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High ankle sprain injuries occur when the ankle bends, twists and rolls simultaneously with a lot of forces splitting the ligament that hold the two lower leg bones together. When the perfect storm of forces hit an athlete’s ankle, the effects on their season can be devastating. The forces involve a plantar flexed and inverted ankle with rotatory forces causing the ankle to roll forward. These forces cause the syndesmotic ligament which runs vertically between the two lower leg bones (tibia and fibula) to tear longitudinally. The torn syndesmotic ligament has a poor blood supply and takes a long time to heal.
The good news is most high ankle sprains will heal if treated properly. The biggest requirement in the early phase of treatment is rest and a walking boot. Usually non–weight bearing ambulation and a properly fitted walking boot provide maximal stability for proper healing. Once your surgeon determines the ankle is well healed (manual testing, MRI, X-ray etc…) physical therapy is recommended to address the effects of immobility. A 4 to 6 week physical therapy program would address weakness, atrophy and decreased proprioception before resuming any sports activity.
Things to remember when an athlete hears “High Ankle Sprains”