High ankle sprain (syndesmosis injury)

Injury to the ligaments connecting the two lower-leg bones above the ankle.

Overview

A high ankle sprain injures the syndesmosis, the ligaments binding the shin bones just above the ankle. It often takes longer to recover than a typical ankle sprain and benefits from a careful, graded return to loading.

Symptoms

  • Pain above the ankle, between the shin bones
  • Pain with twisting and pushing off
  • Pain on weight-bearing
  • Slower recovery than a typical sprain

Causes

  • Forceful twisting of the ankle
  • Sporting collisions and pivots
  • Outward rotation of the foot

Treatment

  • Protected weight-bearing early
  • Graded loading and strengthening
  • Balance and control work
  • Surgical opinion for unstable injuries