What Is a Syndesmosis Injury?
Introduction:
A syndesmosis injury refers to damage to the syndesmotic ligaments that connect the two bones of the lower leg, the tibia, and fibula. This type of injury often occurs as a result of excessive external rotation or dorsiflexion of the ankle, commonly seen in sports like football, basketball, or skiing. Syndesmosis injuries are also known as high ankle sprains.
Causes
Causes of syndesmosis injuries may include:
Trauma: Direct impact or twisting forces on the ankle joint, such as those occurring during sports or accidents, can cause syndesmosis injuries.
Overuse: Repetitive stress on the ankle joint, especially during activities that involve sudden changes in direction or jumping, can lead to syndesmosis injuries over time.
Ankle Fractures: Syndesmosis injuries often accompany ankle fractures, particularly when the force of impact causes the ligaments to stretch or tear.
Poor Biomechanics: Factors such as muscle weakness, imbalance, or poor ankle stability can predispose individuals to syndesmosis injuries.
Physiotherapy
Physiotherapy plays a crucial role in the management of syndesmosis injuries. Here's a general outline of a physiotherapy treatment plan:
Rest and Protection: Initially, the injured ankle may require rest and protection to prevent further damage. This may involve using crutches to avoid weight-bearing on the affected leg and wearing a supportive brace or boot.
Ice Therapy: Applying ice to the injured area can help reduce pain and inflammation. Ice therapy should be applied for about 15-20 minutes several times a day, especially during the acute phase of injury.
Compression and Elevation: Compression with an elastic bandage and elevation of the affected leg can also help reduce swelling and promote healing.
Range of Motion Exercises: Once pain and swelling begin to decrease, gentle range of motion exercises can be initiated to prevent stiffness and maintain flexibility in the ankle joint. These exercises should be performed within a pain-free range.
Strengthening Exercises: Strengthening the muscles around the ankle, particularly the muscles of the lower leg and foot, is essential for restoring stability and preventing future injuries. Exercises may include calf raises, ankle dorsiflexion/plantarflexion, eversion/inversion exercises, and resistance band exercises.
Balance and Proprioception Training: Balance and proprioception exercises help improve joint stability and reduce the risk of re-injury. This may involve activities such as single-leg balance exercises, wobble board or balance pad exercises, and proprioceptive drills.
Functional Training: As the ankle strength and stability improve, functional training exercises are introduced to simulate real-life movements and activities. This may include walking, jogging, jumping, and sport-specific drills.
Gradual Return to Activity: Once the ankle has regained strength, stability, and range of motion, a gradual return to sports or other physical activities is recommended. It's essential to progress slowly and listen to the body to avoid re-injury.
Follow-up and Monitoring: Regular follow-up appointments with a physiotherapist or healthcare provider are essential to monitor progress, address any concerns, and modify the treatment plan as needed.
Conclusion
It's important to note that the severity of syndesmosis injuries can vary, and treatment plans should be individualized based on factors such as the extent of ligament damage, presence of associated fractures, and the patient's specific needs and goals. Consulting with a healthcare professional, such as a physiotherapist or sports medicine specialist, is crucial for an accurate diagnosis and appropriate management of syndesmosis injuries.
