SYNDESMOSIS INJURY by Senior Physiotherapist Daniel Browne

SYNDESMOSIS INJURY

In recent times with the return to football, we are noticing an increased incidence of syndesmosis injuries (sometimes referred to as a “high ankle sprain”).

Today I’m going to break down what the syndesmosis is, how it’s impacted when we roll our ankle, and some strategies and management tips for overcoming and preventing syndesmosis injuries.

 

WHAT IS IT?

The syndesmosis in the lower leg serves is part of a mesh known as the interosseus membrane which helps to both hold the tibia (shin bone) and fibula (bone on the outside of the lower leg) together as well as serve as a pathway for neurovascular structures.

WHAT DOES IT DO?

Functionally, the role of the syndesmosis is to provide stability during rotational movements when the foot is planted and loading occurs through the ankle. During weightbearing activities, there will be a natural small amount of movement that occurs between the bones of the lower leg. The syndesmosis prevents these two bones from widening too far. In a syndesmosis injury, there is a disruption of the lower  attachment between these bones causing issues with stability and pain.

HOW COMMON IS IT?

Syndesmosis injury is relatively common reportedly occurring in up to 18% of all ankle sprains to varying degrees. Easily missed, these injuries can lead to chronic ankle instability, ongoing pain, poor balance as well as a longer recovery to return to sport/physical activity.

HOW WILL A PHYSIOTHERAPIST HELP?

A physiotherapist will perform a detailed assessment on both the ankle and syndesmosis to determine the nature of your injury. This will be a combination of both a subjective and objective assessment. From here, immobilisation of the joint will be required either with taping or a moon boot as deemed necessary based on the severity. Manual therapy may also be used for pain relief of surrounding muscles. Following this, education on appropriateness of current activities is offered, with a graduated return to exercise through a structured rehabilitation program.