Medical Disclaimer
The information on this page is for educational purposes only and is not intended to replace professional medical advice, diagnosis, or treatment.
Always seek the advice of your doctor or other qualified health professional with any questions you may have regarding a medical condition.
🚨Emergency? If you have severe symptoms, difficulty breathing, or think it's an emergency, call 000 immediately.
High Ankle Sprains (Syndesmotic Injuries)
Syndesmotic injuries (high ankle sprains) are tears of the ligaments connecting the two lower leg bones (tibia and fibula) just above the ankle - less common than regular ankle sprains (10% of all ankle injuries) but more serious, occurring from external rotation (twisting foot outward) or hyperdorsiflexion (excessive upward bending) during sports like rugby, AFL, skiing - most require 6-12 weeks immobilization in a walking boot, though severe unstable injuries require surgery with screws or flexible fixation devices to hold the bones together while ligaments heal, with return to sport typically 3-6 months due to risk of chronic ankle instability if healing inadequate
📖What is High Ankle Sprains (Syndesmotic Injuries)?
Syndesmotic injuries (high ankle sprains) are tears of the ligaments connecting the two lower leg bones (tibia and fibula) just above the ankle - less common than regular ankle sprains (10% of all ankle injuries) but more serious, occurring from external rotation (twisting foot outward) or hyperdorsiflexion (excessive upward bending) during sports like rugby, AFL, skiing - most require 6-12 weeks immobilization in a walking boot, though severe unstable injuries require surgery with screws or flexible fixation devices to hold the bones together while ligaments heal, with return to sport typically 3-6 months due to risk of chronic ankle instability if healing inadequate
🔬What Causes It?
- External rotation injury (foot planted and twisted outward) - most common in rugby, AFL, American football when tackled
- Hyperdorsiflexion injury (foot bent excessively upward) - skiing falls, landing from jump with foot dorsiflexed
- High ankle sprain with lateral ankle fracture (Maisonneuve fracture pattern)
- Eversion injury (ankle rolling outward) combined with rotation
⚠️Risk Factors
You may be at higher risk if:
- Contact sports (rugby, AFL, American football, ice hockey)
- Skiing (twisting falls)
- Previous syndesmotic injury (ligaments heal with lengthening, reduced stability)
- Inadequate rehabilitation from previous ankle injury
- Playing on artificial turf (increased traction, more twisting forces)
🛡️Prevention
- ✓Ankle strengthening exercises (especially eversion and dorsiflexion muscles)
- ✓Proprioceptive training (balance exercises, wobble board)
- ✓Adequate rehabilitation after any ankle injury before returning to sport
- ✓Ankle taping or bracing during high-risk sports (may reduce severity, unclear if prevents injury)
- ✓Avoid returning to sport with residual ankle pain or instability