Tall People Have More Sprained Ankles, Especially During Basketball and Volleyball or When Wearing High Heels

If you are tall, and particularly if you are also heavy, you are more likely to sprain your ankle: A prospective study of military recruits found the most statistically significant
factors affecting ankle sprain prevalence were stature and mass [1]. The combination of being both tall and heavy was particularly detrimental. The authors explained that taller recruits had a larger moment of inertia (approximated as mass x height2), and thus common angular accelerations corresponded with greater loads on the tissues of the ankle joint.
The question, however, is why aren’t the larger and thus stronger tissues of taller people better able to sustain the proportionally larger loads? A good thought, but outside of the scope of this article… For now, let’s focus on the results of the study, that taller and heavier people are more likely to experience ankle sprains.

And what sports do tall people like to play? Volleyball and Basketball, where they have an unfair advantage :-). Unfortunately, these are also the sports where ankle injuries are the most common (they account for ~80% of all Volleyball and Basketball injuries) [2]. The typical injury mechanism is where a player lands on another’s foot, and their foot rolls inwards resulting in an inversion sprain. The tissues on the lateral side of the ankle joint, particularly the anterior and posterior talofibular ligaments and the calcaneofibular ligament, are over-stressed.

Add all this up, and here’s how the dreaded small talk should really go, “Wow you’re tall! Do you play basketball? You better take care of your ankles!”

So how do you take care of your ankles? Taping and bracing have both been shown effective as well as balance and jump training programs [4]. And what do you do if you are unlucky enough to join the statistical ranks?  Rest, Ice, Compression, Elevation (RICE, or RICED if you’re OK with
drugs) is a commonly recommended paradigm that you might consider [5]. But
perhaps best to get it looked at by a doctor or physiotherapist and get some imaging done to ensure a proper diagnosis, at least
for your first sprain. For your second sprain (repeats are more probable [1]) you
likely know the drill. For my first ankle sprain (was playing basketball), I did entirely the wrong regimen: played some cool down squash, then stood up in a hot shower for an hour and when I finally learned I should be icing, I overdid it and got frost bite. That, folks,
was stupid!

And one final thing: Tallettes, high heels further increase your chance of ankle sprains [6]. So if you needed one more reason not to make yourself even taller, this, sadly, would be it.

[1] Charles Milgrom, Natan Shlamkovitch, Aaron Finestone, Arieh Eldad, Arie Laor,Yehuda L. Danon, Ofer Lavie, Joseph Wosk, Ariel Simkin, Ein Kerem, “Risk Factors for Lateral Ankle Sprain: A Prospective Study Among Military Recruits”, Foot and Ankle International, 1991.

[2] Daniel Tik-Pui Fong, Youlian Hong, Lap-Ki Chan, Patrick Shu-Hang
Yung, and Kai-Ming Chan, “A Systematic Review on Ankle Injury and Ankle
Sprain in Sports”, Sports Medicine, 2007.

[3] G D McKay1, P A Goldie1, W R Payne, B W Oakes, “Ankle injuries in basketball: injury rate and risk factors”, B J of Journal of Sports Med, 2000.

[4] Bahr R, Lian 0, Bahr IA, “A twofold reduction in the incidence of acute ankle sprains in volleyball after the introduction of an injury prevention program: a prospective cohort study”, Scand J Med Sci Sports, 1997.

[5] Wolfe, Michael W, “Management of Ankle Sprains”, American Family Physician, 2001.

[6] Alicia Foste, Mark G. Blanchett,Yi-Chen Cho,Christopher M. Powers, The Influence of Heel Height on Frontal Plane Ankle Biomechanics: Implications for Lateral Ankle Sprains Foot and Ankle International, 2012.

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