Toggle Sliding Bar Area. Rotational ligamentous injuries to the ankle in football.
It will often take many weeks or even months to fully recover from high ankle sprain. Unlike a typical ankle sprain, the foot is usually rotated outwardly externally , typically with the foot planted on the ground. These injuries often occur in a sporting event, where there is a sudden change of direction, and an excessive applied force, such as being tackled while playing football.
In severe high ankle sprains, there may be generalized ankle swelling and even tenderness on the inside of the ankle. Physical Examination On exam, the ankle may demonstrate moderate, to severe swelling after the acute event. Most of this swelling will be centered over the front outside anterolateral part of the ankle. Pressing on this area will reveal significant localized tenderness to the front and outside of the ankle.
Often, the ankle motion will be restricted, especially with bringing the foot upwards dorsiflexion. Certain maneuvers or special tests will reproduce or aggravate the symptoms. For example, the squeeze test is performed by squeezing the two bones of the lower legs tibia and fibula together, approximately four inches above the ankle joint. This test will tend to reproduce the symptoms in the front, outside part of the ankle in patients who have had a high ankle sprain.
The external rotation test involves twisting the foot to the outside, thereby stressing the outer part of the ankle. This will also reproduce symptoms. Imaging Studies Plain x-rays of the ankle rarely demonstrate any abnormalities. Occasionally, with a severe high ankle sprain, a stress view force applied to the heel in an outward direction will show some displacement and separation of the tibia and fibula syndesmosis at the level of the ankle joint, although this is uncommon.
MRIs and CT scans are more effective diagnostic tools, especially if the x-ray does not show an injury. These diagnostic tests will also help the doctor to determine the severity of the injury and if there is any displacement between the tibia and fibula. If a high ankle sprain is diagnosed, your doctor will then determine if it is stable or unstable.
If the ankle is stable the injury is not as severe, and the tibia and fibula are generally unaffected. If the ankle is unstable, at least two, and possibly all three of the syndesmotic ligaments are torn, and the tibia and fibula are displaced.
There are generally three phases in the recovery process for a high ankle sprain. The first phase involves rest, reducing swelling, and protecting the ankle. Generally, this takes one week. The third phase allows the injured person to gradually return to normal activities. The patient is given physical therapy , doing slower maintenance exercises at first, gradually increasing movements to sharper, more sudden turns. Depending on the severity of the injury, the last phase may last for a month or two.
Your doctor will determine the severity of your injury and create an appropriate treatment plan. Protecting the ankle is critical to the healing process. Compression should be done with an elasticized bandage such as an ACE bandage , which should be removed if any symptoms begin to appear that indicate the blood supply is impaired. Your foot should be elevated at least one foot above your heart level.
Braces, splints, and casts may also be used to minimize movement of the lower leg, ankle, and foot. Ambulatory devices such as crutches are used to protect the ankle from further injury if a person needs to be mobile. In more severe cases, surgery may be required to reestablish stability in the ankle joint. This is done by inserting one or two screws in the lower leg for a few months, or until the ligaments have reformed and are able to hold the bones in their respective positions.
Surgery usually requires six months of recovery time, with little or no pressure applied to the ankle or foot during the healing process. If you do not need surgery to recover, you may be able to return to your normal activities within six to eight weeks. It is important to know that once you have incurred a high ankle sprain, your ankle is susceptible to future sprains. This is because the ligaments remain looser than normal even after they have healed. Here are a few prevention tips to help you avoid high ankle sprains:.
Does this rare condition affect your child? Learn what you can do to help. Foot pain can sometimes be a sign of an underlying condition that requires medical attention. Find out when to see your doctor, and much more. Many people use orthotics to improve the function and stability of their feet. Learn about the various types of orthotics used to help restore mobility. There are five metatarsals in all. The metatarsals are the long bones located in our feet, between the tarsal ankle bones and the phalanges toes.
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A high ankle sprain occurs from a twisting or rotational injury. It also can occur in the setting of an ankle fracture, which means the bones of the ankle are broken. In some cases, the ligament on the inside of the ankle, the deltoid, will be torn. Jan 21, · A high ankle sprain is a significant injury and can sideline an athlete much longer than a typical ankle sprain. Ankle injuries are one of the most common injuries in sports constituting approximately 10% of all acute injuries that are treated by physicians/5(8). A high ankle sprain, also known as a syndesmotic ankle sprain (SAS), is a sprain of the syndesmotic ligaments that connect the tibia and fibula in the lower leg, thereby creating a mortise and tenon joint for the ankle. High ankle sprains are described as high because they are located above the ankle.