An ankle sprain is one of the most common sports injuries. The majority of ankle sprains are inversion sprains wherein your foot is turned on the lateral border damaging the ligaments and joint structures on the outside of the joint. A syndesmosis sprain is a different type of ankle sprain which affects ligaments higher up in the ankle when compared to those ligaments affected with common inversion ankle sprains. For this reason, syndesmosis sprains are frequently referred to as "high ankle sprains".High ankle sprains are not as common as inversion ankle sprains and they often take longer to heal. The primary structures that are damaged with high ankle sprains are the anterior inferior tibiofibular ligament, the posterior inferior tibiofibular ligament and the interosseous ligament. In simple terms, these are some of the ligaments at the very bottom of your tibia and fibula (the bones in your leg) including the long thin membrane that separates these two bones. There are various mechanisms for a high ankle sprain but external rotation of the foot, dorsiflexion (bringing your toes toward your shin) or a combination of these movements are the most common. It is usually painful to walk after a high ankle sprain. In some instances the patient with a high ankle sprain will prefer to walk on the forefoot as dorsiflexion causes pain (since it mimics the mechanism of injury). X-ray imaging can be helpful for ruling our fracture or assessing the severity of the sprain. (For any chiropractors or medical practitioners reading this blog, we can check the tibia-fibula clear space which should be less than 6mm if undamaged and we can check the tibia-fibula overlap which should be greater than 1mm in the mortise view).
Treatment of a high ankle sprain depends on the severity of the case. Immobilization and non-weight bearing is sometimes necessary in more severe cases, while others can continue walking during the course of recovery. Initially passive modalities can be helpful in reducing inflammation and promoting tissue healing. Examples of these treatments include laser therapy, ultrasound,microcurrent and interferential current (IFC). Restoration of normal joint motion and proper tissue function can be accomplished through such treatments asActive Release Technique and Graston Technique. Combining these treatment approaches with the proper strengthening, proprioception and bracing is an effective and efficient way to recover from a high ankle sprain.
