What is a High Ankle Sprain?
Amy Leslie, ATC
Hughston Athletic Training Fellowship
By definition, a sprain is the stretching and/or tearing of a ligament. The high ankle sprain is a term used to describe a specific type of ankle sprain. The ligament associated with a high ankle sprain is the syndesmosis or syndesmotic ligament. Therefore, the proper term for a high ankle sprain is a syndesmotic sprain.
The syndesmotic ligament is a large ligament that holds the two lower leg bones, the tibia, or shin bone, and the fibula, together. This ligament is most likely torn with an increased external rotation (turned to the outside) at the ankle joint or forced dorsiflexion (the foot pointed up). Coincidently, this injury is more common than has been realized in the past.
Symptoms
A person sustaining a high ankle sprain will complain of severe pain, swelling, and discoloration, and loss of function in the ankle joint. The pain will be increased if the patient’s lower leg is squeezed. The Squeeze Test, as it has been fittingly coined, is a classic test for determining whether someone has a high ankle sprain. However, it is important to obtain x-rays from a trained professional to make a proper diagnosis.
Treatment
High ankle sprains are extremely hard to treat and generally take months to heal. Return to daily activities and sport may be delayed for a longer period of time when compared to other types of low grade ankle sprains.
An orthopedic physician will determine whether the sprain is stable or unstable. If it is diagnosed as stable, the high ankle sprain may be casted for approximately 6 weeks, with rehabilitation to follow in order to achieve full function.
On the other hand, if a physician determines the sprain to be unstable then a screw can be placed between the two lower leg bones. The syndesmotic screw will be in place for 3 months while the syndesmotic ligament heals. Walking is prohibited during these three months due to the sensitivity of the screw. Oftentimes, the physician will elect to have another surgery to remove the screw after the syndesmotic ligament has healed. While other doctors leave the screw in place after the syndesmotic ligament has healed with the knowledge that few reported problems have existed if the screw were to break.
References
Cluett, J. (2005). High ankle sprain. Retrieved November 12, 2008, from About.com: Orthopedics Web site: http://orthopedics.about.com/od/sprainsstrains/a/syndesmosis.htm
Prentice, W. E. (2006). Arnheim’s principles of athletic training: A competency-based approach. New York: McGraw-Hill.
| Amy Leslie, ATC, is a first year graduate student and recipient of the Hughston Athletic Training Fellowship Program in Columbus, Georgia. Ms. Leslie, a native of Raleigh, NC, graduated Magna Cum Laude from Greensboro College with a Bachelor of Science degree in Athletic Training in May 2008. While attending GC she completed rotations with football, men’s basketball, men’s soccer, women’s lacrosse, men’s lacrosse, Urgent Family and Medical Care, Murphy Wainer Orthopedic Specialists, Greensboro Orthopaedics, and Southeast Guilford High School. Amy was a member of Beta Beta Beta Biological Honor Society, Alpha Chi Inter-Disciplinary Honor Society, and Who’s Who Among Students in American Universities &Colleges. She served as President of GC’s Athletic Training Club from 2007-2008 and is an active member of the National Athletic Trainers Association (NATA). Amy has been assigned to serve as the head athletic trainer at Jordan Vocational High School. |
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