High Ankle Sprain

The enigmatic syndesmosis injury… look back even five years and you’d struggle to see a syndesmosis injury reported anywhere in the world of sport. Deemed the ‘new osteitis pubis’ by Lions legend and footy commentator Jonathan Brown, a syndesmosis injury is the way a high ankle sprain is reported in sports media nowadays.

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Put simply, a high ankle sprain involves the syndesmosis complex. This high ankle complex is made up of the AITFL, PTFL, and the interosseous membrane. This complex is responsible for holding the two bones of the lower leg together and provide stability during walking and running. When injured, typically it becomes very difficult to walk and nearly impossible to run. As such, these injuries are treated differently to the more traditional low ankle sprain.

High ankle sprains most commonly occur when the foot is forced up and rotated out at the same time. This combined of dorsiflexion and external rotation spreads the tibia and fibula apart, causing injury to one or multiple parts of the syndesmosis complex.

Diagnosis is made by a physiotherapist through a series of tests and may require X-Ray or MRI to rule out high grade injuries. Lower grade injuries are managed conservatively, with a short amount of time in a moon boot to allow the ligaments to heal in a position to restore stability. After a short time, a rehab program is commenced, aimed at restoring strength and control at the ankle joint. High grade injuries are crucial to catch early, as they often require surgery to stabilise the joint.

As we advance in the field of sports medicine, so does the terminology we use in the media. If you’ve had an ankle injury, it’s vital to have it assessed by a physio ASAP to determine what structures are involved and how to best manage it to return to the court or field safely and quickly.

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