Symmetry Blog

Injury of the week - High Ankle Sprain

Symmetry Physio - Friday, May 18, 2018
Adelaide plays tonight and they will be without Mitch McGovern with a high Ankle Sprain.

Injury of the week - High Ankle Sprain 

Adelaide has been in the headlines lately due to their high rates of hamstring injuries, but unfortunately, their injury woes do not stop there. Their key forward Mitch McGovern is set to miss two months with a high ankle sprain.

A high ankle sprain occurs when the ankle is overstretched and twisted in a way that means the higher ankle ligaments are affected. The high ankle ligaments are also known as the “syndesmosis” which is a fibrous joint connecting the bottom of the two leg bones (tibia and fibula) together and forms the upper part of the ankle joint (see image). It is supported and held together by three main ligaments below. These are the anterior inferior tibiofibular ligament (AITFL), the posterior inferior tibiofibular ligament (PITFL) and the transverse ligament.

A high ankle, or syndesmosis, injury typically occurs when the ankle is forcefully twisted outwards, or when the foot is planted, and the leg twists inwards such as in a tackle. These injuries are less common, but more disabling and much slower to recover than traditional lower ankle sprains. The reason for this is that if the ligaments are injured and are not adequately holding the tibia and fibula tightly together, then they can start to splay apart with the high load of weight bearing, leaving the ankle unstable. X-rays should be obtained if an injury to the syndesmosis is suspected. Because normal x-rays may not show a syndesmosis injury, a stress x-ray is often necessary and/or MRI.

Mild syndesmosis sprains usually involve a stretch or slight tear in only one of the ligaments and moderate tears of the ankle syndesmosis may lead to ankle joint instability. In these cases, a period of non-weight bearing is often required and/or immobilization to let healing occur. In severe tears of the ligaments, the ends of the tibia and fibula actually spread apart and in these cases, surgery is often necessary to stabilize the joint with screws so that healing can occur.

As reported Mitch McGovern will not be having surgery although the Adelaide Crows are taking a conservative approach and expect Mitch to be out for up to two months depending on how his rehabilitation goes.

Sara Clapham 

Symmetry Physiotherapy.

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