A syndesmotic ankle, commonly known as a high ankle sprain, is a type of injury that affects the ligaments located above the ankle joint, specifically those that hold the tibia and fibula together. This injury is distinct from the more common lateral ankle sprain, which affects the ligaments on the outside of the ankle. Understanding, diagnosing, and treating this type of sprain is crucial for ensuring proper recovery and preventing long-term instability or complications.
What is a Syndesmotic Ankle (High Ankle Sprain)?
Definition and Anatomy
A syndesmotic ankle sprain involves the injury of the syndesmotic ligaments, which are integral in maintaining the alignment between the tibia and fibula. The syndesmosis is a fibrous joint that holds these two bones together, and it is reinforced by the anterior inferior tibiofibular ligament and the posterior inferior tibiofibular ligament. Unlike a common ankle sprain, which affects the lateral ankle ligaments, a syndesmotic sprain can lead to significant ankle instability due to the crucial role these ligaments play in stabilizing the ankle joint. Injury to these ligaments can occur when there is excessive external rotation or twisting of the foot and ankle, often during sports or high-impact activities.
Causes and Risk Factors
The primary cause of a high ankle sprain is the forceful twisting or rotation of the ankle and foot, often resulting from activities that involve sudden changes in direction or speed. Sports such as soccer, football, and skiing, which require rapid pivoting movements, are common culprits for this type of injury. Additionally, individuals with previous ankle injuries or chronic ankle instability are at a higher risk of experiencing a syndesmotic ankle sprain. Factors such as poor footwear, uneven surfaces, and inadequate warm-up routines can also contribute to the likelihood of sustaining this injury. Understanding these causes and risk factors is essential in preventing high ankle sprains and ensuring proper treatment and recovery.
Recognizing the Symptoms of a High Ankle Sprain
How to Identify a High Ankle Sprain
Symptoms of a syndesmotic ankle sprain can be more subtle than those of a lateral ankle sprain, making it crucial to recognize the signs early. Individuals often experience pain located above the ankle, particularly when the ankle rolls outward or during activities that involve weight-bearing or twisting motions. Swelling and bruising around the ankle and lower leg may also occur, along with a sensation of instability in the ankle joint. Because these symptoms can easily be mistaken for a more common ankle sprain, it is important to pay close attention to the specific location and nature of the pain, as well as any associated difficulties in movement.
When to Seek Medical Attention
It is crucial to seek medical attention when experiencing persistent pain, swelling, or instability following an ankle injury, as these could be indicative of a syndesmotic ankle sprain. If symptoms do not improve with rest and self-care measures within a few days, or if the pain worsens, a healthcare professional should be consulted. Additionally, if there is a noticeable deformity in the ankle or an inability to bear weight on the affected foot, this could signal a more severe injury, such as an associated fracture, requiring immediate medical evaluation. Timely diagnosis and treatment are key to preventing complications and ensuring proper healing.
Diagnosis of Syndesmotic Ankle Injuries
Clinical Examination Techniques
The diagnosis of a high ankle sprain typically begins with a thorough clinical examination by a healthcare professional. This may include a physical assessment of the injured ankle, where the doctor will check for tenderness, swelling, and range of motion. The squeeze test is a common technique used to evaluate the integrity of the syndesmotic ligaments, by applying pressure to the tibia and fibula together in the lower leg. This test can help identify any instability or separation between the bones, which is indicative of a syndesmotic injury. Additionally, the doctor may assess for any signs of an associated fracture or other injuries of the ankle to ensure a comprehensive diagnosis.
Imaging and Advanced Diagnostics
In some cases, imaging tests such as X-rays, MRI, or CT scans may be necessary to confirm the diagnosis and assess the extent of a syndesmotic ankle injury. X-rays can help rule out any associated fractures, while MRI and CT scans provide detailed images of the soft tissues, including the syndesmotic ligaments. These advanced diagnostic tools are particularly useful in identifying subtle injuries that might not be apparent during a physical examination. By combining clinical examination findings with imaging results, healthcare professionals can develop an accurate diagnosis and tailor a treatment plan that addresses the specific needs of the injured ankle.
