Ankle & Foot
High Ankle Sprain (Syndesmosis Injury)
Also called: Syndesmotic sprain
Injury to the ligaments binding the two shin bones together just above the ankle — from forced outward twisting (football piles, ski falls). Sneakier and slower than a regular sprain: less swelling, more disability, roughly double the recovery time. Missing this diagnosis is the classic reason an 'ankle sprain' won't heal.
Common signs
- Pain above the ankle joint, especially with pushing off
- Pain when the lower leg is squeezed together above the ankle
- Difficulty with toe raises and pivoting
- Often modest swelling relative to the disability
Seek help now if
- Inability to bear weight (fracture and unstable syndesmosis assessment)
- Visible deformity
- Numbness or vascular changes
Any of these: call 911 or get to an emergency room first. Everything else can wait.
What to do first
- Get specifically tested for syndesmosis involvement — squeeze and rotation tests, and weight-bearing X-rays when indicated
- Stable injuries: protected weight-bearing (often a boot) longer than a standard sprain
- Respect the timeline: 6–10+ weeks is normal for stable injuries; frustration is expected, shortcuts are punished
If it's become chronic
- Rehab progresses through strength and balance to a push-off/cutting progression with objective criteria
- Unstable injuries (widening on X-ray) need surgical stabilization — this is why the diagnosis matters
- Lingering pain after 'a bad sprain' months ago deserves a syndesmosis re-look
Natural healing options we use
- Phase-appropriate chiropractic and manual care for the foot-ankle-knee chain
- Progressive loading and balance programming
- PEMF and attended e-stim
- Collagen, protein, vitamin D support
About imaging
Weight-bearing X-rays assess stability; MRI characterizes ligament injury when the exam raises concern.
Daily self-care
- Follow the boot/weight-bearing plan exactly
- Push-off activities return last, by criteria
- Balance training through the full course
More in Ankle & Foot
Lateral Ankle SprainAchilles TendinopathyAchilles Tendon RupturePlantar FasciitisPosterior Tibial Tendon DysfunctionShin SplintsBone Stress Injury / Stress FractureMorton's Neuroma
Please read: this page is education, not a diagnosis. A proper examination is how a condition gets confirmed and a plan gets built. See our medical disclaimer.