Syndesmotic Ankle Injury: What You Need To Know For A Faster Recovery

A syndesmotic ankle injury, also known as a high ankle sprain, occurs when the ligaments that connect the tibia and fibula, two of the major bones in your lower leg, are damaged. While not as common as other types of ankle sprains, this injury can be quite painful and take longer to heal. Understanding how it happens, recognizing the symptoms, and following a proper recovery plan can help you heal faster and avoid long-term complications.

What is a Syndesmotic Ankle Injury?

The syndesmosis is the joint between the tibia and fibula, held together by three main ligaments: the anterior tibiofibular ligament (AITFL), the posterior tibiofibular ligament (PITFL), and the interosseous membrane. These ligaments help keep the bones stable and prevent excessive movement. A syndesmotic sprain occurs when these ligaments are stretched or torn, usually due to external rotation or hyper-dorsiflexion of the foot.

Syndesmotic sprains are common in sports that involve sudden changes of direction, such as football, soccer, and hockey. However, even activities like skiing or running on uneven surfaces can put you at risk.

Symptoms of a Syndesmotic Ankle Injury

The symptoms of a high ankle sprain can be similar to other types of ankle sprains but typically occur higher up on the leg, just above the ankle joint. Here’s what to look out for:

Pain located above the ankle, especially during activities that involve weight-bearing or rotating the foot.
Swelling and bruising, although these symptoms might not be as severe as in lateral ankle sprains.
Difficulty walking or bearing weight. Severe injuries may cause an inability to walk at all.
Pain during dorsiflexion or external rotation of the ankle.
Tenderness and swelling over the AITFL (anterior tibiofibular ligament).

How is a Syndesmotic Ankle Injury Diagnosed?

To diagnose a syndesmotic injury, your healthcare provider may perform several physical tests:

External Rotation Test: The provider will rotate your foot while it’s held in a neutral or slightly dorsiflexed position to recreate the pain.
Fibular Squeeze Test: By applying compression between the tibia and fibula, this test looks for pain over the syndesmosis, which would suggest a sprain.
Crossed Leg Test: This self-service test is when you cross the affected leg over your opposite knee while applying a downward compressive force over your tibia.

In addition to physical testing, imaging such as X-rays, MRI, or CT scans may be used to rule out fractures or assess the extent of the ligament damage.

Treatment for Faster Recovery

The recovery time for a syndesmotic sprain can vary depending on the severity of the injury, but it often takes longer than a typical lateral ankle sprain. Here’s what you can do to speed up the healing process:

Rest and Protection: Initially, avoid putting weight on the affected foot. Use crutches or a walking boot to protect the injured area.
Ice and Elevation: Apply ice for 15–20 minutes every few hours to reduce swelling. Keep your foot elevated above heart level whenever possible.
Pain Relief: Over-the-counter pain relievers like acetaminophen or NSAIDs can help manage pain and inflammation.
Compression: Compression wraps or an ankle brace can help control swelling.
Gentle Range-of-Motion Exercises: Once the initial pain and swelling subside, start doing some gentle ankle movements to maintain mobility.
Physical Therapy: As part of your rehabilitation for spine and joints, a physical therapist can help restore strength, balance, and flexibility to your ankle. Exercises focused on improving fitness and function are critical for preventing future injuries.
Strengthening: Strengthening the muscles around your ankle, including the peroneals and tibialis anterior, is essential to support the joint. Myofascial pain syndrome treatments, such as dry needling, can also help relieve tight muscles and improve mobility.
Proprioception: Balance exercises, such as using a BAPS board, are effective at reducing the likelihood of future sprains, especially for athletes involved in golf or crossfit performance.
Advanced Interventions: For severe injuries, surgery might be needed, especially if there is diastasis or instability in the syndesmosis joint.

Prevention Tips

After healing, it’s essential to take steps to stay injury-free and strengthen the muscles surrounding the ankle joint:

Wear supportive footwear to prevent planter fasciitis and reduce stress on the ankle ligaments.
Warm up and stretch before engaging in physical activities to reduce muscle strain.
Incorporate prehabilitation exercises into your routine, including stability drills and stretching, to keep your joints flexible and strong.
Consider adding Vitamin D supplements for bone health to ensure your bones and ligaments are in optimal condition.

A syndesmotic ankle injury may take time to heal, but following the proper treatment plan can help speed up recovery and reduce the risk of future injuries. Make sure to rest when needed, stay consistent with your physical therapy exercises, and always listen to your body.

By understanding the causes, symptoms, and treatments, you can bounce back from a syndesmotic sprain stronger and more prepared for future activities.

If you’re unsure about the severity of your injury or need a detailed recovery plan, don’t hesitate to consult a referring physician or a physical therapist who specializes in ankle injuries.

NEW PATIENTS

Step 1

Call today to schedule your convenient appointment.

Step 2

Pre-register your important health information on your phone or computer to save time.

Step 3

Meet your new doctor for a customized plan and start moving toward your goal!

Discover how we may help!

We are the Memphis area’s top-rated chiropractic group, providing you with gentle chiropractic care, dry needle therapy, exercise therapy, and therapeutic massage.

2845 Summer Oaks Dr, Memphis, TN 38134
(901) 377-2340

Life Shouldn't Hurt!

You Deserve To Feel Great. We Can Help!
Your go-to Chiropractor in Memphis, TN

Richard L. Cole, DC, DACNB, DAIPM, FIACN, FICC
Jeffrey D. Luebbe, DC, CCRD, CCSP
W. Steven Vollmer, DC, DAAPM
Bradford J. Cole, DC, MS, CSCS
J. Colby Poston, DC
Daniel H. Smith, DC
2845 Summer Oaks Dr., Memphis, TN 38134
(901) 377-2340

Monday – Friday:
8:00 AM – 6:00 PM
Saturday :
8:00 AM – 12:00 PM
Walk-ins are Welcome!