Background Sport participation is the leading cause of injury in youth and ankle sprain is the most common sport injury. This study evaluates the effectiveness of neuromuscular training (NMT) in reducing the risk of ankle sprains in youth soccer and basketball players. The secondary objective includes evaluation of sex, age, sport and previous lower extremity (LE) injury as independent risk factors for ankle sprain.

Methods A secondary data analysis of three cohort studies and two randomised controlled trials conducted in one season of play in youth soccer and basketball players (ages 11–18) in Alberta, Canada (2005–2011) was completed. The definition of ankle sprain and injury surveillance methodology was consistent in all studies. Multivariable Poisson regression analysis (controlling for clustering by team) was used to estimate incidence rate ratios (IRR) with 95% confidence intervals (CI), considering confounding and effect modification (e.g., sex, age, sport, previous injury).

Results There were 188 ankle sprains in 171 players in 2,265 study participants. Multivariable analysis suggests that NMT was protective for ankle sprain injury [IRR = 0.69 (95% CI: 0.45–1.05)] based on the point estimate. Sex, age, sport and previous injury did not modify this effect. Independent risk factors for ankle sprain injury included previous LE injury history [(IRR = 1.77 (95% CI: 1.34–2.35)] and participation in basketball vs. soccer [(IRR = 1.98 (95% CI: 1.30–3.01)]. The risk of ankle sprain injury did not differ by sex [IRR = 1.01 (95% CI: 0.53–1.92)].

Conclusions Exposure to a NMT program is protective for ankle sprain injury in youth soccer and basketball players. Independent risk factors for ankle sprain in youth sport include basketball participation (vs. soccer) and previous LE injury. Future research should focus on optimising NMT programs for the prevention of ankle sprain injuries and maximising player-adherence to NMT programs in youth soccer and basketball.