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Year : 2019  |  Volume : 19  |  Issue : 3  |  Page : 72-77

Critical review of incidence and etiology of ankle sprain and stress fracture in basketball

Department of Physical Therapy, King Abdulaziz Hospital, Makkah, Kingdom of Saudi Arabia

Date of Submission17-Jun-2020
Date of Decision30-Jul-2020
Date of Acceptance04-Aug-2020
Date of Web Publication21-Aug-2020

Correspondence Address:
Mr. Ahmad Khiyami
Department of Physical Therapy, King Abdulaziz Hospital, Makkah
Kingdom of Saudi Arabia
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DOI: 10.4103/sjsm.sjsm_7_20

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Basketball is the most engaging game to take place in any community. It involves high-intensity physical activities that require changing direction continuously, along with high-load actions. To make this sport safer, it is essential to understand the causes of injuries during games. Furthermore, understanding the intrinsic, extrinsic, biomechanical, psychological, and physiological risk factors, it is also crucial to be aware of the incidence and prevalence of associated injuries. Such knowledge will facilitate the development of new prevention techniques and methods that will help prevent extensive sports injuries and make sports safer.

Keywords: Ankle sprain, basketball, rule changes, stress fracture

How to cite this article:
Khiyami A. Critical review of incidence and etiology of ankle sprain and stress fracture in basketball. Saudi J Sports Med 2019;19:72-7

How to cite this URL:
Khiyami A. Critical review of incidence and etiology of ankle sprain and stress fracture in basketball. Saudi J Sports Med [serial online] 2019 [cited 2022 Jan 24];19:72-7. Available from: https://www.sjosm.org/text.asp?2019/19/3/72/292948

  Introduction Top

It is essential for people to contribute in sports. One of the most significant benefits of engaging in sports is an improvement to overall health which can diminish the risk of many diseases. Moreover, sports play a crucial role in enhancing human psychology. Sports can also enhance people's quality of life, leading to achievement, success, and self-satisfaction.[1]

Jumping and landing is an essential component of basketball, as players must make multiple shots and use many skills such as layup and jumping shots or guarding. These skills are essential in basketball, yet they raise the risk and incidence of injury. Basketball also depends on high-intensity physical activities that require a continuous change of direction along with high-load actions.[2] During a competition, many contact or noncontact injuries can occur. The study shows the lower-limb injuries during competition sustained (58%–66%).[3]

Ben Abdelkrim et al.[4] illustrated that a basketball player's position might lead to several injuries. There are five positions in basketball which are guard, point guards, power forward, small forward, and centers. These positions can play an important role in terms of leading to different injury types due to different performance and endurance according to the player's position. According to Ben Abdelkrim et al.[4] and Harris and Stone,[5] a forward player position is more likely to suffer from a stress fracture. While the center is more likely to get an ankle sprain, a muscle strain, a fracture, or a hand injury due to a high level of physical activity during the game. The shooting guard is more likely to get an ankle sprain injury due to the high rate of jumping and landing. Considering the player's position in relation to lower-limb injuries is very important in order to prevent injuries and should be studied more.

A study demonstrated that the incidence of overall basketball injuries during one competitive season is 9.8/1,000 h,[6] whereas other studies done in Swedish related to elite basketball showed that the incidence rate of basketball injuries is 2.5 injuries/1000 activity-hours in male and 2.85 injuries/1000 h of activity in female players.[7] Another research illustrated that the basketball injury rate associated with the National Basketball Association (NBA) is 19.3/1000 athlete-exposures and 24.9/1000 athlete-exposures among the Women's NBA; the study had done with 702 NBA athletes and 443 Women's NBA athletes.[8]

Moreover, another study had focused on basketball players' physical activity during games and has shown that the player is required to change direction every 2–3 s and to continuously accelerate and decelerate. This places a massive load on the ankle parts, particularly on ligaments, because of the sudden and quick movements. Indeed, basketball can involve 35–46 jumping and landing activities per game, which is 2–4 times greater than that found in soccer, volleyball, or any other sports.[9],[10],[11],[12]

