Background We aimed to identify whether triple hop distance (THD) and asymmetry is associated with ankle injury in elite youth volleyballers. Method A convenience sample of 100 elite youth male volleyball players (age 15.06 ± 0.87 years, height 178.74 ± 5.71 cm, and weight 68.38 ± 6.37 kg) were followed up in this prospective cohort study. Pre-season triple hop measures were obtained in 100 elite youth male volleyball players, and ankle injuries were tracked across the 6-month season. Logistic regression analysis was used to examine the relationship between triple hop distance and asymmetry and injury. Results Eighteen ankle injuries occurred during season. Greater hop distances on the dominant (odds ratio [OR] = 0.28, 95% confidence intervals [CI] = 0.13 to 0.61, p = 0.001; moderate effect) and non-dominant (OR = 0.26, 95% CI = 0.12 to 0.56, p = 0.001; moderate effect) limbs were associated with a lower incidence of injury, as was greater height-normalized distances on the dominant (OR = 0.10, 95% CI = 0.02 to 0.40, p = 0.001; large effect) and non-dominant (OR = 0.08, 95% CI = 0.02 to 0.33, p = < 0.001; large effect) limbs. However, there was no significant association with triple hop test absolute or normalized asymmetry (OR = 1.18, 95% CI = 0.06 to 24.90, p = 0.915; trivial effect) or limb symmetry index (OR = 0.94, 95% CI = 0.87 to 1.01, p = 0.088; trivial effect) and injury risk. Conclusion Lower THD are associated with future ankle injuries in elite volleyballers. The THD potentially offers a simple, reliable, and effective screening tool that can be used in volleyball to identify players at a greater risk of injury before the season commences.
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