High Ankle Sprain


High Ankle Sprain
Image Credit: Hospital For Special Surgery

Article Authors: Gordon Slater|Tandose Sambo

The current Olympic activities give us all something to cheer about. Athletes from all dimensions of sport showcase their talents after years of physical training. Every sport that you can think of can induce injury to the body, as athletes condition themselves to conduct the skills that are relevant to ensure that passes, leaps, tumbles, sprints and hurdles are accomplished. The feet are heavily utilized in the sporting realm and injuries to the ankles can result. From a physical standpoint, a lot of pressure is applied to the feet as the force of the body exerted over the small area of the soles can generate shockwaves through the system.

During the Olympics, you may have noticed various athletes wrapping their ankles. This is a preventative measure that is designed to protect the ankles from any sudden injury induced by the momentum of sporting activities. One injury that athletes experience is the high ankle sprain. Accounting for approximately 15% of all ankle related injuries, the high ankle sprain  or syndesmotic ankle sprain (SAS) occurs when there’s a sprain of the syndesmotic ligaments that connect the two bones in the higher ankle region. These bones are the tibia and the fibula. Located just above the ankle, the high ankle sprain is induced when there is an external twist of the leg. Root causes involve physical tackles.  

High Ankle Sprain
Image Credits: ACRO Physical Therapy and Fitness 

Extremely common among hockey players and football players, the high ankle sprain is a prime candidate for a chronic condition, which must be dealt with, or else it can degenerate over time. Because the fibia and the tibula are vertical bones, a counter twist ninety degrees to the plane of the leg is extremely detrimental to the stability of the joint. With such an external twist, as the ligaments become displaced, the patient will experience pain in the upper ankle region. Often unrecognized till long after a game, it is critical for sufferers to identify when there is an unusual sensation in the region. 

What is compromised in the external twist is the anterior inferior tibio-fibular ligament, which supports the tibia and the fibula, and enables the upper ankle mortise joint to stabilize, and support the body. The severity of damage to the ligament is variable, with the worst condition being a complete rupture, depending on how aggressive the rotation was. Consultation with an orthopaedic surgeon will clarify the path of treatment. 

Non-contact high ankle sprains also do occur in sports such as gymnastics. If a gymnast “lands short” while conducting a tuck and has incorrect body rotation, they can land in a forced dorsiflexed position that can result in a high ankle sprain. 

Symptoms of a High Ankle Sprain

Consult with your foot and ankle surgeon, if you are experiencing chronic pain in the upper ankle. In the preliminary stages of a high ankle sprain, you may experience the following:

  1. Pain above your ankle, right between your tibia and fibula. 
  2. Pain during motion, especially when strenuous activity such as climbing or descending stairs is experienced. 

You will be able to maneuver with a high ankle sprain, but if you’ve experienced a fracture in the upper ankle region, you will find it extremely difficult to apply pressure to the affected foot. 

Early Treatment Options

Consult with your foot and ankle surgeon, if you suspect that you have a high ankle sprain. If you can, apply a brace to stabilize the joint, until the area can be carefully assessed by a specialist. Utilizing technology such as a CT scan or an MRI image, the internal portions of the ankle will be assessed, in order to identify the severity of the injury. In the interim however, you are allowed to utilize the standardized RICE procedure, in order to facilitate appropriate pre-treatment. The acronym RICE stands for: Rest, Ice, Compression and Elevation. 

References for this article: https://www.healthline.com/health/high-ankle-sprain#The-takeaway-

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Dr. Gordon Slater

Dr. Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions.

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Dr Gordon Slater is a highly-skilled surgeon specialising in foot and ankle conditions and sports injuries. Dr Slater is one of the first foot and ankle surgeons in Australia to adopt minimally invasive surgical techniques. He routinely uses MIS to treat a range of conditions, including bunions. MIS  has many advantages including shorter operating times, reduced post-operative pain, reduced risk of infection, minimal scarring and better cosmetic outcomes.

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