You gaze at the tennis ball flying toward you from the other side of the court, and you manage to hit it successfully, but ah-oh, and ouch! Your ankle was twisted. When athletes give their all in competition, mishaps like syndesmotic injuries are common, keeping them off the field for weeks.
Unlike a regular ankle sprain, these require special care for a full recovery. The best high ankle sprain treatment combines rest, specific exercises, and advanced therapies to rebuild strength and stability. Let’s go over the right treatment approaches that help athletes fully recover.
What Is a High Ankle Sprain?
You might have heard the terms ‘high ankle sprain’ and ‘low ankle sprain’ during sports broadcasts, especially in American football. However, it is important to note that they are both different injuries. The high ankle ligaments, also called the syndesmosis, are located above the ankle, unlike the more commonly injured ligaments on the outer ankle.
Causes of High Ankle Sprain
High ankle sprains occur when the foot is twisted outward or when excessive upward movement stretches the syndesmosis ligaments. These high ankle sprain injuries are common in high-impact sports like football, soccer, and hockey, where sudden twisting and collisions happen often. They can also occur with ankle fractures, leading to more serious injuries like a Maisonneuve fracture. Risk factors include walking on uneven surfaces, past ankle injuries, and poor physical conditioning.
Symptoms of High Ankle Sprain
Common symptoms of a high ankle sprain include:
- Pain
- Swelling
- Bruising
- Difficulty Walking
- Limited Ankle Motion
- Tenderness
- Snap or Pop Feeling
- Ankle Weakness
Orthopedically Supported High Ankle Sprain Treatment
High ankle sprains are serious injuries that need proper treatment to heal correctly and prevent long-term issues. Treatment options are divided into:
Non-Surgical Treatments
For mild to moderate high ankle sprains, doctors usually recommend:
- RICE Method: Rest, Ice, Compression, and Elevation to reduce pain and swelling. Some use “PRICE,” adding “Protect” to prevent further injury.
- Immobilization: Wearing a walking boot or a short cast to keep the ankle stable while it heals.
- Pain Relief: Taking anti-inflammatory medications (NSAIDs) to manage pain, though their effectiveness is debated.
- Physical Therapy: After the initial healing phase, exercises help restore movement, strengthen the ankle, and improve balance.
Surgical Treatment
Surgery is needed for severe sprains, especially when ligaments are badly damaged, or the ankle joint is unstable. Common procedures include:
- Syndesmotic Screw Fixation: Screws are placed between the tibia and fibula to stabilize the joint, but recovery can take longer.
- Tightrope Surgery: A newer technique using flexible cords instead of screws, allowing for faster recovery and earlier weight-bearing.
- Arthroscopic Surgery: A minimally invasive procedure to check and repair internal damage, like cartilage or tendon injuries.
High Ankle Sprain Pain Location
High ankle sprains usually cause pain in the front of the ankle, which can spread up the leg. The pain often worsens with activities like walking or climbing stairs since these movements stretch the injured ligaments. It is typically felt just above the ankle, where the syndesmotic ligaments connect the tibia and fibula. Unlike regular ankle sprains, there may not be much swelling or bruising, but the injury can still lead to weakness and instability in the ankle.
High Ankle Sprain Test
X-rays and MRIs are a must to check for fractures or deformities. However, your orthopedic doctor might also perform a physical exam. Some common tests include:
- Squeeze Test: The doctor squeezes the lower leg just below the knee. If pain travels down to the ankle, it may indicate a high ankle sprain.
- External Rotation Test: The patient bends their knee while the foot is turned outward. Pain in the ankle suggests a high ankle sprain.
- Kleiger’s Test: The doctor rotates the foot outward while the ankle is flexed upward. This helps check for ligament injuries in the ankle.
- Cotton Test: The heel is moved from side to side to check for instability. Pain or excessive movement suggests ligament damage.
- Fibular Translation Test: The doctor moves the fibula forward and backward to see if it is unstable.
Wrapping Up
Sports that involve quick changes in direction, like football, are especially challenging with ankle injuries. However, advanced high ankle sprain treatment approaches are effective and offer quick recovery. All you need to do is follow your healthcare provider’s instructions.
Visit our board-certified orthopedic surgeon at Mufaddal M. Gombera, MD. Our doctor completed a fellowship in sports medicine and arthroscopy at Northwestern University in Chicago, IL. Call us at (713) 794-3457 to book an appointment.
