High Ankle Sprain Treatment for Syndesmosis Injury

High Ankle Sprain - Syndesmosis Injury

A sprained ankle is one of the most common injuries for athletes, as well as people of all activity levels and lifestyles. There are different types of sprains, and a High Ankle Sprain, also known as a Syndesmosis Injury, can be serious and painful.

It only takes one wrong step to cause an injury to the foot or ankle. While low ankle sprains are more common, a high ankle sprain usually comes with a longer recovery time.

Having a grasp on the causes of high ankle sprains, as well as the symptoms and the most effective treatment approaches, can help amateur or professional athletes, and anyone else suffering from a syndesmosis injury, get back on their feet as soon as possible.

What is a High Ankle Sprain of the Syndesmosis Joint?

In the lower leg and high ankle, the distal tibia/fibula joint is held together by a membrane that extends the length of the bones, which helps secure and stabilize it.

This is known as the syndesmosis joint of the ankle and it is connected to syndesmotic ligaments.

A high ankle sprain is any injury to either the ligaments of the high ankle, the syndesmosis membrane or, in some cases, both.

In very serious cases, syndesmosis ruptures or tears are associated with fractures in the tibia and fibula bones of the upper ankle.

These types of fractures and membrane ruptures can make the joint significantly weak and unable to sustain a person’s weight.

Syndesmosis Sprain or High Ankle Sprain

High Ankle Sprain Symptoms

A high ankle sprain comes with many of the normal symptoms of a low ankle sprain, such as pain and swelling.

But there are some additional signs that can indicate a syndesmosis injury.

Symptoms of a high ankle sprain can include:

  • Moderate swelling in the lower leg, just above the ankle
  • Tenderness to the touch in the high ankle tibiofibular joint
  • Pain when bearing weight on the foot
  • Tenderness or pain with dorsiflexion, which is the technical term for moving the toes up toward the shin
  • Pain when rotating the ankle
  • Bruising to the foot or ankle

Knowing some of the common causes of high ankle sprains can help athletes and others try to avoid this painful injury.

Causes of a High Ankle Sprain or Syndesmosis Injury

One of the most common causes of a high ankle sprain or syndesmosis injury is over-rotating the foot toward the outer side of the leg.

Athletes are at the greatest risk of high ankle sprains, especially those who compete in medium to high-impact sports, as well sports with quick stop and start motions.

For example, basketball, football, and volleyball players are at risk for a high ankle sprain from landing on another player’s foot or body at the end of a jumping movement.

During this type of collision, both the weight of the athlete and gravity create a force greater than the ankle’s ability to support it.

However, skiers with their feet secured in boots can also suffer from a high ankle sprain when the force of a twist moves up the lower leg and into the syndesmosis joint.

A high ankle sprain is sometimes misdiagnosed because it is a similar, yet less common injury than lower ankle sprains.

High Ankle Sprain Treatment

It is best not to self-diagnose a high ankle sprain. If you’re experiencing any of the above symptoms, see a doctor for a diagnosis to avoid further injury and begin treatment to speed up recovery.

A physician will ask where you are experiencing the pain, perform a physical examination, and discuss your recent activity.

He or she might want to take x-rays to rule out broken bones or other injuries, as well as an MRI to have a closer look at the surrounding muscles and soft tissue.

High ankle sprain treatment methods may vary depending on the severity of the syndesmosis injury, but can include several approaches.

High Ankle Sprain Treatment for Syndesmosis Injury

Effective High Ankle Sprain Treatment includes:

1. RICE Method

The RICE Method stands for Rest, Ice, Compress, and Elevate. This healing approach to injuries is typically the first step when noticing pain in the high ankle.

Though it might seem basic, just giving the body a break by resting the injury, icing the inflammation, using compression in the form of a wrap or sports bandage, and elevating the ankle and leg above the heart can be extremely effective.

2. Anti-Inflammatory Pain Medications

Over-the-counter, non-steroidal anti-inflammatory medications (NSAIDs), should be used as directed to reduce pain and swelling while resting the injured area.

The most common ones are ibuprofen, such as Advil, or naproxen (Aleve).

3. Immobilize the Injured Area

Immobilizing the ankle injury by using a walking cast or boot for at least two weeks, or longer in some cases, is recommended for partial snydesmosis ruptures.

Many people use KT Tape or a sports wrap even after the injury heals for added support to avoid a re-injury to the ankle.

4. EPAT / Shockwave Therapy

Extracorporeal Pulse Activation Technology is the technical term for EPAT Therapy, which is a painless and noninvasive technique for healing many types of injuries, including a high ankle sprain.

EPAT is frequently called Shockwave Therapy (Extracorporeal Shockwave Therapy) because it produces high or low-energy impulse pressure waves, or shockwaves, directed at the injured area.

During a typical session, a Shockwave Therapy Machine delivers targeted shockwaves to the high ankle sprain connective tissue to stimulate new cell growth and increase blood flow to speed up healing and recovery time.

Shockwave Therapy is used by professional sports teams and sports medicine doctors because of its effectiveness, and it allows athletes to heal more quickly.

In fact, Shockwave Therapy also works well for treating and healing Peroneal Tendonitis, which is commonly known as ankle tendonitis.

5. Physical Therapy

Physical Therapy may be called for as a treatment option. A physical therapist can help educate athletes about using proper techniques to avoid injuries, recommend appropriate gear, and perform rehab exercises to improve healing and reduce the likelihood of another injury in the future.

Physical therapists can also suggest appropriate braces or taping methods, as well as proper foot support and orthotics to ensure better stability for the syndesmosis joint.

6. High Ankle Sprain Surgery

High ankle sprain surgery is reserved for the most serious cases of syndesmosis injuries, such as fractures that create instability. This may mean the bones and ligaments are so damaged that they require reconstruction.

Older surgical approaches use metal screws to stabilize the fibula to the tibia, but this requires a second surgery to remove the screws. Newer techniques use more flexible methods that only require one surgery.

Obviously, surgery is the most invasive approach for treating a high ankle sprain and is not recommended unless absolutely necessary because of the inherent risks. Even successful surgery involves significant downtime for the healing process.

The recovery time for a high ankle sprain due to a syndesmosis injury can take approximately six weeks to 3 to 6 months for more severe symptoms to subside.

This is why it’s important to talk to a doctor at the first sign of a possible injury and use these treatment methods to speed the healing process.