A high ankle sprain after a crash may need a closer look
A foot and ankle surgeon on injuries to the syndesmosis
A high ankle sprain hurts the ligaments that hold the lower ends of the shinbone and the fibula together. The fibula is the thinner bone in the lower leg. This connection is called the syndesmosis. [1, 2]
In a crash, the foot can twist against the leg. A crash can also break a bone along with this ligament injury. It may feel like a normal ankle sprain. Even so, the joint can be unstable and may need a different treatment plan. [1, 2]
Check whether the ankle is stable
Tell your doctor where it hurts. Mention it especially if the pain sits above the ankle or runs up the outside of your leg. Ask whether your images show a broken bone or a gap between the lower leg bones. [1, 2]
Some people need stress X rays, an MRI or other imaging. If pain reaches toward the knee, ask whether the top of the fibula was checked. Your treatment is based on how stable the joint is. Swelling by itself isn’t enough to decide. [1, 2]
Follow the right walking plan
A stable injury may heal with protection and rehab. A broken bone or an unstable syndesmosis may need surgery. Ask exactly how much weight you can put on the leg. Find out which boot, cast or walking aid to use. [1, 2]
Wearing a boot doesn’t clear you to walk normally. Therapy should bring back your motion, strength and balance step by step. [1, 2]
Go back if symptoms change
Get urgent care for a cold or pale foot, major new numbness or severe pain that keeps climbing. Call your care team if swelling or pain gets worse once you start walking. Also call if the ankle feels unstable even though you’re following the plan. If symptoms linger, get rechecked instead of easing back into running on your own. [1, 2]
What to ask about your ankle
- Is the syndesmosis stable, and is any bone broken?
- What are my exact rules for the boot and for putting weight on the leg?
- What will show that I’m ready to do more?
Have the weight limit shown to you
Sources and further reading
- 1American Academy of Orthopaedic Surgeons ankle fractures
- 2American Academy of Orthopaedic Surgeons sprained ankle
This article is general education written from a foot and ankle surgery point of view. A high ankle sprain can happen along with a broken bone. Your exam and imaging decide how much weight you can bear and how you’ll be treated.
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