Sex-related differences in functional and psychological recovery-related outcomes after lateral ankle sprain assessed with the Ankle-GO score

<title>Abstract</title> <p>Lateral ankle sprain (LAS) is a highly prevalent injury associated with incomplete recovery and frequent recurrence, and sex may influence recovery. Yet few studies have examined sex-related differences across the return-to-sport continuum after LAS. Using the recently developed Ankle-GO score, sex-related differences were investigated in a retrospective analysis of 10,495 individuals (6,467 males, 4,028 females) assessed after LAS. Multivariable linear regression, adjusted for age, body mass index, time from injury, and sport type and level, examined the association between sex and the total Ankle-GO score and its components; single-leg stance was analysed by ordinal logistic regression. After adjustment, males scored 1.50 points higher on the 25-point Ankle-GO than females (95% CI 1.28–1.73; p &lt; 0.001), slightly exceeding the previously reported minimal detectable change for repeated individual measurements. The difference was driven mainly by psychological readiness (+ 2.63%; p &lt; 0.001) and hopping tasks (side hop − 2.52 s; figure-of-8 hop − 1.65 s; both p &lt; 0.001), whereas self-reported function and dynamic balance showed no meaningful sex difference. Females outperformed males on static single-leg balance (OR 0.86; p &lt; 0.001). These domain-specific differences warrant consideration in assessment and should be investigated prospectively when developing targeted rehabilitation strategies.</p>