Treatment Options for High Ankle Sprains
Conservative Management Strategies
For many individuals with a syndesmotic ankle sprain, conservative management strategies are effective in promoting healing and recovery. In some cases, immobilization with a brace or walking boot may be recommended to prevent further injury and support the healing ligaments.
- Physical therapy can also play a crucial role in restoring strength, flexibility, and range of motion to the injured ankle. Exercises may focus on strengthening the muscles around the ankle joint and improving balance and proprioception to prevent future sprains. Adhering to these conservative treatment strategies can significantly reduce recovery time and facilitate a return to normal activities.
If you would like to learn more about an excellent at-home rehab program that heals the ankle fully and fast, please click: HEM ANKLE REHAB
Pay once. Get lifetime access.
30 day money back guarantee
15 YEARS. 100K HEALED.
Once I started HEM, the swelling and bruising subsided significantly and on the 4th day, I was walking comfortably again. I was shocked!
– Erikka Fernando
Thank you so much! It’s pretty amazing that I am doing as much as I am after a severe sprained ankle! Thanks for your support!!!
– Laurie Prindle
From the desk of Scott Malin, NASM-CPT
Creator, HEM Ankle Rehab
January 20, 2025
If you want to heal your ankle fully & fast…
And get back to doing what you love PAIN-FREE, without the fear of re-injury…
This will be the most important thing you ever do for yourself.
Here’s why:
My name is Scott Malin and fifteen years ago, I had to give up what I love… playing basketball. It literally crushed me to give it up!!
But, I had sprained my ankles so many times that I could no longer play.
Every time it happened, I used R.I.C.E. (rest, ice elevation, compression), but my ankles took months to heal and just kept getting weaker and more painful.
I tried everything, including ankle braces, but they made my ankles even weaker and then my knees started hurting too!
When I sprained my ankle one last time and had to crawl off the court, I knew I was done.
That night, I sat in my apartment and cried.
I was in my early thirties and thought I had to give up what I loved for the rest of my life.
But, I had no other option…
My ankles were just way too weak, stiff and unstable and painkillers/ice did nothing anymore.
As I lay in bed, staring up at the ceiling, I remembered back to when I trained with a clinician for the National Academy of Sports Medicine and Soft Tissue Therapist for the Los Angeles Clippers.
I also thought about a revolutionary Naturopath that taught me so much about healing the body naturally.
Then, I came up with a crazy idea…
It instantly improved how my ankle felt.
And the more I did it, the better my ankle got.
By day 6, my ankle was 100% pain-free and felt stronger and more stable than BEFORE I got injured.
The best part… I PLAYED BASKETBALL AGAIN, BUT THERE WAS NO PAIN!!
Afterward, I cried again, but they were tears of joy!!
When I told them what I did, my basketball buddies laughed and said I was crazy.
They called me a “dreamer”.
But, I didn’t care.
Because I had nothing to lose and everything to gain.
I threw my ankle braces away.
After months of late nights, early mornings, and lots of trial and error…
I created a complete, at-home healing system with incredibly reliable results:
- Heals new ankle injuries including ANY type and grade of ankle sprain.
- Heals old ankle injuries that never fully healed.
- Heals weak and unstable ankles.
- Even heals most Achilles, calf and foot injuries!
Since I was a fitness trainer, I was able to help all my clients (celebrities and athletes) whenever they got injured (which happened a lot!).
I was even on the news a few times!!!
The response from my clients was so overwhelming that a few of them eventually convinced me to make it available to everyone.
And even though it is incredibly complete, I always wanted to keep it SUPER simple and easy to do.
So, just follow along with me on any device and that’s it!
You get instant access to all the videos, which are short and focused on quickly giving you the information you need.
I will show you the absolute BEST rehab techniques, exercises, stretches, activations, holistic techniques, prehab techniques, etc….
These are techniques you will NOT find online anywhere else.
You will learn the perfect form for everything to get the best possible results.
It has taken many years of incredibly hard and dedicated work, but I am so humbled that over 100,000 people have healed themselves fully and fast with my program.
If you don’t believe me, please, check out all the reviews, including video testimonials, before and after pictures, etc. from people of all ages.
And listen, I know you’re probably still skeptical. That’s totally fair…
That’s why we have a very simple, no hassle, 30 day money back guarantee, so it’s completely risk-free to give it a try right now.