  Ankle Joint Sprain Top

Ankle injuries incur an annual health-care cost of over $4 billion in the U.S. alone.[13] Lateral ligament injuries are the most common, constituting 7%–10% of all admissions to hospital emergency departments.[14],[15],[16],[17] The incidence of acute ankle sprain of 139 players related to basketball was 6.0/1000 h.[6] Moreover, other researches showed that the incidence of ankle sprains related to basketball in emergency departments in the United States is 41.1% (2.15/1000 person-years).[13] Furthermore, another study prepared in U.S. high schools shows that ligament sprain injuries consist of up to 44% of overall lower-limb injuries.[18] Further, ankle injuries are more potential to occur in females than males.[19],[20] They are also more likely to be recurrent at 73% rather than a new injury.[6],[21] Another study shows that ankle injuries occurred at a rate of 3.85 per 1000 basketball players' participation.[22]

Ligament sprain is divided into three grades of injury: 1 – partial tear, 2 – incomplete tear, and 3 – complete tear.[23] The study showed that inversion injuries constitute about 25% of all musculoskeletal system injuries, around 50% of which are related to sporting activity.[24] The lateral ligament of the ankle is made up of the anterior talofibular ligament, calcaneofibular ligament, and posterior talofibular ligament.[25] One or more ligaments may become injured depending on the force applied resulting in the injury. Moreover, as noted earlier, basketball requires an immense amount of jumping and landing.[10] During games, the player may land badly (inversion of the plantar-flexed foot or eversion), twisting the ankle, either inward or outward causing a severe injury to the ankle joint.[26] McKay et al.[22] showed that 45% of ankle injuries occur during landing.

In fact, inversion with plantar flexion is the most prevalent type of ankle injury. When the load is very high, a tear of the anterior talofibular ligament occurs.[27] It also leads to a tearing of the calcaneofibular ligament. This is because the calcaneofibular ligament is the next ligamentous structure to resist stress: if it tears, this leads to ankle joint instability.[28],[29],[30] The injury rate of lateral ankle sprain in the US college athlete between the years 2009 and 2014 is 11.96 male and 9.50 female/10,000 athlete-exposures.[31] The eversion type of ankle injury (medial ankle sprain) is less frequently seen and constitutes up to 5.1% of all ankle injuries with an incidence rate of 3.5/1000 person,[28] alternatively male athletes having a higher incidence than female athletes in this type.[32]

In addition, acute lateral ankle sprains do not cause any long-term disability according to Hertel[33] but may lead to residual symptoms or joint dysfunction on the part of athletes. However, the incidence of recurrent ankle lateral sprain is more than 40%, and it is a significant cause of chronic ankle instability (CAI).[33] Moreover, as many as 80% of patients with CAI are expected to suffer from osteoarthritis (OA) and, in some cases, require surgical intervention.[34] OA can be prevented by developing a prophylactic program which includes advanced mobilization and strengthening exercises that avoid recurrent injury and enhance joint stability. Herb et al.[30] showed that players with a history of acute ankle sprain are more likely to get CAI and generally depending on landing strategies. However, acute ankle injuries and recurrent ankle instability during functional activities have been related to mechanical and functional impairments. Such impairments constitute limitations and restrictions in sports competition or professional activities which consequently affect a sportsperson's health-related life.[35],[36]

The normal biomechanics of the ankle joint when the foot in a nonweight-bearing position, if the ankle is plantar flexed the foot rotates inward, while rotated outward if the ankle is dorsiflexed. The foot rotated internally, if the ankle is dorsiflexed, and externally if plantar flexed during weight-bearing.[28] Many biomechanical risk factors can lead to ankle injuries including increased ankle plantar flexion, residual ligamentous laxity, cavus foot (high-arched foot), postural sway, impaired balance, center of gravity displacement, loss of the base of support, and increased body mass index.[37],[38],[39],[40] They all can lead to a lateral ankle sprain and increase the rate of reinjury.[41],[42] Moreover, postural balance problems, loss of joint position sense, abnormal range of motion (ROM), and impairment muscle reaction time (either very slow or fast) can lead to muscle time imbalance between the agonist and antagonist, muscle weakness which leads to diminishing support to the ankle joint, abnormal gait pattern, and ankle instability (hypermobility).[37],[39],[41],[42] Furthermore, abnormal ankle and forefoot mechanism, muscle tightness, and poor alignment of the lower limb may lead to ankle injuries.

