Syndesmosis injury

This refers to an injury of the tough fibrous joint between the lower tibia (shin bone) and fibula just above the ankle on the outside. It is often referred to as a high ankle sprain. It is a very strong joint between the bones that allows very little movement. It becomes injured when the leg is twisted on the foot or when the ankle is rolled, and is common in sports that involve twisting pivoting and cutting especially when wearing studs (which prevent the foot from slipping on the ground and transfer the force to the body).

You will have a notable ankle injury or sprain and will feel pain just above, in front and to the outside of the ankle. Activities involving twisting or pivoting may bring on pain. Sometimes you make have an ankle sprain that largely settles but you are left with this sort of residual pain. This is when there has been a syndesmosis injury that has been missed. If you have had this as a fresh injury you should stop activity. Rest, ice, compression and elevation are important in the first 48 hours to limit swelling.

If you think you have this condition it is well worth getting it checked out by Mr Willis-Owen. In the mean time you should avoid any activities with may exacerbate the problem. Depending on the severity X-rays may be required to assess the joint. There may be damage which is best seen on an MRI scan. Mild syndesmosis sprains will settle on their own within a matter of a few weeks, but more severe injuries may require a period of time in a surgical boot to allow the ligaments to heal. Sometimes with a significant injury surgery is needed to stabilise the joint. This can be done with metal screws which are taken out after 8 -12 weeks, or more recently Mr Willis-Owen have been using a new technique using a 'tightrope' device. Good physiotherapy is required to fully recover and regain you joint position sense. Failing to do this is a common cause of recurrent ankle sprains.