Rehabbing a High Ankle Sprain
What is a high ankle sprain?
A high ankle sprain, also known as a syndesmotic ankle sprain, happens when the ligaments connecting the tibia (shinbone) and fibula (outside leg bones) are stretched or torn.
Because the ankle offers the stability you need to walk or run, injury to this ligament may lead to instability of the ankle joint.
There are three grades of high ankle sprains.
- Grade 1: sprains involve mild stretching with minimal impact on function and a quick recovery.
- Grade 2: sprains are more serious with partial tears and require more intensive treatment and a longer recovery period.
- Grade 3: sprains are the most severe, involving complete ligament tears and often necessitating surgery and extensive rehabilitation.
These ligaments are directly involved in leg movement; thus, any weakening or injury to the ligament will affect its ability to bear the normal load and will inhibit normal maneuvering.
In this article, we’ll discuss:
- Symptoms of high ankle sprains
- What causes a high ankle sprain
- Treatment options
- Recovery tips
Recognizing Symptoms and Getting Diagnosed
Symptoms of a high ankle sprain include:
- Pain above the ankle that increases with outward rotation of the foot
- Significant bruising and swelling across the higher ankle
- Difficulty bearing weight on the affected leg
- Pain felt upon walking/Increased pain with movement
- A sensation of instability or the ankle “giving way”
If you’re experiencing these symptoms, it’s crucial to seek medical attention.
A thorough physical examination, often accompanied by X-rays or MRIs, helps confirm the diagnosis and rule out other injuries.
What Causes A High Ankle Sprain?
A high ankle sprain results when ligaments are torn or damaged, usually from a forcible outward twisting of the foot and ankle.
– Sports-Related Injuries
High ankle sprains are prevalent in sports that involve quick changes in direction, sudden impacts, or intense rotational forces.
The most common sports associated with high ankle sprains include:
- Football
- Basketball
- Soccer
- Wrestling
- Ice Hockey
- Rugby
- Lacrosse
– Non-Sports Related Causes
High ankle sprains can also occur outside of sports contexts.
Common non-sports related causes include:
- Falls: Falling from a height or slipping can lead to awkward ankle twists and high ankle sprains.
- Accidents: Car accidents or other types of trauma can cause the foot to twist forcefully, resulting in a high ankle sprain.
- Missteps: Walking or running on uneven surfaces or stepping into a hole can create enough force to injure the ankle.
- Traumatic Impact: Direct blows to the ankle, such as during physical altercations or accidents, can result in ligament damage.
Mechanics of the Injury
A high ankle sprain typically occurs due to a forcible outward twisting of the foot and ankle.
This action puts stress on the ligaments connecting the tibia and fibula, leading to their stretching or tearing.
Specific movements or forces that can cause high ankle sprains include:
- Rotational Forces: Rapid twisting or turning motions of the ankle can stretch or tear the syndesmotic ligaments.
- Direct Impact: A direct blow to the ankle or lower leg can force the ankle into an unnatural position.
- Inversion Injury: While more common in low ankle sprains, severe inversion (where the foot turns inward) can sometimes contribute to high ankle sprains if combined with rotational forces.
Treatment Options For High Ankle Sprains
Treatment varies based on the severity of the sprain.
Here’s what you might expect:
– Conservative Treatments:
- RICE Method: Rest, ice, compression, and elevation can help manage pain and swelling.
- Immobilization: A brace, splint, or walking boot can stabilize the ankle and limit movement.
- Pain Management: NSAIDs can help reduce pain and inflammation.
- Rehabilitation Exercises: During the healing period, physical therapy interventions and exercise will improve joint range of motion, muscle length and nerve function
- Range of Motion Exercises: Focus on restoring and enhancing the ankle’s flexibility and movement capabilities, which can be significantly affected by the injury.
- Strengthening Exercises: Weight-bearing and resistance loaded exercises will strengthen your foot, ankle and calf muscles.
- Balance Training: to prevent reinjury, we will assess your balance and proprioception (the sense of knowing where your body is in space) and retrain you to manage both by using a balance or wobble board.
– Surgical Options:
In severe cases, where conservative treatments aren’t effective, surgery might be needed.
This is usually considered if:
- The ankle remains unstable despite treatment
- There’s significant ligament damage
- There are fractures or other complications
- If a fracture has occurred, screws will be inserted to stabilize the tibia and fibula and, by association, the high ankle ligaments.
- After the screws are removed, physical therapy will help restore joint range of motion, flexibility and strength.
Consulting a physical therapist or orthopedic specialist can guide you to the best treatment plan.
Tips for Recovery and Prevention
To aid recovery:
- Rest: Avoid weight-bearing activities and use crutches if needed.
- Ice: Apply ice packs to the ankle for 15-20 minutes every 2-3 hours in the first 48-72 hours.
- Compression: Wrap the ankle with an elastic bandage to support and reduce swelling.
- Elevation: Keep your ankle elevated above heart level to improve blood flow and reduce swelling.
- Physical Therapy: Engage in prescribed exercises to regain strength and flexibility.
Prevent future sprains by:
- Warming Up: Prepare your muscles and joints with a good warm-up before activities.
- Choosing Proper Footwear: Wear shoes with adequate ankle support and avoid high heels or tight shoes.
- Strengthening Ankles: Incorporate exercises like calf raises and ankle rotations into your routine.
- Being Mindful of Surfaces: Avoid uneven or slippery surfaces.
- Listening to Your Body: Rest and avoid pushing through pain to prevent further injury.
Seeking Professional Help
If you suspect a high ankle sprain, consulting a specialist is crucial. An orthopedic expert will perform a detailed examination and provide a personalized treatment plan.
Timely professional care can significantly improve recovery chances and help avoid long-term complications.
Final Thoughts
A high ankle sprain does not have to mean an end to your athletic participation. We can start a physical therapy program to alleviate your pain and teach you how to prevent a high ankle sprain in the future.
Did you know you have Direct Access* to Physical Therapy? No referral, no problem!
For tailored advice and treatment, don’t hesitate to contact The Jackson Clinics. Your path to recovery starts with the right care and guidance.
The Jackson Clinics serves 18 locations throughout Northern Virginia.
Find one near you: https://thejacksonclinics.com/locations/