High Ankle Sprain
Editor: Dr. Amy Spencer, PT, DPT, OCS, MTC, CSCS, CKTP - A Board Certified Clinical Specialist in Orthopedic Physical Therapy and Certified Manual Therapist. Owner and Physical Therapist, Specialized Physical Therapy in North Reading, MA.
The ligament joining the two bones of the lower leg (tibia and fibula) is called the syndesmotic ligament. When this ligament is torn or stressed, it will result in a high ankle sprain. A high ankle sprain causes pain and swelling similar to a true ankle sprain, but it can take longer to heal. High ankle sprains are graded similar to true ankle sprains on a 1 to 3 scale.
Symptoms of High Ankle Sprain:
- Severe pain
- Inability to walk
- Significant bruising
- Minor swelling
- Pain when you attempt to rotate the ankle outward
Causes of High Ankle Sprain:
- A high ankle sprain occurs from a forceful twisting or outward rotational injury at the ankle. This injury is more common in football, hockey, wrestling, and soccer. In these sports there is a higher chance of becoming tangled under another person.
- Another way to injure these ligaments is by excessive dorsiflexion. This means the toes are forced toward the shin beyond their normal range. This can occur when an athlete has a foot planted and falls or is pushed forward. In either event the pulling apart of the two bones causes the ligaments to tear.
Syndesmotic injuries tend not to heal as well as more common ankle sprains, which is why trainers and coaches are often concerned about their athletes protecting their ankles. An orthopedic doctor will first determine if the injury is stable or unstable. If the injury is stable, then the high ankle sprain can be treated in a cast for a period of six weeks. Unstable injuries may require surgery to stabilize the ankle.
Treatment of High Ankle Sprain:
Most high ankle sprains can be treated in a manner similar to typical ankle sprains. Physical therapy helps by restoring ankle mobility, flexibility, strength, balance, proprioception, and gait. Modalities such as ultrasound, electrical stimulation, or Kinesio tape may be used to decrease inflammation and swelling and to accelerate the healing of the injury. High ankle sprains are much less common than low ankle sprains. They are also harder to treat and can cause long-term complications.
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