Injury characteristics, outcome, and return to play after ankle sprains and Achilles tendon ruptures in tennis

Abstract

Background: Ankle sprains and acute Achilles tendon ruptures are common injuries among recreational tennis players. Objectives: This study investigated the specific cause, return to play, and ability to play tennis after an ankle sprain and Achilles tendon rupture. Methods: Patients who sustained an ankle sprain (n=39) or an Achilles tendon rupture (n=7) while playing tennis were retrospectively evaluated, with a mean follow-up of 6.0 and 5.2 years, and follow-up rates of 80% and 78%, respectively. Results: Ankle sprain patients were younger (39 years), smaller and lighter (BMI males 24.3, females 22.5) than Achilles tendon rupture patients (49 years, BMI males 26.8). Ankle sprains occurred more often on clay (56% [CI 40-72%]) and Achilles tendon ruptures on carpet courts (57% [CI 18-90%]). The return-to-play rate for tennis was 90% in patients with ankle sprains after a mean of 3.6 months and 29% in patients with Achilles tendon ruptures (two patients), with returns occurring at 5 and 36 months. The return to any sport was 97% and 100%, respectively. Twenty-nine players (74%) with an ankle sprain reported no complaints while playing tennis, and 6 (15%) had some instability or slight pain. Twenty-one per cent of all ankle sprain patients experienced subsequent events (1–3), with a 10% recurrence rate after a first-time event and a 33% rate in patients with recurrent instability episodes. Conclusion: The return-to-play rate for tennis was high after an ankle sprain and low after an Achilles tendon rupture. The reason for not returning in recreational players was either fear of re-injury or preference for other sports, not because of injury-related disabling factors. Patients after Achilles tendon rupture who returned to play tennis did not have any functional problems, and patients after ankle sprain rarely experienced minor instability or pain.