Neuromuscular control deficits are independently associated with recurrent ankle sprains in professional male soccer players across a ten-year retrospective cohort

Recurrent ankle sprains pose a persistent challenge in professional soccer, yet how specific neuromuscular control deficits relate to injury recurrence has not been fully elucidated. To examine associations between neuromuscular control deficits and recurrent ankle sprains in professional soccer players. This ten-year retrospective cohort study (2013–2022) enrolled 1,524 professional male soccer players from 18 top-tier clubs. Standardized neuromuscular assessments and multivariable logistic regression models were used to quantify associations between functional deficits and recurrent injury risk. A total of 162 players (10.6%) sustained recurrent ankle sprains. Proprioceptive deficits exceeding 6.0° angular error showed the strongest independent association with recurrence (adjusted OR = 2.87, 95% CI: 1.91–4.31), followed by peroneal strength asymmetries greater than 15% (adjusted OR = 2.34, 95% CI: 1.52–3.61). The composite neuromuscular deficit scoring system achieved a C-statistic of 0.847; the cut-offs reported are exploratory and require prospective validation. Specific neuromuscular control deficits are independently associated with recurrent ankle sprain risk in professional soccer players. Risk stratification based on composite neuromuscular scoring may guide future prevention research, although prospective intervention trials remain necessary to confirm effectiveness.