Ankle injuries are a common concern, especially in sports or high-impact activities. One of the more serious and often misunderstood injuries is the ankle syndesmosis injury, also known as a high ankle sprain.
This guide covers everything you need to know—from causes and symptoms to treatment, rehab, and how physiotherapy plays a crucial role in your recovery.
What Is an Ankle Syndesmosis Injury?
An ankle syndesmosis injury affects the ligaments that connect the tibia and fibula, the two bones in your lower leg. These ligaments form the syndesmosis joint, which provides stability to the ankle during movement.
Unlike a standard ankle sprain (which affects the outer ligaments), a syndesmosis sprain occurs higher up and often takes longer to heal.
Common Causes of High Ankle Sprains
Ankle syndesmosis injuries typically happen due to:
Twisting or rotating the ankle while the foot is planted
Sudden direction changes in sports like soccer, football, or basketball
Falls during skiing or snowboarding
Direct impact to the leg or ankle
Symptoms of Ankle Syndesmosis Injuries
Here are the main signs to watch out for:
Sharp pain above the ankle
Swelling and bruising, especially at the front or side of the ankle
Pain when walking or bearing weight
Tenderness when the tibia and fibula are squeezed together
Increased pain with foot rotation
If these symptoms sound familiar, don’t brush them off. Early diagnosis is key.
How Is It Diagnosed?
A healthcare professional may use the following tools:
Physical Assessment
Squeeze Test – Pain when the lower leg bones are compressed
External Rotation Test – Pain when the foot is turned outward
Single-Leg Hop Test – Difficulty jumping or bearing weight
Imaging Techniques
X-rays – To rule out fractures
MRI – To assess ligament damage
CT scans – Used for complex or chronic cases
Treatment for Ankle Syndesmosis Injuries
Treatment depends on how severe the injury is.
Mild (Grade I)
Rest, Ice, Compression, Elevation (R.I.C.E.)
Temporary use of crutches or walking boot
Physiotherapy for mobility and strength
Moderate (Grade II)
Extended immobilization
Use of crutches or walking boot for 4–6 weeks
Rehabilitation to restore balance and range of motion
Severe (Grade III)
Surgical repair using syndesmosis screws or tightrope technique
Longer recovery time (8–12+ weeks)
Post-surgery physical therapy essential for recovery
Physiotherapy for Ankle Syndesmosis Injury
Physiotherapy plays a vital role in every stage of recovery. At clinics like Pitt Meadows Physiotherapy, treatment is personalized for your needs.
Key Physio Goals:
Reduce pain and inflammation
Restore ankle range of motion
Strengthen surrounding muscles
Improve balance and joint control
Prevent future ankle injuries
Rehab Phases with Physio Support
Phase 1: Pain & Inflammation Control
Ice therapy, elevation, manual lymph drainage
Phase 2: Mobility and Strengthening
Gentle range of motion exercises
Resistance training for calves, hamstrings, and foot muscles
Phase 3: Balance & Return to Activity
Single-leg stands, agility drills, sport-specific movement
Additional Physiotherapy Services for Overall Health
Physiotherapy isn’t just for ankle injuries. At Pitt Meadows Physiotherapy, we offer a wide range of services to help with various conditions:
💪 Sports Injury Rehabilitation
Custom recovery plans for sprains, strains, torn ligaments, and post-surgical recovery.
🤕 Chronic Pain Management
Treatments for back pain, neck pain, fibromyalgia, and other long-term conditions.
🧍♂️ Postural Correction & Ergonomics
Correct poor posture from sitting or working at a desk all day. Great for office workers!
🦵 Pre/Post-Surgical Rehab
Supportive therapy before and after surgery (ACL repair, joint replacements, etc.) to speed healing.
🧠 Concussion and Vestibular Therapy
Specialized programs for dizziness, balance issues, and post-concussion symptoms.
👶 Pediatric Physiotherapy
Gentle, age-appropriate care for children with developmental delays or injuries.
🤰 Pelvic Floor & Women's Health
Help for incontinence, pelvic pain, or postpartum recovery.
🦽 ICBC & WorkSafeBC Claims
Direct billing available. Return-to-work programs for auto or workplace injuries.
Explore all services here: Physiotherapy Services Overview
Recovery Time: What to Expect
Mild injuries: 3–6 weeks
Moderate injuries: 6–12 weeks
Severe cases (with surgery): 3–6 months
Consistency with physical therapy speeds healing and improves long-term outcomes.
Preventing Future Ankle Injuries
Take these steps to lower your risk:
Always warm up before exercise
Strengthen ankle and leg muscles
Use ankle support braces if advised
Wear proper footwear for your sport
Don’t return to play too soon after injury
Frequently Asked Questions (FAQs)
💬 Can I walk on an ankle syndesmosis injury?
If mild, you might walk with discomfort. Severe cases need rest and support. Always consult a physiotherapist or doctor first.
💬 Do I need surgery for a high ankle sprain?
Not always. Mild to moderate cases usually heal with non-surgical care. Severe ligament tears may require surgery.
💬 How soon can I play sports again?
Return-to-sport depends on healing and rehab progress. It may take 6–12 weeks or longer. A physiotherapist will guide you safely back.
💬 What happens if I don’t treat this injury?
Ignoring it can lead to chronic pain, arthritis, and long-term instability. Get professional help early.
Final Thoughts
An ankle syndesmosis injury is more than just a simple sprain—it’s a serious condition that needs proper diagnosis, treatment, and care. With expert support from physiotherapists, recovery is not only possible—it can be complete and long-lasting.
Start Your Recovery with Expert Care
Are you dealing with ankle pain or recovering from a high ankle sprain? Pitt Meadows Physiotherapy is here to help. Our team of experienced therapists will create a plan that’s right for your injury and your life.
👉 Book your appointment today at pittmeadowsphysio.ca
Let’s get you back to doing what you love—pain-free
We provide same-day physiotherapy appointments for healthcare workers, first responders, and seniors. With over 50 years of combined experience, our team has been delivering high-quality care since 1991. We proudly serve residents of Pitt Meadows, Maple Ridge, Port Coquitlam, Coquitlam, and Langley, helping individuals recover from a wide range of injuries. We are available six days a week to accommodate your needs.
Email: pittmeadowsphysio@gmail.com
Phone: (604) 465-8733
Address: 19133 Ford Road Pitt Meadows, BC, V3Y 2R5 Canada
Website: https://www.pittmeadowsphysio.ca/contact-us
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