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.

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.

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