Bali[43] studied the psychological risk factors related to ankle sprain injuries and found that mental readiness was strongly associated with success in sports, as excessive stress, anxiety, tension, fear of injury, aggression, and negative arousal may dramatically diminish an overall player's performance[43] as well as increase the incidence of ankle sprain injuries. Many studies have also shown that psychological aspects significantly affect the general player's performance after an ankle joint injury, leading to a decline in performance and increased fear of reinjury during competition. Moreover, psychological factors can reduce the mental ability during the competition makes players more susceptible to injury. In addition, seeing an injured colleague may also distract athletes, leading to a decrease in performance and an increased risk that they themselves become injured.[44] There are five stages after injury according to the Kübler-Ross model including isolation or denial, anger, bargaining, depression, and acceptance.[45] If the player fails to overcome any of these phases, this may lead to reduced performance and an increase in the incidence of injury.[44] Many studies showed that psychological factors should be assessed in order to improve the player's performance and reduce the injury incidence. Arousal can be measured by electroencephalogram, electromyograph, heart rate, and blood pressure.[46] Furthermore, anxiety can be measured by sport concussion assessment tool[47] or sport anxiety scale.[48]

Moreover, there are significant demographic and morphological factors that affect and increase the incidence of ankle sprain injuries. These include age (younger athletes more than adult athletes due to laxity), gender (female more than male),[49] previous injuries,[50],[51] and somatotype.

Furthermore, physiological risk factors include muscle fatigue, heart failure, reduced cardiorespiratory endurance, central balance problems, co-ordination disorder, residual ligamentous laxity, decreased muscle power, loss of muscle flexibility, and reduced reaction time of the tibialis anterior and gastrocnemius muscles.[38],[41],[52]

In addition, extrinsic risk factors such as day temperature[53] and the playing field surface,[54] ankle bracing, taping, the intensity of competition, equipment, the time of the game or season, the training level, the level of competition, and player position also are key factors.[38],[55] According to McKay et al.,[22] the ankle injury rate increases 4.9 times if there is a previous history and 2.7 times if the player does not stretch his muscles. In addition, another study shows that shoe design does not increase the incidence of ankle sprain in basketball.[56],[57] Therefore, I think that there needs to be more focus on intrinsic and extrinsic risk factors with regard to ankle injuries in basketball.

  Lower-Limb Stress Fracture Injuries Top

Stress fractures are common overuse injuries in the lower limb that are regularly seen in athletes and elite players. They constitute approximately 10% of all overuse injuries in basketball.[58] Another study shows that stress fractures account for 0.7%–20% of all sports injuries in a medical clinic.[59] However, the prevalence may be higher than 15% in a sport such as running.[60] Another study has shown that stress fractures account for up to 7% of all sports injuries[61] and mostly affect larger bones.[62] The familiar site of a stress fracture is in the lower extremities, and it affects women more than men.[63],[64] A stress fracture affects such lower-limb bones as the tibia (34%), distal fibula (24%), metatarsals (18%), the femoral neck and shaft (14%), and the pelvis (6%).[65] The injury mechanism is that the bones fail to adjust to the continuous mechanical load and the summation of repetitive forces during physical activity, and there is an insufficient recovery time for remodeling. Microdamage then accumulates and propagates into a stress fracture.[66],[67],[68] Stress fracture complications include pain, swelling, and missed playing time, which lead to decreased player performance. Surgical intervention results in improved performance metrics for players compared to players whose injuries are treated nonoperatively.[13],[68]

The physiological risk factors of stress fracture include muscle fatigue,[62] a deficiency of Vitamin K which can reduce the healing process,[69] lower-limb joint OA (knee and ankle),[70] age,[71] sex (female more than male),[72] hormonal factors (like postmenopausal women),[73] footwear[74] and low bone density,[73] training parameters, muscle imbalance, restricted joint ROM, and lack of flexibility, whereas biomechanical risk factors include poor skeletal alignment,[75] hyperpronation of the ankle,[58] a high longitudinal arch of the foot,[76] various alignments in the ankle and forefoot,[75] foot deformity, body mass index, central of gravity displacement, and a high degree of external rotation of the hip.[77]

Furthermore, psychological risk factors include depression which can reduce the efficiency of the healing process,[78] anger and anxiety can directly lead to a stress fracture. These factors reduce the athlete's performance dramatically.[79] In addition, there are many extrinsic risk factors which can increase the prevalence of stress fracture including the level of competition, player position, time of the game or season and the training, and play surface.

