Could Your Ankle Injury Be a High Ankle Sprain?
posted: Feb. 09, 2015.
Like I shared last week, Tom Brady of the New England Patriots played his way to Super Bowl XLIX with an ankle sprain. This was a low ankle sprain. Many readers may have heard the term “high ankle sprain” without really knowing the difference. High ankle sprains involve a completely different set of ligaments called the distal tibiofibular syndesmosis. This is a band of tissue that connects the tibia to the fibula, which are the 2 bones that make up the leg below the knee.
As I mentioned last week, ankle sprains are very common athletic injuries ranging from relatively minor to very traumatic. High ankle sprains generally fall under the “traumatic” category, yet they occur much less frequently than low sprains. A recent study suggests that high ankle sprains account for 6.7% of all ankle sprains. However, calcification of the syndesmosis was reported in 32% of professional football players, suggesting a much higher incidence.
While a swollen ankle may just be a typical “sprain” to the layperson, high ankle sprains actually present differently and require more aggressive treatment. For example, high ankle sprains actually have less swelling even though they represent more severe injuries. They will also show a delayed appearance of ecchymosis (red, flat, dot-like lesions of skin) and are often associated with ankle fractures.
In my Hempstead podiatry office, I've evaluated all types of foot and ankle injuries. It is important to be evaluated if you experience ankle trauma with pain presenting over the front of the ankle. At Cast A Foot Podiatry in Hempstead, NY, I may perform a squeeze test in order to decipher between a syndesmotic injury and other associated injuries. I may also perform an external rotation test. X-rays are always warranted when presenting with this type of injury.
Treatment also varies greatly from low ankle sprains. While acute ankle sprains rarely require surgery, high ankle sprains very well may, especially if there is a significant widening between the tibia and fibula. However, these decisions are made by foot and ankle specialists on a case by case basis.
Regardless of the severity of injury, diagnosing a syndesmotic sprain is as much informational as it is therapeutic. Athletes and coaches must be counseled on a realistic time frame for returning to a sport. Syndesmotic sprains that do not fully heal, or do not heal correctly, can lead to further damage down the road.