","volume":"39","author":"Sawkins","year":"2007","journal-title":"Med. Sci. Sports Exerc."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/j.fcl.2006.05.004","article-title":"Acute Lateral Ankle Sprains in Track and Field Athletes: An Expanded Classification","volume":"11","author":"Malliaropoulos","year":"2006","journal-title":"Foot Ankle Clin."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1177\/03635465030310021201","article-title":"Anterior Drawer Test for Acute Anterior Talofibular Ligament Injuries of the Ankle: How Much Load Should be Applied during the Test?","volume":"31","author":"Tohyama","year":"2003","journal-title":"Am. J. Sport. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"435","DOI":"10.3109\/17453679708996258","article-title":"Mechanics of the anterior drawer and talar tilt tests: A cadaveric study of lateral ligament injuries of the ankle","volume":"68","author":"Bahr","year":"1997","journal-title":"Acta Orthop. Scand."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"619","DOI":"10.1016\/S0268-0033(00)00020-6","article-title":"The manual stress test may not be sufficient to differentiate ankle ligament injuries","volume":"15","author":"Fujii","year":"2000","journal-title":"Clin. Biomech."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7478\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:42:49Z","timestamp":1760146969000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7478"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,16]]},"references-count":42,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jcm11247478"],"URL":"https:\/\/doi.org\/10.3390\/jcm11247478","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,16]]}}}