I created this program, because I don’t want others to go through all the pain and misery that I did!!
I don’t want anyone else to give up what they love…
Life is too short!!!
And now, there’s an easy way you can heal yourself and get back to your life.
I wish you all the best and thank you!!
Pay once. Get lifetime access.
30 day money back guarantee
Pay once. Get lifetime access.
30 day money back guarantee
15 YEARS. 100K HEALED.
Once I started HEM, the swelling and bruising subsided significantly and on the 4th day, I was walking comfortably again. I was shocked!
– Erikka Fernando
Thank you so much! It’s pretty amazing that I am doing as much as I am after a severe sprained ankle! Thanks for your support!!!
– Laurie Prindle
From the desk of Scott Malin, NASM-CPT
Creator, HEM Ankle Rehab
January 20, 2025
If you want to heal your ankle fully & fast…
And get back to doing what you love PAIN-FREE, without the fear of re-injury…
This will be the most important thing you ever do for yourself.
Here’s why:
My name is Scott Malin and fifteen years ago, I had to give up what I love… playing basketball. It literally crushed me to give it up!!
But, I had sprained my ankles so many times that I could no longer play.
Every time it happened, I used R.I.C.E. (rest, ice elevation, compression), but my ankles took months to heal and just kept getting weaker and more painful.
I tried everything, including ankle braces, but they made my ankles even weaker and then my knees started hurting too!
When I sprained my ankle one last time and had to crawl off the court, I knew I was done.
That night, I sat in my apartment and cried.
I was in my early thirties and thought I had to give up what I loved for the rest of my life.
But, I had no other option…
My ankles were just way too weak, stiff and unstable and painkillers/ice did nothing anymore.
As I lay in bed, staring up at the ceiling, I remembered back to when I trained with a clinician for the National Academy of Sports Medicine and Soft Tissue Therapist for the Los Angeles Clippers.
I also thought about a revolutionary Naturopath that taught me so much about healing the body naturally.
Then, I came up with a crazy idea…
It instantly improved how my ankle felt.
And the more I did it, the better my ankle got.
By day 6, my ankle was 100% pain-free and felt stronger and more stable than BEFORE I got injured.
The best part… I PLAYED BASKETBALL AGAIN, BUT THERE WAS NO PAIN!!
Afterward, I cried again, but they were tears of joy!!
When I told them what I did, my basketball buddies laughed and said I was crazy.
They called me a “dreamer”.
But, I didn’t care.
Because I had nothing to lose and everything to gain.
I threw my ankle braces away.
After months of late nights, early mornings, and lots of trial and error…
I created a complete, at-home healing system with incredibly reliable results:
- Heals new ankle injuries including ANY type and grade of ankle sprain.
- Heals old ankle injuries that never fully healed.
- Heals weak and unstable ankles.
- Even heals most Achilles, calf and foot injuries!
Since I was a fitness trainer, I was able to help all my clients (celebrities and athletes) whenever they got injured (which happened a lot!).
I was even on the news a few times!!!
The response from my clients was so overwhelming that a few of them eventually convinced me to make it available to everyone.
And even though it is incredibly complete, I always wanted to keep it SUPER simple and easy to do.
So, just follow along with me on any device and that’s it!
You get instant access to all the videos, which are short and focused on quickly giving you the information you need.
I will show you the absolute BEST rehab techniques, exercises, stretches, activations, holistic techniques, prehab techniques, etc….
These are techniques you will NOT find online anywhere else.
You will learn the perfect form for everything to get the best possible results.
It has taken many years of incredibly hard and dedicated work, but I am so humbled that over 100,000 people have healed themselves fully and fast with my program.
If you don’t believe me, please, check out all the reviews, including video testimonials, before and after pictures, etc. from people of all ages.
And listen, I know you’re probably still skeptical. That’s totally fair…
That’s why we have a very simple, no hassle, 30 day money back guarantee, so it’s completely risk-free to give it a try right now.
I created this program, because I don’t want others to go through all the pain and misery that I did!!
I don’t want anyone else to give up what they love…
Life is too short!!!
And now, there’s an easy way you can heal yourself and get back to your life.
I wish you all the best and thank you!!
Pay once. Get lifetime access.
