Ankle Syndesmosis Injury elite physiotherapy and sports injury centre

Ankle Syndesmosis Injury (Ankle Sprain) and its Physiotherapy Treatment

Ankle syndesmosis injury

Ankle syndesmosis injury, also known as a high ankle sprain, is a type of ankle sprain that occurs when the ligaments connecting the tibia and fibula bones of the lower leg are injured. Unlike a typical ankle sprain, which involves damage to the ligaments on the outside of the ankle, a syndesmosis injury involves damage to the ligaments on the inside of the ankle joint.

The syndesmosis ligaments help to keep the tibia and fibula bones stable and in place, and when these ligaments are stretched or torn, they can cause pain and instability in the ankle joint. Syndesmosis injuries are often caused by twisting or rolling the ankle, and they can be more severe and take longer to heal than a typical ankle sprain. Treatment may involve rest, ice, compression, and elevation, as well as physical therapy and in some cases surgery.

Causes of Ankle Syndesmosis Injury:

Ankle syndesmosis injuries, also known as high ankle sprains, can be caused by a variety of factors. Some of the most common causes include:

  1. Sports-related activities: Athletes who participate in sports that involve sudden changes of direction or jumping, such as basketball, football, or hockey, are at increased risk of ankle syndesmosis injuries.
  2. Twisting or rotating the ankle: The syndesmosis ligaments can be stretched or torn if the ankle is twisted or rotated too forcefully, such as when landing awkwardly from a jump or stepping on an uneven surface.
  3. Falling: A fall that causes the ankle to twist or bend can also result in a syndesmosis injury.
  4. Repetitive stress: Overuse or repetitive stress on the ankle joint, such as from running or jumping, can weaken the syndesmosis ligaments over time and increase the risk of injury.
  5. Previous ankle injuries: Individuals who have previously injured their ankle may be more prone to a syndesmosis injury due to weakened or damaged ligaments.

Symptoms of Ankle Syndesmosis Injury:

The symptoms of an ankle syndesmosis injury can vary in severity depending on the extent of the damage to the syndesmosis ligaments. Some common symptoms of an ankle syndesmosis injury include:

  1. Pain: Pain is usually felt on the front of the ankle and may worsen with weight-bearing or movement like walking. Pain may also radiate up the leg.
  2. Swelling: Swelling may occur around the ankle joint and may be accompanied by bruising.
  3. Stiffness: The ankle joint may feel stiff and difficult to move, especially when trying to rotate the foot.
  4. Instability: The ankle may feel unstable or “wobbly,” and there may be difficulty bearing weight on the affected leg.
  5. Tenderness: There may be tenderness or soreness when pressing on the front of the ankle or along the syndesmosis ligaments.
  6. Limited range of motion: Range of motion may be limited, especially when trying to dorsiflex (bend the foot upwards) or rotate the foot.

Physiotherapy Treatment:

The physiotherapy treatment of an ankle syndesmosis injury may vary depending on the severity of the injury, but the goal of treatment is to reduce pain and swelling, improve range of motion, restore strength and stability, and prevent re-injury. Some common physiotherapy treatments for ankle syndesmosis injury include:

  • Peace & Love: Peace & Love stands for
    • PROTECTION-Protection from activities and movement that increase pain during the first few days.
      ELEVATION- Elevate the injured ankle higher than the chest as often as possible.
      AVOID ANTI-INFLAMMATORY- Avoid taking anti-inflammatories as they reduce tissue healing, also avoid icing if having bearable pain and inflammation is not so much.
      COMPRESSION- use an elastic bandage and taping to reduce swelling.
      EDUCATION- Education about the body’s natural healing mechanism.
      LOAD- Do optimal loading exercises.
      OPTIMISM- Condition your brain for optimal recovery.
      VASCULARISATION- Choose pain-free cardiovascular activities to increase blood flow.
      EXERCISE- Restore mobility, strength, and proprioception with proper exercises.
      This is the initial treatment for most ankle injuries, including syndesmosis injuries.
  • Ankle mobilization and range of motion exercises: Gentle ankle mobilization exercises can help improve joint mobility, while range of motion exercises can help improve flexibility and reduce stiffness. Also, calf stretch, and soft tissue release.
  • Strengthening exercises: Strengthening exercises for the ankle and surrounding muscles can help restore strength and stability to the joint. Such as Aquatic exercises, Dorsiflexion, and plantar flexion strengthening.
  • Balance and proprioception exercises: These exercises can help improve balance and body awareness, which can reduce the risk of re-injury.
  • Taping and bracing: Taping or bracing the ankle can provide additional support and stability during activities, which can help prevent re-injury.
  • Gradual return to activity: As the injury heals, a physiotherapist can guide a gradual return to activity, taking into account the individual’s level of fitness and the demands of the activity.

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