Some research studies have shown Erase My Back Pain that pain is undertreated currently, but if you look back at the mid-1990s it was significantly undertreated because of the fear of addiction. The way of thinking about pain has changed significantly so that there are physicians who are not as scared to prescribe narcotics for pain management. Now what is happening is that it is being shown that comprehensive pain management clinics are achieving better outcomes with their patients than those who solely prescribed narcotic medication. About 10% of all acute injuries seen by physicians are to the ankle. Most ankle sprains are on the outside of the ankle. The ligament (connecting tissue) between the tibia and fibula is called the syndesmosis. This is injured during a high ankle sprain. The generic term syndesmosis refers to a joint where the rough edges of 2 bones are connected with thick connective ligaments.
The syndesmosis between the tibia and fibula is a long connective tissue that is dense and helps stabilize the ankle joint. A high ankle sprain does not often occur in isolation, there are often other ligaments injured too. This may result in a longer healing time since multiple ligaments may be involved. These are the most severe ankle sprains and can be very frustrating for athletes, coaches, and trainers. At times, syndesmosis injuries occur along with fractures. This article is only discussing soft tissue ligament injury without fracture. Symptoms involved with a high ankle sprain that is isolated include: Point tenderness over the area of the outside ankle above the bony bump. Pain as the person attempts to weight bear on that side. Swelling above the ankle.
Pain as the upper part of the ankle is squeezed together (stressing the injured ligament) Pain as the foot is lifted up or rotated on the outside upper part of the ankle. In the workup for a high ankle sprain, x-rays are necessary to see if there are broken bones. The x-rays may also show the tibia and fibula separated more than usual if the ligament has been completely disrupted. If there is suspicion of significant disruption but x-rays look normal, stress x-rays may be needed.
Who gets high ankle sprains? Around 10% of all ankle sprains involve a syndesmosis injury. Sports that involve quick changes in direction or lots of jumping are prone to these injuries including soccer, basketball, football, and volleyball, or skiing. In skiing for instance, during a fall a person's binding may not release which can cause the initial ankle ligament injury and then travel up higher into the syndesmosis. At times, the syndesmosis sprain is missed, and is only noticed when conventional treatments are not working in a satisfactory timeframe for getting the athlete back in the game without pain. Syndesmosis injuries typically take twice as long to heal as regular ankle sprains.