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High Ankle Sprain

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High Ankle Sprain SYNDESMOSIS INJURY (HIGH ANKLE SPRAIN) A syndesmosis injury, also known as a high WHAT ARE THE SYMPTOMS ● Restore joint proprioception ankle sprain, is an injury to the ligaments OF A SYNDESMOSIS and balance at the top of your ankle. These high ankle INJURY? ● Restore normal function ligaments connect your tibia (shin bone) and ● Pain felt above the ankle that increases ● Walking fi bula (outside leg bone) to your calcaneum with outward rotation of the foot ● Running (heel bones), and form part of your ankle. ● Pain with walking and often signifi cant ● Jumping and landing The injury involves the syndesmosis, a bruising and swelling across the higher ● Speed and agility ligament that holds the lower part of your ankle rather than around the malleolus ● Sport-specifi c skills tibia and fi bula together just above your (ankle bones) ● Resume sport. ankle joint. ● Inability to perform a one-legged calf High ankle sprains are much less raise (going up onto your toes) Phase 1 of treatment is focused around common but are more disabling than your ● Feeling of instability/‘no confi dence’ pain relief and reducing infl ammation. traditional lower ankle sprain (when you jumping on the injured leg. This includes the RICE protocol - rest, ice, roll over the outside of your ankle). They compression and elevation. Treatments must be diagnosed early and appropriate The severity of the symptoms will depend may also include electrotherapy, strapping treatment started, which differs from a on the grade of ankle sprain. Patients with and gentle massage after the fi rst 48 hours. traditional ankle sprain, in order to get best a high ankle sprain without fracture may be Phase 2 of treatment, the therapist will results. able to stand and walk. Pain over the back start mobilising your ankle joint to restore of the ankle is of particular concern and full movement and avoid stiffness. You will WHAT HAPPENS WHEN YOU may be associated with a fracture or bone be prescribed exercises to move your ankle HAVE A SYNDESMOSIS bruising. appropriately and safely without disturbing INJURY? the stability of the healing ligaments. High ankle or syndesmotic injuries do not WHAT’S THE TREATMENT Phase 3 is where strengthening of your heal as well as more common lower ankle FOR SYNDESMOSIS INJURY? ankle begins. These may include localised sprains. The main reason being a lack of It is important to have stability exercises for muscles around the joint ankle stability when weight-bearing, which between the tibia and fi bula because and then progress to involve the entire can prolong recovery. It is important to there is a tremendous amount of force that lower limb and functional strengthening determine whether your injury is stable or passes through this area when walking and with squats and lunges. Balance and unstable. If you play sport at a high level, it running. Once you rupture or overstretch proprioception are key to rehabilitation may require surgical repair. these high ankle ligaments, the bones of and preventing a subsequent injury. your lower leg move apart with every step Your therapist will teach you exercises to WHAT CAUSES A causing pain and loss of function. You will improve your ankle and foot balance and SYNDESMOSIS INJURY? often require crutches or a walking boot in adjustments to movement. High ankle sprains most commonly the beginning. Most injuries will not require Rehabilitation will progress occur when your foot is planted on the surgery, but all injuries will require good introducing agility, and speed work as well ground and then an excessive outward physical therapy rehabilitation. as endurance (when you, and your ankle twisting of your ankle occurs. This can Physical therapy treatment aims to start to fatigue you increase your risk of be caused by you turning on a fi xed foot effectively rehabilitate your ankle and injury). due to studs on your boots, or due to prevent recurrence, or even worse, Your physiotherapist will discuss your a rigid boot used for skiing, skating or premature ankle arthritis. These include: goals, time frames and training schedules snowboarding. Another mechanism to injure ● Injury protection (boot, crutches, with you to optimise your recovery your syndesmosis is if you are standing on strapping), pain relief and control for complete and safe return to sport. your foot and another player makes impact infl ammation Depending on the severity of your injury, with your lower leg or ankle – as in a sliding ● Regain full range of motion this may take anywhere from 2-6 weeks, tackle in soccer or a tackle in rugby. ● Strengthen your ankle and calf muscles up to 3-6 months if you’ve had surgery. The information contained in this article is intended as general guidance and information only and should not be relied upon as a basis for planning individual medical care or as a substitute for specialist medical advice in each individual case. ©Co-Kinetic 2019 PRODUCED BY: TIME-SAVING RESOURCES FOR PHYSICAL AND MANUAL THERAPISTS.
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