  Rule Changes Top

Recently, basketball injuries have been reduced as a result of rules being continually changed to make basketball safer and more secure. Given that different age groups participate in this game, the rules should also be designed to protect younger players, especially in schools.

In addition, it has been proved that applying strict adherence to the rules in basketball will prevent injuries. Indeed, the rate of basketball injuries has significantly decreased throughout the world. As noted previously, most basketball injuries occur in the ankle joint. However, there is inadequate research on the relationship between ankle injuries and rule changes.

In basketball, the rules have changed continuously. For example, injuries such as concussion and lower- and upper-limb injuries can be prevented by prohibiting elbow swinging, blocking, and charging, and there has also been the introduction of the 30-s rule.[19] Nowadays, the 30-s rule has changed to 24 s. Furthermore, jewelry and metal items are forbidden. In order to prevent ankle injuries, each player should wear suitable shoes. In addition, using a leg block is forbidden, reducing illegal activity.[80] These new rules should dramatically reduce the injury rate.[81]

Furthermore, there are restricted rule modifications aimed at avoiding injuries such as each player being allowed five fouls. If exceeded, the player will be sent off. In addition, a hand on the dribbler and excessive contact are forbidden. Before rules modifications, these actions were permitted.[82]

  Conclusion Top

In this critical review, we have highlighted the limitations and shortfalls in the current literature which explore how risk factors are related to injuries. We found that studies focusing on risk factors do not clarify the connection between the injury and its risk factors. Furthermore, studies have been carried out in different areas of the world, such as in the USA, Japan, and the UK, without referencing the criteria in other countries. Moreover, the incidence and prevalence rates in some of the studies are out of date (too old) because many rules have recently been changed. I believe that research can encourage changes to rules once the evidence is strong enough.

Moreover, many studies claim that understanding the psychology of players can prevent many injuries. This has been overlooked in Saudi Arabia because of inadequate studies yet may help to reduce treatment cost and even save players' lives. Furthermore, some research criteria in one country do not appropriate in many other countries such as fitness level and the injury rate, that the reason for taking the control group. However, we think that we can reduce the incidence of many injuries by developing and inventing new prophylactic programs. As things stand, there are limitations and gaps in existing prophylactic programs which must be addressed to prevent recurrent injury.

Addressing risk factors is the most suitable and effective way to envisage and predict injuries. We may prevent many sports injuries once we understand the possible risk factors. Among the physiological, psychological, and biomechanical risk factors associated with an ankle sprain that are mentioned above, we believe that the most important factors that can lead to ankle sprain are postural imbalance, joint position sense, ankle dorsiflexion ROM, wrong muscular reaction time, ankle instability, and co-ordination system disorder. Moreover, we suppose that the most significant factor is that of the previous injury, while the field surface and player's position are the most critical extrinsic risk factors. Among the psychological risk factor, anxiety, depression, previous injury, and anger are the most significant factors, whereas the significant factors that lead to stress fracture are joint OA, training parameters, foot deformity and alignment, shifting of COG, depression, and anger.

In conclusion, there needs to be a greater focus on the extrinsic risk factors in basketball, as well as on prophylactic programs aimed at inventing new equipment that makes basketball safe for both elite players and young players.

Financial support and sponsorship


Conflicts of interest

There are no conflicts of interest.

