Well, following the Week Two injury massacre, things didn’t get much better, especially for Saquon Barkley and the New York Giants. He was formally diagnosed with a syndesmotic ankle sprain (high ankle sprain) and is in a boot and using crutches to get around. But what the heck is a high ankle sprain anyway? I’ll four questions about the dreaded high ankle sprain. Make sure you follow me on Twitter for up to the minute injury evaluations @FFStudentDoc.

What it is a syndesmosis sprain? 

A syndesmosis sprain is disruption of the connective tissue that holds the tibia and fibula together at the ankle joint (which is called a syndesmotic joint). It’s responsible for stabilizing the joint, which is made up of the talus, the tibia, and the fibula. A sprain to the ligaments around that joint is considered a “high ankle sprain” or a sprain of the syndesmosis joint. Make sense now? Check the picture if it’s still not clear.

Reference 1

How does it happen?

This injury usually occurs when several of the body’s joint kinematics are forcibly altered at once:

  1. The foot is planted flat on the ground.
  2. The same knee is slightly bent.
  3. Next, a defender simultaneously forces the ankle into dorsiflexion (think knee over the toes) and external rotation (think “duck feet”). 

This severely compromises the structures holding the ankle in place, and usually causes damage visible on an MRI or ultrasound. 

How long does it take to heal?

Most of these sprains heal on their own but depending on the severity it could take any where from four to eight weeks to heal. Luckily, the average return to sport time for these injuries is just around five weeks with a range of four to six weeks (reference 2). 

How do you fix it?

Like almost every muscle, bone, nerve or tendon injury, most people who suffer a high ankle sprain will be spending a lot of time with a Doctor of Physical Therapy for rehab. Their plan of care will include some combination of pain control, swelling reduction, offloading the joint, calf strengthening, and eventually progress to sport specific strength and conditioning (reference 3). It’s a very fixable injury with a rare need for surgery.

I appreciate you reading, and I hope you found this article helpful!

Reference 1: https://www.physio-pedia.com/Distal_Tibiofibular_Syndesmosis

Reference 2: https://www.uptodate.com/contents/syndesmotic-ankle-injury-high-ankle-sprain/abstract/55

Reference 3: https://www.physio-pedia.com/Syndesmotic_Ankle_Sprains

Edwin Porras is a Contributor for the Unwrapped Sports Network website. Follow him @FFStudentDoc on Twitter.