College athletes with ankle sprain history exhibit greater Fear-Avoidance Beliefs

Context: Postinjury, college athletes have reported elevated levels of fear. However, it is unclear how a history of ankle sprain impacts injury-related fear. Objective: The aim of this study was to determine if Fear-Avoidance Beliefs Questionnaire (FABQ) scores differ between college athletes with a history of a single ankle sprain, those with recurrent ankle sprains, and healthy controls. Design: Cross-sectional design. Setting: National Collegiate Athletic Association institutions. Patients: From a large database of college athletes, 75 participants with a history of a single ankle sprain, 44 with a history of recurrent ankle sprains (≥2), and 28 controls with no injury history were included. Main Outcome Measures: Participants completed an injury history questionnaire and the FABQ. On the injury history form, the participants were asked to indicate if they had ever sustained an ankle sprain and, if yes, to describe how many. FABQ scores ranged from 0 to 66 with higher scores representing greater fear. Results: Athletes with a history of recurrent ankle sprains (median, 28.00; interquartile range, 18.25-38.00) reported higher levels of fear than those with a history of a single ankle sprain (21.00; 8.00-31.00; P = .03; effect size = 0.199) and healthy controls (5.50; 0.00-25.00; P < .001; effect size = 0.431). Athletes with a history of a single sprain reported greater fear than healthy controls (P = .01, effect size = 0.267). Athletes with a history of a single sprain reported greater fear than healthy controls (P = .02, effect size = 0.23). Conclusions: College athletes with a history of ankle sprain exhibited greater levels of fear on the FABQ than healthy controls. These findings suggest that ankle sprains in general may increase injury-related fear and that those with a history of recurrent sprains are more vulnerable.