The syndesmosis is the articulation between the distal tibia and fibula, it is bound by a number of ligaments and an interosseous membrane. A syndesmosis injury or ‘high ankle sprain’ refers to damage of this connective tissue. This most commonly occurs as a result of extreme external rotation or dorsiflexion of the ankle which can distract (separate) the tibia and fibula from each other and strain or rupture the supporting tissue.
Acute Period:
Secondary:
Whilst more often an acute injury, there are many factors that can contribute to a syndesmosis injury, these may include (but are not limited to):
DIAGNOSE
In the acute stages of an ankle injury it is crucial to determine the severity of the injury, and decide if imaging, referral to an orthopaedic surgeon and/or a period of immobilsation or non-weightbearing is required. Syndesmosis injuries often coincide with other ligamentous injuries and fractures, and need to be assessed thoroughly in the early stages to optimise recovery.
REHABILITATION
Without adequate rehabilitation targeted at addressing strength, motor control, balance and proprioception, there is a high likelihood you will injure your ankle again. Your physio will design a program specific to you and your sport, for a successful return.
SOFT TISSUE TECHNIQUES AND DRY NEEDLING
These techniques can be beneficial in addressing muscle function and joint position
EXTERNAL SUPPORTS
Your physio will use boots, braces and taping strategies where required to manage your symptoms, allow healing and prevent re-injury.
REST AND LOAD MANAGEMENT
Initial rest from aggravating factors is important to reduce the inflammatory response of affected tissues. Your physio will guide your return to sport/activity to limit aggravation that can slow the rehab process.
STRENGTHENING
A progression of strengthening into a gym environment is often advised to ensure that improvements in strength, endurance and proprioception are made. As management often requires a period of immobilisation, it is vital that strength and range is restored following this.
REFERRAL
Your physio may suggest referral for imaging, or to other health professionals for pain management or injection-based therapy if required. In some circumstances, referral to an orthopaedic surgeon may be required.
If you have any questions about your ankle injury or possible syndesmosis injury, please do not hesitate to contact us on (03) 5229 3911, email us at info@theinjuryclinic.com.au or book an appointment to see one of our physiotherapists in Geelong.
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