An ankle sprain is a common injury that most often occurs to the outside, or lateral, side of your ankle when the joint turns inward. A less-common form of ankle injury is a syndesmotic ankle sprain, sometimes referred to as a high ankle sprain. A syndesmotic joint sprain is the straining of the ligaments above the ankle joint, and is common among hockey players. This type of sprain heals more slowly than a lateral ankle sprain; recovery includes rest and rehabilitation exercises.
RICE
The first step in rehabilitating a syndesmotic ankle sprain is use of the RICE method: rest, ice, compression and elevation. Like lateral ankle sprains, inflammation of the ligaments above the ankle causes pain and a limited range of motion. Wrapping your swollen foot in a compression bandage, putting your leg up and icing at 20-minute intervals can relieve some of the pain as well as reduce swelling. Moderate to severe sprains may require you to use crutches for several days until you bear weight more comfortably. During this phase of rehab, your ankle is stabilized with a support called a Donjoy walking boot or an air cast when your foot is not elevated.
Range of Motion Exercises
Slowly regaining your range of motion is the second phase of managing a syndesmotic ankle sprain. Perform ankle flexion and ankle rotations as much as pain allows. Point your toes to the ceiling and then down toward the floor to flex your ankle; rotate the joint in small circles to increase flexibility. You will still wear a boot or cast when not exercising. Range of motion exercises are recommended after approximately five to six days, once your swelling and pain has receded.
Strengthening Exercises
By the second week after your injury, you can start a strengthening routine, based on your physician's recommendations. Exercises include calf raises -- either static or walking on your toes -- balancing on your injured foot, and single-leg hops. You may also be instructed to use resistance bands to strengthen your ankle. Sit on the floor with your injured leg straight out in front of you. Loop a resistance band around the ball of your foot. Push against the band with your foot as you point your toes toward your body and away. During this period of rehab, you may try jogging without the boot.
Sport-Specific Exercises
Sport-specific exercises are the last phase of rehabilitation for a syndesmotic sprain, and come into play after the walking boot or air cast is no longer required. Most people are ready to begin sport-specific activities between three and four weeks post-inury. Your ankle will be taped to provide support during your drills and you will be cleared to resume your regular workout once you can participate in specified exercises without pain or limping. Activities may include lateral slides on a slide board to increase your strength for hockey or speed skating, two sports in which ankles are especially vulnerable to injury.
References
- "Athletic Therapy Today"; Management of Syndesmotic Ankle Sprains; Paul G. Silvestri, et al.; September 2002
- "Massage Today"; Syndesmosis Ankle Sprains; Whitney Lowe, LMT; February 2005
- The Athletic Coast Conference; Syndesmotic Ankle Sprains; Bert Lenz, ATC; Dec. 9, 2005
- Drugs.com: Active Range of Motion Exercises
