Prevalence of Functional Ankle Instability and Associated Risk Factors Across Different Age Groups in Saudi Arabian Male Football Players in Madinah Province

Background: Functional ankle instability (FAI) is a sequela of ankle sprain. Despite national league participation in the Kingdom of Saudi Arabia (KSA), the prevalence of FAI among footballers was not studied. The purpose was to investigate the prevalence of FAI and to ascertain the group at higher risk and its associated risk factors among male football players in Madinah Province. Methods: A cross-sectional study consisted of 218 male football players aged 16-17 years (beginners), 18-19 years (youth), and 20 years and above (first team) and used the Arabic version of the Identification of Functional Ankle Instability (Ar-IdFAI) questionnaire after meeting the inclusion and exclusion criteria. A two-stage cluster random sampling was employed. The prevalence was presented as a frequency and a percentage. The Kruskal-Wallis test was performed to assess the age group at risk of FAI. Spearman’s rank correlation (ρ) was employed to report the bivariate correlation between the risk variables and the Ar-IdFAI Score, and a multivariate linear regression model was used to ascertain the risk factors. Results: The prevalence of FAI was 47.7%, with age-group frequencies of 36.5%, 56.2%, and 50.7% in the beginner, youth, and first-team groups, respectively. Regression analysis showed a good model fit: F (4, 213) = 36.219, p < 0.001, R2 = 0.405, and (β = 0.174, t = 2.369, p = 0.019). Regression analysis indicated that injury (β = .275, t = 2.456, p = .017) was the key risk factor among youth, and reinjury in the first team (β = 0.353, t = 2.097, p = .040). Significant group difference between beginners and youth (p = 0.017), demonstrating that youth had the highest prevalence. Conclusion: The present study revealed a 47.7% prevalence of FAI among male football players, especially among youth players (56.2%), with ankle injury as the key risk factor and reinjury as a key concern in the first team. This study emphasizes the importance of integrating systematized rehabilitation to prevent and treat FAI among football players in Madinah province, Saudi Arabia.