Ankle injuries are common in ice hockey because of the nature of the sport. It's a high-speed contact sport played with the feet in rigid boots. The game is played on a hard surface with boards all around. This study reports the number of ankle injuries in two National Hockey League (NHL) franchises. It's the first study of its kind.

Two kinds of ankle sprains were seen: lateral ligament and syndesmosis sprains. Most of the sprains occurred during play time rather than during practice. This study focused on the syndesmosis sprains. A syndesmosis sprain, sometimes called a high ankle sprain injures at least one of the key ligaments that joins the two bones of the lower leg together.

Most of the syndesmosis ankle injuries identified in this study occurred in players who played the forward position. Usually the injury was caused by a fall with the foot turned out (externally rotated). Speeds of 30 mph are common during this sport. Sliding speeds on the ice after a fall have been measured at 15 mph. Players often lose control and are at risk of hitting the goal, another player, or the boards.

Compared to lateral ankle sprains, syndesmosis sprains take much longer to heal. The average number of days missed on the ice was 1.4 for lateral ankle sprains and 45 for syndesmosis sprains. Players with syndesmosis sprains were sore and stiff for several weeks after rehab. Most said they didn't really feel normal until the next season.

According to this study, the hockey skate doesn't protect players from syndesmosis ankle injuries. As the sport gains popularity more and more athletes will be at risk for this injury. Time lost from a sydesmosis injury is much more than for a typical lateral ankle sprain.