  References Top

Soundy A, Roskell C, Stubbs B, Probst M, Vancampfort D. Investigating the benefits of sport participation for individuals with schizophrenia: A systematic review. Psychiatr Danub 2015;27:2-13.  Back to cited text no. 1
Hasan N, Nuhmani S, Kachanathu SJ, Muaidi QI. Efficacy of complex training on angular velocity of shoulder in collegiate basketball players. J Back Musculoskelet Rehabil 2018;31:859-65.  Back to cited text no. 2
Dick R, Hertel J, Agel J, Grossman J, Marshall SW. Descriptive epidemiology of collegiate men's basketball injuries: National Collegiate Athletic Association Injury Surveillance System, 1988-1989 through 2003-2004. J Athl Train 2007;42:194-201.  Back to cited text no. 3
Ben Abdelkrim N, Chaouachi A, Chamari K, Chtara M, Castagna C. Positional role and competitive-level differences in elite-level men's basketball players. J Strength Cond Res 2010;24:1346-55.  Back to cited text no. 4
Harris GR, Stone MH, O'bryant HS, Proulx CM, Johnson RL. Short-term performance effects of high power, high force, or combined weight-training methods. J Strength Condition Res 2000;14:14-20.  Back to cited text no. 5
Cumps E, Verhagen E, Meeusen R. Prospective epidemiological study of basketball injuries during one competitive season: Ankle sprains and overuse knee injuries. J Sports Sci Med 2007;6:204-11.  Back to cited text no. 6
Colliander E, Eriksson E, Herkel M, Sköld P. Injuries in Swedish elite basketball. Orthopedics 1986;9:225-7.  Back to cited text no. 7
Deitch JR, Starkey C, Walters SL, Moseley JB. Injury risk in professional basketball players: A comparison of Women's National Basketball Association and National Basketball Association athletes. Am J Sports Med 2006;34:1077-83.  Back to cited text no. 8
Matthew D, Delextrat A. Heart rate, blood lactate concentration, and time-motion analysis of female basketball players during competition. J Sports Sci 2009;27:813-21.  Back to cited text no. 9
McInnes SE, Carlson JS, Jones CJ, McKenna MJ. The physiological load imposed on basketball players during competition. J Sports Sci 1995;13:387-97.  Back to cited text no. 10
Nedelec M, McCall A, Carling C, Legall F, Berthoin S, Dupont G. The influence of soccer playing actions on the recovery kinetics after a soccer match. J Strength Cond Res 2014;28:1517-23.  Back to cited text no. 11
Sheppard JM, Gabbett TJ, Stanganelli LC. An analysis of playing positions in elite men's volleyball: Considerations for competition demands and physiologic characteristics. J Strength Cond Res 2009;23:1858-66.  Back to cited text no. 12
Waterman BR, Owens BD, Davey S, Zacchilli MA, Belmont PJ, Jr. The epidemiology of ankle sprains in the United States. J Bone Joint Surg Am 2010;92:2279-84.  Back to cited text no. 13
Kannus P, Renström P. Treatment for acute tears of the lateral ligaments of the ankle. Operation, cast, or early controlled mobilization. J Bone Joint Surg Am 1991;73:305-12.  Back to cited text no. 14
Garrick JG. The frequency of injury, mechanism of injury, and epidemiology of ankle sprains. Am J Sports Med 1977;5:241-2.  Back to cited text no. 15
Lynch SA. Assessment of the Injured Ankle in the Athlete. J Athletic Train 2002;37:406-12.  Back to cited text no. 16
Lopezosa-Reca E, Gijon-Nogueron G, Morales-Asencio JM, Cervera-Marin JA, Luque-Suarez A. Is there any association between foot posture and lower limb-related injuries in professional male basketball players? A cross-sectional study. Clin J Sport Med 2020;30:46-51.  Back to cited text no. 17
Borowski LA, Yard EE, Fields SK, Comstock RD. The epidemiology of US high school basketball injuries, 2005-2007. Am J Sports Med 2008;36:2328-35.  Back to cited text no. 18
Zuckerman SL, Wegner AM, Roos KG, Djoko A, Dompier TP, Kerr ZY. Injuries sustained in National Collegiate Athletic Association men's and women's basketball, 2009/2010-2014/2015. Br J Sports Med 2018;52:261-8.  Back to cited text no. 19
Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wikstrom EA. The Epidemiology of Lateral Ligament Complex Ankle Sprains in National Collegiate Athletic Association Sports. Am J Sports Med 2017;45:201-9.  Back to cited text no. 20
Yeung MS, Chan KM, So CH, Yuan WY. An epidemiological survey on ankle sprain. Br J Sports Med 1994;28:112-6.  Back to cited text no. 21
McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: Injury rate and risk factors. Br J Sports Med 2001;35:103-8.  Back to cited text no. 22
Nuhmani S, Khan MH. Lateral ankle sprain: A review. Saudi J Sports Med 2014;14:14.  Back to cited text no. 23
van den Bekerom MP, Kerkhoffs GM, McCollum GA, Calder JD, van Dijk CN. Management of acute lateral ankle ligament injury in the athlete. Knee Surg Sports Traumatol Arthrosc 2013;21:1390-5.  Back to cited text no. 24
Milner CE, Soames RW. Anatomy of the collateral ligaments of the human ankle joint. Foot Ankle Int 1998;19:757-60.  Back to cited text no. 25
van Dijk CN. Diagnostic Strategies in Patient with Severe Ankle Sprain: University of Amsterdam, The Netherlands; 1994.  Back to cited text no. 26
Raina S, Nuhmani, S. Factors leading to lateral ankle sprain: A review of the literature. J Musculoskeletal Res 2014;17:1430001.  Back to cited text no. 27
Kaumeyer G, Malone TR. Ankle injuries: Anatomical and biomechanical considerations necessary for the development of an injury prevention program. J Orthop Sports Phys Ther 1980;1:171-1.  Back to cited text no. 28
Renstrom FH, Lynch SA. Acute injuries of the ankle. Foot Ankle Clin 1999;4:697-711.  Back to cited text no. 29
Herb CC, Grossman K, Feger MA, Donovan L, Hertel J. Lower extremity biomechanics during a drop-vertical jump in participants with or without chronic ankle instability. J Athlet Train 2018;53:364-71.  Back to cited text no. 30
Roos KG, Kerr ZY, Mauntel TC, Djoko A, Dompier TP, Wikstrom EA. The epidemiology of lateral ligament complex ankle sprains in national collegiate athletic association sports. Am J Sports Med. 2017;45:201-9.  Back to cited text no. 31
Waterman BR, Belmont PJ Jr., Cameron KL, Svoboda SJ, Alitz CJ, Owens BD. Risk factors for syndesmotic and medial ankle sprain: Role of sex, sport, and level of competition. Am J Sports Med 2011;39:992-8.  Back to cited text no. 32
Hertel J. Functional anatomy, Pathomechanics, and pathophysiology of lateral ankle instability. J Athl Train 2002;37:364-75.  Back to cited text no. 33
Harrington KD. Degenerative arthritis of the ankle secondary to long-standing lateral ligament instability. J Bone Joint Surg Am 1979;61:354-61.  Back to cited text no. 34
Hiller CE, Nightingale EJ, Raymond J, Kilbreath SL, Burns J, Black DA, et al. Prevalence and impact of chronic musculoskeletal ankle disorders in the community. Arch Phys Med Rehabil 2012;93:1801-7.  Back to cited text no. 35
Ko J, Rosen AB, Brown CN. Functional performance deficits in adolescent athletes with a history of lateral ankle sprain (s). Phys Ther Sport 2018;33:125-32.  Back to cited text no. 36
Kobayashi T, Tanaka M, Shida M. Intrinsic risk factors of lateral ankle sprain: A systematic review and meta-analysis. Sports Health 2016;8:190-3.  Back to cited text no. 37
Beynnon BD, Murphy DF, Alosa DM. Predictive factors for lateral ankle sprains: A literature review. J Athl Train 2002;37:376-80.  Back to cited text no. 38
Halabchi F, Angoorani H, Mirshahi M, Pourgharib Shahi MH, Mansournia MA. The prevalence of selected intrinsic risk factors for ankle sprain among elite football and basketball players. Asian J Sports Med 2016;7:e35287.  Back to cited text no. 39
Huurnink A, Fransz DP, Kingma I, Verhagen EA, van Dieën JH. Postural stability and ankle sprain history in athletes compared to uninjured controls. Clin Biomech (Bristol, Avon) 2014;29:183-8.  Back to cited text no. 40
