Common Injuries & Problems
High Ankle Sprain (Syndesmosis)
1st December 2017
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A high ankle sprain is a specific type of ankle sprain that occurs between the Shin bone (Tibia) and the Splint bone (Fibula). Although a normal ankle sprain usually occurring over the lateral (outside) ankle ligament is one of the most common injuries seen in sports, the high ankle sprain is a lot rarer.

A high sprain is a result of damage to a structure called the Syndesmosis, this ligamentous fibrous band of tissues connects the two shin bones together.

Causes:  The mechanism most familiar with the injury is an excessive dorsi- flexion (toes and ankle bend up towards the shin) combined with excessive external (Outwards) rotation of the shin.

Symptoms & Diagnosis:
This type of injury can be classified into 3 levels;

Grade 1: In which a small percentage of the fibres are damaged, usually there will be pain on ankle movements and the ankle painful to touch
Grade 2: A much higher percentage of the fibre are damaged, as a result there may be gaping between the Tibia and fibular joint, usually there will be substantial pain, swelling present around the whole point and weight bearing will be painful.
Grade 3: This is a full rupture of all the fibres, he joint will look deformed and possibility it may be dislocated. Pain will be excruciating and not weight will be able to be put onto the leg

Management:

For a Grade 1 and 2 the average recovery time is approx. 0ne-two months.  Grade 3 injuries may require surgery. During the first 48-72hours it is important to following normal PRICE protocols; Protection, Rest, Ice, Compression and Elevation. Weight bearing should be limited during this period if painful to do so. Crutches may be given out for the first couple of days to help with mobility while reduced weight bearing.
Following a full assessment by a physiotherapy and once any x-rays have been cleared, treatment can begin early on, Electrotherapy, soft tissue and manual therapy can help to reduced swelling and aid with healing and scar tissues formation.
Once able to walk pain free a rehabilitation programme can begin, this will involve more active session working to gain strength, movement and proprioception back to the ankle joint.

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