30 day money back guarantee
REAL PEOPLE, REAL RESULTS
Just got your videos for the holistic rehab the other day. It has already helped and I am so grateful as I know Drs want to cut you open and ask questions later. My left ankle is very badly sprained, completely black and purple and swollen half way up my calf. I am an athlete and have zero intentions of being cut on now or in the future! It was a major eversion off a curb and I just want it to get back to normal. Thanks so much for putting this HEM ankle rehab together, it's a godsend! Have a beautiful day.
Warm regards,
Faith Washington BSPharm, RPh, CSCS, CPT
Hey there,
I literally purchased this program about 20 minutes ago, and now having gotten partially through the videos... The content is already blowing my mind and I feel like this will be information I'll carry with me the rest of my life... Thank you for this info! Clearly you are a master of PT.
Hello Mr. Malin,
I want to thank you for this website. In the end of november, I sprained my ankle and my doctor said that there is an avulsion fracture in my ankle(ATFL). I had really hard times after this incident. When I was looking for how to heal fast, I saw your website. I tried to do as much as different exercises that you showed. Now I face some difficulties during my daily life due to my foot but swelling is decreasing everyday thanks to exercises. Especially, the video about how to activate ankle is very beneficial for me.
Thanks for your support both mentally and physically.
Sincerely,
Orhun Oktar, Electrical and Electronics Engineer
Your program is great. I actually broke one ankle and sprained the other. I just got the cast off and will begin rehab on that ankle now.
I bought your Hem Ankle program in 2018 and used it very successfully with THREE ankle injuries. I am also interested to buy the programme for knees etc.
Pay once. Get lifetime access.
30 day money back guarantee
REAL PEOPLE, REAL RESULTS
Just got your videos for the holistic rehab the other day. It has already helped and I am so grateful as I know Drs want to cut you open and ask questions later. My left ankle is very badly sprained, completely black and purple and swollen half way up my calf. I am an athlete and have zero intentions of being cut on now or in the future! It was a major eversion off a curb and I just want it to get back to normal. Thanks so much for putting this HEM ankle rehab together, it's a godsend! Have a beautiful day.
Warm regards,
Faith Washington BSPharm, RPh, CSCS, CPT
Hey there,
I literally purchased this program about 20 minutes ago, and now having gotten partially through the videos... The content is already blowing my mind and I feel like this will be information I'll carry with me the rest of my life... Thank you for this info! Clearly you are a master of PT.
Hello Mr. Malin,
I want to thank you for this website. In the end of november, I sprained my ankle and my doctor said that there is an avulsion fracture in my ankle(ATFL). I had really hard times after this incident. When I was looking for how to heal fast, I saw your website. I tried to do as much as different exercises that you showed. Now I face some difficulties during my daily life due to my foot but swelling is decreasing everyday thanks to exercises. Especially, the video about how to activate ankle is very beneficial for me.
Thanks for your support both mentally and physically.
Sincerely,
Orhun Oktar, Electrical and Electronics Engineer
Your program is great. I actually broke one ankle and sprained the other. I just got the cast off and will begin rehab on that ankle now.
I bought your Hem Ankle program in 2018 and used it very successfully with THREE ankle injuries. I am also interested to buy the programme for knees etc.
Pay once. Get lifetime access.
30 day money back guarantee
Pay once. Get lifetime access.
30 day money back guarantee
15 YEARS. 100K HEALED.
Once I started HEM, the swelling and bruising subsided significantly and on the 4th day, I was walking comfortably again. I was shocked!
– Erikka Fernando
Thank you so much! It’s pretty amazing that I am doing as much as I am after a severe sprained ankle! Thanks for your support!!!
– Laurie Prindle
From the desk of Scott Malin, NASM-CPT
Creator, HEM Ankle Rehab
January 20, 2025
If you want to heal your ankle fully & fast…
And get back to doing what you love PAIN-FREE, without the fear of re-injury…
This will be the most important thing you ever do for yourself.
Here’s why:
My name is Scott Malin and fifteen years ago, I had to give up what I love… playing basketball. It literally crushed me to give it up!!
But, I had sprained my ankles so many times that I could no longer play.
Every time it happened, I used R.I.C.E. (rest, ice elevation, compression), but my ankles took months to heal and just kept getting weaker and more painful.
