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A high ankle sprain, also known as a syndesmotic sprain, is a significant injury and is much more serious than typical ankle sprains. Whereas typical ankle sprains occur below the ankle, high ankle sprains result in injury above the ankle. Lateral ankle sprains are most common and medial side are least common. They tend to occur with medial ligament injuries and/or distal tibia/fibula fractures where the ligaments are torn with extreme rotation or flexing. When they do, they are considered more serious.
High ankle sprains tend to occur in sports where quick changes in direction or pivots are made often such as basketball, football, and soccer. They also over in sports where players are required to jump and land among other people, such as basketball and volleyball.
Typical symptoms of high ankle sprains include: tenderness or swelling in the area just above the ankle; pain when ankle bears weight, particularly during activities that involve passive dorsiflexion like climbing stairs or passive dorsiflexion.
Injuries to the high ankle area should be treated immediately. X-rays are necessary for diagnosis especially since high ankle sprains tend to be accompanied by ligament injuries and fractured fibulas.
Suspected high ankle sprains should be immediately immobilized. Overall treatment is similar to normal ankle sprains only on a much longer timeline. Partial ruptures are treated with forced immobilization by a cast or bandage wrapping. Total ruptures require surgical treatment, followed by casting, and a recovery period. Taken together, it takes a little over two months to return from high ankle sprains.
Unlike normal sprained ankles, expect players with high ankle sprains to be out for a few weeks to a couple of months.
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