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Understanding and Managing High Ankle Sprains


Saquon Barkley recently injured in his week 2 game against the Cardinals reported that he has a high ankle sprain. Looks like he will miss some time on the field and here's why: High ankle sprains, also known as syndesmotic ankle sprains, are injuries that affect the ligaments connecting the tibia (shinbone) and fibula (calf bone) in the lower leg. These injuries, while less common than typical ankle sprains, can be more severe and require a longer recovery period. In this article, we will explore what high ankle sprains are, their causes, symptoms, and the necessary steps for diagnosis, treatment, and recovery. Understanding High Ankle Sprains High ankle sprains occur when there is damage to the syndesmotic ligaments that hold the tibia and fibula together, just above the ankle joint. These ligaments are responsible for maintaining stability in the ankle and allowing proper rotation of the lower leg. When they are stretched or torn, it can lead to instability and pain. Causes of High Ankle Sprains High ankle sprains are often the result of a sudden and forceful twisting of the ankle, commonly seen in sports or activities that involve quick changes in direction. Common causes include:

  1. Sports Injuries: High-impact sports such as football, soccer, and basketball frequently result in high ankle sprains due to the sharp cutting and pivoting movements.

  2. Traumatic Falls: Falling from a significant height or sustaining a direct blow to the lower leg can also cause these injuries.

  3. Motor Vehicle Accidents: High-speed car accidents can lead to high ankle sprains due to the extreme forces exerted on the lower leg.

Symptoms of High Ankle Sprains High ankle sprains have distinctive symptoms, which differ from those of typical lateral ankle sprains. Common signs and symptoms include:

  1. Pain: You may experience pain above the ankle joint rather than on the side, as is common in lateral sprains.

  2. Swelling: Swelling around the ankle and the lower leg may occur within hours of the injury.

  3. Bruising: Bruising may appear on the shin or the inner part of the lower leg.

  4. Limited Range of Motion: You may find it difficult to move the ankle or bear weight on the affected leg.

  5. Tenderness: Tenderness is often felt along the front of the ankle joint.

Diagnosis and Treatment If you suspect a high ankle sprain, it is crucial to seek immediate medical attention. A healthcare provider will typically use the following diagnostic methods:

  1. Physical Examination: The doctor will examine the affected ankle, looking for signs of swelling, tenderness, and range of motion.

  2. Imaging: X-rays may be taken to rule out fractures, while MRI or CT scans can help assess the extent of ligament damage.

Once diagnosed, the treatment approach may include:

  1. R.I.C.E. Method: Rest, ice, compression, and elevation are essential in the initial phase to reduce swelling and minimize pain.

  2. Immobilization: A splint, cast, or brace may be used to stabilize the ankle and promote healing.

  3. Physical Therapy: Rehabilitation exercises help strengthen the ankle and improve flexibility, promoting a faster and more complete recovery.

  4. Non-Surgical and Surgical Options: Depending on the severity of the injury, non-surgical or surgical interventions may be recommended. Surgery typically involves repositioning and fixing the torn ligaments.

Recovery and Rehabilitation Recovery from a high ankle sprain can be a prolonged process, often taking several weeks to months. Some people may recover in about 6 weeks while others may take 6 months. Returning to activities too soon can lead to re-injury, so it is crucial to follow a structured rehabilitation plan. During the recovery process, the patient will gradually reintroduce weight-bearing and mobility exercises. Working with a physical therapist is often recommended to ensure a safe and effective recovery. Conclusion High ankle sprains can be painful and debilitating injuries, especially for athletes and individuals with an active lifestyle. Seeking prompt medical attention, following a proper treatment plan, and allowing adequate time for recovery are key factors in regaining ankle stability and function. If you suspect a high ankle sprain, don't hesitate to consult a healthcare professional to receive the appropriate care and guidance toward a full recovery.


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