Denegar CR, Hertel J, Fonseca J. The effect of lateral ankle sprain on dorsiflexion range of motion, posterior talar glide, and joint laxity. J Orthop Sports Phys Ther 2002;32:166-73.  Back to cited text no. 41
de Noronha M, Refshauge KM, Herbert RD, Kilbreath SL, Hertel J. Do voluntary strength, proprioception, range of motion, or postural sway predict occurrence of lateral ankle sprain? Br J Sports Med 2006;40:824-8.  Back to cited text no. 42
Bali A. Psychological factors affecting sports performance. Int J Phys Educ Sports Health 2015;1:92-5.  Back to cited text no. 43
Mittly VNeacute; meth Z, Mintá l KarBenaT. Mind does matter: The psychological effect of ankle injury in sport. J Psychol Psychother 2016;6:278.  Back to cited text no. 44
Kübler-Ross E. On Death and Dying. New York: Macmillan; 1969.  Back to cited text no. 45
Weinberg RS, Gould D. Foundations of Sport and Exercise Psychology. Champaign, IL: Human Kinetics; 1995.  Back to cited text no. 46
Martens R. Sport Competition Anxiety Test; 1979.  Back to cited text no. 47
Smith RE, Smoll FL, Cumming SP, Grossbard JR. Measurement of multidimensional sport performance anxiety in children and adults: The sport anxiety scale-2. J Sport and Exercise Psychology 2006;28:479-501.  Back to cited text no. 48
Dallinga JM, van der Does HT, Benjaminse A, Lemmink KA. Dynamic postural stability differences between male and female players with and without ankle sprain. Phys Ther Sport 2016;17:69-75.  Back to cited text no. 49
Amoako AO, Nassim A, Keller C. Body mass index as a predictor of injuries in athletics. Curr Sports Med Rep 2017;16:256-62.  Back to cited text no. 50
de Noronha M, França LC, Haupenthal A, Nunes GS. Intrinsic predictive factors for ankle sprain in active university students: A prospective study. Scand J Med Sci Sports 2013;23:541-7.  Back to cited text no. 51
Willems TM, Witvrouw E, Delbaere K, Mahieu N, De Bourdeaudhuij I, De Clercq D. Intrinsic risk factors for inversion ankle sprains in male subjects: A prospective study. Am J Sports Med 2005;33:415-23.  Back to cited text no. 52
Lawrence DW, Comper P, Hutchison MG. Influence of extrinsic risk factors on national football league injury rates. Orthop J Sports Med 2016;4:2325967116639222. Published 2016 Mar 29. doi:10.1177/2325967116639222.  Back to cited text no. 53
OʼKane JW, Gray KE, Levy MR, Neradilek M, Tencer AF, Polissar NL, et al. Shoe and field surface risk factors for acute lower extremity injuries among female youth soccer players. Clin J Sport Med 2016;26:245-50.  Back to cited text no. 54
Murphy DF, Connolly DA, Beynnon BD. Risk factors for lower extremity injury: A review of the literature. Br J Sports Med 2003;37:13-29.  Back to cited text no. 55
Curtis CK, Laudner KG, McLoda TA, McCaw ST. The role of shoe design in ankle sprain rates among collegiate basketball players. J Athl Train 2008;43:230-3.  Back to cited text no. 56
Barker HB, Beynnon BD, Renström PA. Ankle injury risk factors in sports. Sports Med 1997;23:69-74.  Back to cited text no. 57
Korpelainen R, Orava S, Karpakka J, Siira P, Hulkko A. Risk factors for recurrent stress fractures in athletes. Am J Sports Med 2001;29:304-10.  Back to cited text no. 58
Bennell K, Matheson G, Meeuwisse W, Brukner P. Risk factors for stress fractures. Sports Med (Auckland, NZ) 1999;28:91-122.  Back to cited text no. 59
Greaser MC. Foot and ankle stress fractures in athletes. Orthop Clin North Am 2016;47:809-22.  Back to cited text no. 60
Gehrmann RM, Renard RL. Current concepts review: Stress fractures of the foot. Foot Ankle Int 2006;27:750-7.  Back to cited text no. 61
Weidauer LA, Binkley T, Vukovich M, Specker B. Greater polar moment of inertia at the Tibia in athletes who develop stress fractures. Orthopaedic J Sports Med 2014;2:2325967114541411. https://doi.org/10.1177/2325967114541411. [Last accessed on 2020 Jun 20].  Back to cited text no. 62
