Syndesmosis Injury

Syndesmosis Injury

- Article by John Miller

Syndesmosis Injury

Understanding and Managing the Condition

Defining Syndesmosis Injury

A syndesmosis injury involves damage to the syndesmosis joint, the fibrous structure connecting the tibia and fibula above the ankle joint. This injury encompasses a range of damages, including high ankle sprains, and affects the ligaments and possibly other structures within the joint.

Syndesmosis vs. High Ankle Sprains

While a high ankle sprain is a type of syndesmosis injury affecting specific ligaments, syndesmosis injuries can be more complex, involving broader trauma to the joint.

Causes and Symptoms

How Syndesmosis Injuries Occur

These injuries often result from similar mechanisms as high ankle sprains, such as forceful twisting of the foot or severe ankle loading, but can also include other trauma types affecting the lower leg.

Recognising Symptoms

Common symptoms are akin to high ankle sprains but may also include a wider range of pain and instability in the ankle. The severity and involved structures dictate symptom variation.

Diagnosis and Treatment Strategies

Diagnosing Syndesmosis Injuries

Healthcare professionals, including physiotherapists and sports doctors, conduct clinical assessments and may use imaging tests like X-rays, CT scans, or MRIs for a precise diagnosis.

Effective Treatment Approaches

The treatment of syndesmosis injuries varies depending on stability and severity. Stable injuries may be managed conservatively, while unstable injuries often require surgical intervention. Physiotherapy is integral to both conservative and post-surgical rehabilitation.

Syndesmosis Injury
Syndesmosis Injury

Physiotherapy Treatment Phases

Phase 1: Initial Management

RICE (Rest, Ice, Compression, Elevation) is the first line of treatment, supplemented by active rest, compression bandages, and elevation. Physiotherapists may also employ pain-relieving techniques. If you don’t require immediate surgery you will be placed in a moon boot.

Phase 2: Regaining Range of Motion

Focused exercises and massage target improving joint range of motion, muscle length, and neural tissue movement, avoiding overstretching.

Phase 3: Muscle Strength Restoration

Progressing from non-weight-bearing exercises to resistance-loaded ones is essential for restoring ankle and foot muscle strength.

Phase 4: Foot Biomechanics Normalisation

Foot arch control is assessed, potentially leading to orthotic use or stabilisation programs.

Phase 5: High-Speed, Power, Proprioception, and Agility Restoration

Rehabilitation addresses balance and proprioception to reduce re-injury risks and prepares for sport-specific activities.

Phase 6: Sport Reintegration

Customised training programs ensure safe sport resumption, focusing on the individual’s specific needs.

Recovery and Prevention

Understanding Recovery Timelines

Recovery duration varies widely, influenced by injury severity and the specific structures involved. Professional rehabilitation is crucial for effective healing and function restoration.

The Importance of Professional Care

Untreated syndesmosis injuries can lead to chronic problems, including joint stiffness, instability, and arthritis. Early and proper treatment is vital.

Conclusion: The Central Role of Physiotherapy

Physiotherapy is key in the successful management of syndesmosis injuries. Accurate diagnosis, tailored treatment plans, and comprehensive rehabilitation are essential for optimal recovery and prevention of long-term complications.

For anyone suspecting a syndesmosis injury, it’s crucial to seek professional advice from a physiotherapist and or an ankle specialist. Timely and appropriate care is the cornerstone of effective recovery and return to active life.

Foot, Ankle & Heel Pain Products & FAQs

Common Ankle Injuries

Welcome to an exploration of common ankle injuries. The ever-present sprained ankle is at the forefront, accompanied by various sources contributing to ankle pain. Fractures, stress fractures, and tendinopathies are part of this landscape, each with implications. Ankle impingement and foot posture issues emerge, and biomechanical issues take centre stage, affecting alignment and eventually fast-tracking ankle arthritis. Even the younger population experiences heel concerns, with Severs disease impacting many young athletes' seasons. This article serves as a concise guide to understanding the complexities of ankle problems.

Sprained Ankles

The most common ankle injury is a sprained ankle, but ankle pain can have numerous sources.

Ankle Fractures

An ankle fracture occurs when there is a break in one or more of the bones. The most common ankle fractures are avulsion fractures of your distal fibula, which can be a side effect of an ankle sprain. All suspected fractures require medical investigation and professional management by your health professional to avoid long-term foot and ankle issues. If your healthcare professional suspects an ankle fracture, you will be referred for at least an X-ray and potentially an Orthopaedic Surgeon.

Ankle Tendinopathies

While muscle strains are more common in your legs, there are essential muscles that converge into tendons that wrap around your ankle to stabilise your ankle and foot to protect them from sprains and allow you to walk and run. These muscles and their tendon vitally provide a normal foot arch and avoid flat feet. Your muscles or tendons can become injured or inflamed due to overuse or trauma. The inflammation is called tendonitis. They can also tear, completely rupture, or sublux out of place. Medically tendon injuries are known as tendinopathies, and at the ankle may include:

Ankle Arthritis

Your ankle pain and dysfunction can lead to degenerative conditions such as ankle osteoarthritis. While arthritis usually is a chronic deterioration of your ankle joint, it is crucial to slow ankle arthritis progression. Would you please seek the professional advice of your ankle and foot health practitioner, e.g. physiotherapist or podiatrist?

Biomechanical Conditions

Biomechanical disorders may result in foot deformation, painful weight-bearing and potentially nerve compression. In simple terms, this is where your foot and ankle do not have normal bone alignment and motion control. Here are a few possible conditions related to poor ankle biomechanics.

Muscle Injuries

Nerve-Related Ankle Pain

Children & Youth Conditions

Systemic Conditions That May Cause Ankle Pain

Soft Tissue Inflammation

Other Useful Information

Foot, Ankle & Heel Pain FAQs

Welcome to our comprehensive FAQ guide on Foot, Ankle & Heel Pain. In this guide, we aim to address common questions and concerns related to foot, ankle, and heel pain. We will cover various topics, including ankle injuries, heel pain, Achilles pain, foot pain, shin pain, youth injuries, and balance and proprioception. Whether you're experiencing discomfort or seeking preventive measures, this guide will provide valuable insights and advice to help you understand and manage these conditions effectively.

Ankle Injuries

Heel Pain

Achilles Pain

Foot Pain

Shin Pain

Youth Injuries

Balance & Proprioception

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