I tried everything, including ankle braces, but they made my ankles even weaker and then my knees started hurting too!
When I sprained my ankle one last time and had to crawl off the court, I knew I was done.
That night, I sat in my apartment and cried.
I was in my early thirties and thought I had to give up what I loved for the rest of my life.
But, I had no other option…
My ankles were just way too weak, stiff and unstable and painkillers/ice did nothing anymore.
As I lay in bed, staring up at the ceiling, I remembered back to when I trained with a clinician for the National Academy of Sports Medicine and Soft Tissue Therapist for the Los Angeles Clippers.
I also thought about a revolutionary Naturopath that taught me so much about healing the body naturally.
Then, I came up with a crazy idea…
It instantly improved how my ankle felt.
And the more I did it, the better my ankle got.
By day 6, my ankle was 100% pain-free and felt stronger and more stable than BEFORE I got injured.
The best part… I PLAYED BASKETBALL AGAIN, BUT THERE WAS NO PAIN!!
Afterward, I cried again, but they were tears of joy!!
When I told them what I did, my basketball buddies laughed and said I was crazy.
They called me a “dreamer”.
But, I didn’t care.
Because I had nothing to lose and everything to gain.
I threw my ankle braces away.
After months of late nights, early mornings, and lots of trial and error…
I created a complete, at-home healing system with incredibly reliable results:
- Heals new ankle injuries including ANY type and grade of ankle sprain.
- Heals old ankle injuries that never fully healed.
- Heals weak and unstable ankles.
- Even heals most Achilles, calf and foot injuries!
Since I was a fitness trainer, I was able to help all my clients (celebrities and athletes) whenever they got injured (which happened a lot!).
I was even on the news a few times!!!
The response from my clients was so overwhelming that a few of them eventually convinced me to make it available to everyone.
And even though it is incredibly complete, I always wanted to keep it SUPER simple and easy to do.
So, just follow along with me on any device and that’s it!
You get instant access to all the videos, which are short and focused on quickly giving you the information you need.
I will show you the absolute BEST rehab techniques, exercises, stretches, activations, holistic techniques, prehab techniques, etc….
These are techniques you will NOT find online anywhere else.
You will learn the perfect form for everything to get the best possible results.
It has taken many years of incredibly hard and dedicated work, but I am so humbled that over 100,000 people have healed themselves fully and fast with my program.
If you don’t believe me, please, check out all the reviews, including video testimonials, before and after pictures, etc. from people of all ages.
And listen, I know you’re probably still skeptical. That’s totally fair…
That’s why we have a very simple, no hassle, 30 day money back guarantee, so it’s completely risk-free to give it a try right now.
I created this program, because I don’t want others to go through all the pain and misery that I did!!
I don’t want anyone else to give up what they love…
Life is too short!!!
And now, there’s an easy way you can heal yourself and get back to your life.
I wish you all the best and thank you!!
Pay once. Get lifetime access.
30 day money back guarantee
REAL PEOPLE,
REAL RESULTS
Just got your videos for the holistic rehab the other day. It has already helped and I am so grateful as I know Drs want to cut you open and ask questions later. My left ankle is very badly sprained, completely black and purple and swollen half way up my calf. I am an athlete and have zero intentions of being cut on now or in the future! It was a major eversion off a curb and I just want it to get back to normal. Thanks so much for putting this HEM ankle rehab together, it's a godsend! Have a beautiful day.
Warm regards,
Faith Washington BSPharm, RPh, CSCS, CPT
Hey there,
I literally purchased this program about 20 minutes ago, and now having gotten partially through the videos... The content is already blowing my mind and I feel like this will be information I'll carry with me the rest of my life... Thank you for this info! Clearly you are a master of PT.
Hello Mr. Malin,
I want to thank you for this website. In the end of november, I sprained my ankle and my doctor said that there is an avulsion fracture in my ankle(ATFL). I had really hard times after this incident. When I was looking for how to heal fast, I saw your website. I tried to do as much as different exercises that you showed. Now I face some difficulties during my daily life due to my foot but swelling is decreasing everyday thanks to exercises. Especially, the video about how to activate ankle is very beneficial for me.
Thanks for your support both mentally and physically.
Sincerely,
Orhun Oktar, Electrical and Electronics Engineer