High Ankle Sprain Treatment

high-ankle-sprain-treatmentA high ankle sprain, also known as a syndesmotic sprain, is a sprain of the syndesmotic ligaments that connect the tibia and fibula.  This is referred to as a high ankle sprain because it is located high above the ankle joint.

This type of sprain makes up approximately 15% of all ankle sprains.  Although this is a less common type of sprain, it is more serious and requires appropriate treatment.

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Causes of High Ankle Sprains

High ankle sprains can occur when the foot is planted on the ground followed by excessive outward twisting.  Another cause of this type of sprain is when the ankle is severely loaded and pushed into excessive flexion.  This trauma causes the syndesmosis joint to move beyond its limited mobility, stretching and often tearing the ligaments.

Symptoms of a High Ankle Sprain

High ankle sprains are common among football and soccer players, and are sometimes attributed to the artificial turf fields as well as the more flexible cleats that players currently use.

Following a traumatic injury, it may be difficult to determine if the sprain is high ankle or low ankle.  Patients with high ankle sprains may have the following symptoms:

  • Pain above the ankle that increases when the foot is rotated outward
  • Pain when walking on the affected leg
  • Significant tenderness, bruising, and swelling above the ankle
  • Pain where the tibia and fibula connect just above the ankle

The symptoms become more apparent in accordance with the grade of the sprain.  A mild sprain may have only stretched the ligaments, resulting in less apparent symptoms.  A severe sprain involves tears to the ligament and results in more debilitating symptoms.

Diagnosing a High Ankle Sprain

Based on the location of the pain you may be able to diagnose a high ankle sprain yourself. The higher up the symptoms, the more likely it is that it’s a high ankle sprain.  If you are unsure or unable to diagnose yourself, a doctor may recommend an X-ray, CT scan, or MRI.  There are a variety of diagnostic tests that can be performed as well:

  • Squeeze – compressing the tibia and fibula above the midpoint of the calf
  • Dorsiflexion with compression – the foot is examined while it is flexed and compressed
  • External Rotation – leg is dangling and ankle is rotated externally from a 90-degree angle

Often times, multiple diagnostic tests are required in combination with imaging in order to make a firm diagnosis.

Treatment for a High Ankle Sprain

The goal of treatment is to return stability between the tibia and fibula.  There are two common treatments that can be prescribed for a high ankle sprain: RICE (rest, ice, compression, elevation) and H.E.M. (healthy blood flow, eliminate swelling, mobility). RICE begins with rest, which is needed to allow the injured ligaments to heal.  Minimize movement for the first 48 hours after the injury.

During this time the ankle should be iced to help reduce the swelling and pain.  Ice should be applied for 20 minutes at a time, 4 to 8 times a day.  Do not apply ice directly to skin – make sure there is a layer of material to protect the skin.

When you are not icing the injury, compression will help to minimize the swelling.  Elastic bandages and braces can be used to apply compression.  Finally, the injured ankle should be elevated above your heart to help blood flow which will also minimize swelling.

Another option is the H.E.M. ankle rehabilitation system which can reduce healing time and speed recovery. H.E.M is a three-step program developed by fitness expert Scott Malin.  H.E.M. works for all grades of sprains and is also an effective treatment for the more serious high ankle sprain. The goal of the program is to break down scar tissue in the ankle resulting in increased flexibility.

This flexibility prevents stiffness which allows for shorter recovery time. Healthy blood flow allows healing immune cells to remove the waste and debris that collect in the ankle as a result of the sprain.  Elimination of swelling helps to remove scar tissue which causes stiffness and prevents full range of motion.

Mobility increases the strength and stability of the ankle and allows the injury to heal for a full recovery.  The H.E.M. program can be done in about 30 minutes from home and does not require any special equipment. For faster recovery, it is recommended that you perform the three steps once or twice a day.

Recovery Time

High ankle sprains are more severe than low ankle sprains and typically take longer to heal. Depending on the treatment you choose, recovery could take up to six weeks.

Our Top Pick For Sprained Ankle Treatment

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