Abstract

Introduction: Ankle sprains are among the most frequent musculoskeletal injuries in tactical populations, particularly during structured physical training. Although their epidemiology is well established in military cohorts, data integrating imaging patterns and occupational impact in active-duty law enforcement personnel remain limited. This study aimed to characterize the epidemiology, structural injury patterns, and work incapacity associated with ankle sprains in a specialized police unit. Methods: A retrospective observational study was conducted using clinical and occupational health records from the Special Police Unit Intervention Corps of the Portuguese Public Security Police between January 1, 2018, and December 31, 2025. Cases with a clinical diagnosis of ankle sprain were included. Demographic characteristics, professional rank, injury context, imaging findings, and duration of medically certified work incapacity were collected. Imaging findings were categorized using a hierarchical structural classification (fracture, combined ligament injury, isolated ligament injury, tendon pathology and no imaging). Descriptive statistics and non-parametric inferential tests were applied. Results: A total of twenty-eight ankle sprains were identified, all in male officers (mean age 37.0 years). Most injuries occurred during physical training (85.7%), with 14.3% sustained during operational duty. Imaging was performed in 53.6% of cases. The anterior talofibular ligament was involved in 32.1% of cases. Isolated ligament injuries accounted for 21.4%, combined ligament injuries for 14.3%, tendon pathology for 7.1%, and fractures for 10.7%. Work incapacity ranged from 0 to 251 days, with a median of 22.5 days (IQR 0–65.7) and mean of 44.3 days. Incapacity duration differed significantly across structural categories (H = 13.80, p = 0.009), with combined ligament injuries (median 119.5 days) and fractures (median 90 days) demonstrating the longest absence. Cases undergoing imaging showed significantly longer incapacity than non-imaged cases (p = 0.004). Conclusion: In this specialized police unit, ankle sprains were predominantly trainingrelated and frequently involved the lateral ligament complex. Greater structural complexity was significantly associated with prolonged work incapacity. These findings highlight the occupational impact of ankle sprains in law enforcement and support the implementation of targeted prevention strategies and structured rehabilitation pathways to optimize return-toduty timelines.

Keywords

ankle sprain, occupational injury, police officers, ligament injury, return to duty, work disability