High ankle sprains are less common than lateral ankle sprains, but generally are more serious and require a longer recovery. They occur to the ligaments above the ankle which connect the two bones of the lower leg: the tibia and fibula. The tibia and fibula are held together by the syndesmosis membrane as well as the anterior and posterior tibiofibular ligaments. These two bones and the ligaments form a fibrous joint which is known as the distal tibiofibular joint. In some cases, high ankle sprains are associated with fractures.
High ankle sprains often occur when the ankle is heavily loaded and pushed into excessive dorsiflexion (e.g during a tackle), and when an outwards twisting of the foot occurs while the foot is planted on the ground.
Symptoms will vary depending on the extent of the injury and each individual case, but may include:Pain at the sight of injury and around the lower leg Swelling at the site Increased pain when weight-bearing or inability to weight bear Inability to perform calf raises or similar movements
Depending on the severity of the injury, treatment will vary. Mild cases can be managed conservatively, however more serious cases may require surgery.
Early management will often involve a period of non-weight bearing (either on crutches or in a boot), followed by close monitoring with a physiotherapist to restore strength, function and balance.
Your physiotherapist will also assess to determine the need for imaging. As mentioned, fractures can occur with this injury, and this will change the management plan.
Although you cannot entirely prevent high ankle sprains due to the mechanism in which they occur (particularly in contact sports such as rugby), there are a couple of things you can do to ensure good ankle health and reduce your risk in non-contact situations.Maintain good ankle health: including regular ankle strength exercises in your routine will help to maintain ankle health and mobility. Ensure you wear appropriate footwear, for both your sport and your foot type. A podiatrist can help ensure you have the right shoe for your foot type. Ensure proper return to play protocol after injury to reduce risk of re-injury.
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