Epidemiology and mechanisms of tennis-related ankle and foot injuries presenting to United States emergency departments: A 10-year national analysis (2015-2024)

Abstract

Objective: To characterize the epidemiology, demographics, diagnoses, mechanisms of injury, and temporal trends of tennis-related ankle and foot injuries presenting to United States emergency departments between 2015 and 2024. Methods: This descriptive epidemiology study used the National Electronic Injury Surveillance System database to identify tennisrelated ankle, foot, and toe injuries presenting to United States emergency departments from January 1, 2015, through December 31, 2024. Demographic characteristics, injury diagnoses, body-part involvement, injury location, disposition, narrative mechanism, and temporal trends were analyzed. National estimates were calculated using NEISS sample weights, and approximate 95% confidence intervals were calculated for key proportions to contextualize estimate stability. Results: A total of 616 unweighted cases met inclusion criteria, corresponding to an estimated 22,497 emergency-department presentations nationally. Females accounted for 53.1% of injuries, while males accounted for 46.9%. The most affected age groups were 20-44 years (32.5%) and 14-19 years (31.0%). The ankle represented the most frequently injured body part, accounting for 73.1% of injuries. Sprains and strains were the most common diagnosis (63.2%), with ankle sprains/strains comprising the largest single diagnosis-body part combination (53.9%). Acute non-fall, non-contact injuries represented the predominant mechanism (74.2%). Most injuries occurred at sports and recreation facilities (77.6%), and 98.7% of patients were treated and released from the emergency department. No statistically significant temporal trends were observed across age groups. Conclusion: Tennis-related ankle and foot injuries presenting to United States emergency departments are predominantly ankle sprains sustained through acute non-contact mechanisms. These findings should be interpreted as a descriptive estimate of emergencydepartment burden rather than sport-wide incidence. Tennis-specific prevention programs emphasizing neuromuscular control, balance training, proprioception, and ankle stabilization may help reduce injury burden among tennis players. Level of Evidence III; Retrospective Descriptive Epidemiological Study.