Wentz L, Liu PY, Haymes E, Ilich JZ. Females have a greater incidence of stress fractures than males in both military and athletic populations: A systemic review. Mil Med 2011;176:420-30.  Back to cited text no. 63
Rizzone KH, Ackerman KE, Roos KG, Dompier TP, Kerr ZY. The epidemiology of stress fractures in collegiate student-athletes, 2004-2005 through 2013-2014 academic years. J Athl Train 2017;52:966-75.  Back to cited text no. 64
Boden BP, Osbahr DC, Jimenez C. Low-risk stress fractures. Am J Sports Med 2001;29:100-11.  Back to cited text no. 65
Miller MD, Thompson SR. DeLee & drez's orthopedic sports medicine: Principles and practice, 4th ed.; 2nd Vol. set (online access included). Beaverton: Ringgold Inc.; 2014. Retrieved from: https://library.iau.edu.sa/docview/1651827111?accountid=136546. [Last accessed on 2020 Jun 17].  Back to cited text no. 66
Mandell JC, Khurana B, Smith SE. Stress fractures of the foot and ankle, part 1: Biomechanics of bone and principles of imaging and treatment. Skeletal Radiol 2017;46:1021-9.  Back to cited text no. 67
Kiel J, Kaiser K. Stress Reaction and Fractures. StatPearls. Treasure Island (FL): StatPearls Publishing LLC.; 2018.  Back to cited text no. 68
Bayramoǧlu M, Ünlütürk N. Nonhealing, progressive stress fractures of the foot in a 13-year-old basketball player: Is vitamin K deficiency a risk factor? J Phys Ther Sci 2017;29:763-6.  Back to cited text no. 69
Vaishya R, Vijay V, Agarwal AK, Vaish A. Single-stage management of advanced bilateral knee osteoarthritis with stress fracture of medial malleolus. J Orthop Case Rep 2018;8:89-92.  Back to cited text no. 70
Milgrom C, Finestone A, Shlamkovitch N, Rand N, Lev B, Simkin A, et al. Youth is a risk factor for stress fracture. A study of 783 infantry recruits. J Bone Joint Surg Br 1994;76:20-2.  Back to cited text no. 71
Hulkko A, Orava S. Stress fractures in athletes. Int J Sports Med 1987;8:221-6.  Back to cited text no. 72
Bennell KL, Malcolm SA, Thomas SA, Reid SJ, Brukner PD, Ebeling PR, et al. Risk factors for stress fractures in track and field athletes. A twelve-month prospective study. Am J Sports Med 1996;24:810-8.  Back to cited text no. 73
Anderson EG. Fatigue fractures of the foot. Injury-Int J Care Inj 1990;21:275-9.  Back to cited text no. 74
Giladi M, Milgrom C, Simkin A, Danon Y. Stress fractures. Identifiable risk factors. Am J Sports Med 1991;19:647-52.  Back to cited text no. 75
Matheson GO, Clement DB, McKenzie DC, Taunton JE, Lloyd-Smith DR, MacIntyre JG. Stress fractures in athletes. A study of 320 cases. Am J Sports Med 1987;15:46-58.  Back to cited text no. 76
Finestone A, Shlamkovitch N, Eldad A, Wosk J, Laor A, Danon YL, et al. Risk factors for stress fractures among Israeli infantry recruits. Mil Med 1991;156:528-30.  Back to cited text no. 77
Nie C, Wang Z, Liu X. The effect of depression on fracture healing and osteoblast differentiation in rats. Neuropsychiatr Dis Treat 2018;14:1705-13.  Back to cited text no. 78
Takeda T, Imoto Y, Nagasawa H, Takeshita A, Shiina M. Stress fracture and premenstrual syndrome in Japanese adolescent athletes: A cross-sectional study. BMJ Open 2016;6:e013103.  Back to cited text no. 79
Collins CL, Fields SK, Comstock RD. When the rules of the game are broken: What proportion of high school sports-related injuries are related to illegal activity? Injury Prev J Int Soc Child Adolesc Injury Prev 2008;14:34-8.  Back to cited text no. 80
Arias JL, Argudo FM, Alonso JI. Review of rule modification in sport. J Sports Sci Med 2011;10:1-8.  Back to cited text no. 81
Gardner RB, Wynns T. 2014-15 NFHS Basketball rules: National Federation Of State High School; 2014.  Back to cited text no. 82


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