Has anyone ever had a high ankle sprain?

[HotCarl]

Im not looking for medical advice but someone who's had one of these before. I think i hurt it at work sometime friday night. Ive sprained my ankle in hs playing rugby before but this is different, its high on the leg but below the calf. Ive heard these can be nagging injuries. I dont want to lose work time but i also dont want to deal with this for a long time. If so what was perscribed by the doc? rest? I havent been to the gym in 3 days and im starting to feel it.

[kirks5oh]

time for some xrays, and a visit to the dr. some of these can require surgery to fix properly (not have long term issues). these can be treated with anything from surgery, to a walking boot, to an ace wrap with ibuprofen and some time off running.

[Sturg1647545502]

regardless of what you do make sure to document it at work

 

 

do the squeeze test on your upper calf, see article. you compress your tib fib up high to seperate the two bones down low is one test to do

 

 

 

High Ankle Sprains

 

High ankle sprains are most commonly caused by an external rotation injury in which the foot is forcefully turned outward, away from the midline of the body. These injuries are characterized by a tear of the syndesmotic ligaments of the ankle. As discussed above, the injuries hold the lower ends of the tibia and fibula bones together. There are actually five syndesmotic ligaments, and these include the anterior tibiofibular ligament, the posterior tibiofibular ligament, the transverse ligament, the interosseous ligament, and the interosseous membrane. Although high ankle sprains are much less common than lateral ankle sprains, they are now being recognized more frequently, especially in athletes. This is an important trend because high ankle sprains should be treated differently than lateral ankle sprains and can take twice as long to heal.

 

High ankle sprains are usually more severe injuries than lateral ankle sprains, and patients are often unable to bear weight on the injured extremity. The location of the pain and swelling correspond to the location of the anterior syndesmotic ligaments, which are just above the ankle. This helps to distinguish high ankle sprains from lateral ankle sprains, in which the pain is located more towards the outer, or lateral side of the ankle. Finally, if the deltoid ligament is injured, there may also be pain and swelling along the inner, or medial aspect of the ankle.

 

Two specific physical tests are commonly used to diagnose high ankle sprains. The first is called the squeeze test (figure 16).

 

 

 

Figure 16 – Squeeze test

 

 

 

Figure 17 – External rotation test

 

During this test, the tibia and fibula bones are manually squeezed together several inches above the ankle. If this produces pain further down the leg and in the ankle, a high ankle sprain has may have occurred. The second test is called the external rotation test (figure 17). During this test, the foot is manually externally rotated, but not inverted, by the examiner. If this is painful then a high ankle sprain is suspected.

 

If a high ankle sprain is suspected, x-rays of the ankle should be obtained. These serve two purposes. First, they will reveal a fracture if there is one present. Second, they will help to determine the severity of the injury. Severe high ankle sprains can be associated with a separation, or widening, of the tibia and fibula. This can be diagnosed on routine ankle x-rays. Unlike mild sprains, which can be treated without surgery, more severe injuries with widening usually require surgery.

 

High ankle sprains are more serious injuries that typically entail more damage than lateral ankle sprains. As such, it is important that patients with high ankle sprains be informed that their injury will take longer to heal.

 

High ankle sprains that are not associated with widening between the tibia and fibula can be treated without surgery. The RICE protocol is used initially, and consists of Rest, Ice, Compression, and Elevation. The RICE protocol helps to decrease the inflammation, swelling, and pain, which occur immediately after the injury. Resting the ankle is accomplished by staying off of it as much as possible. Additionally, if the ankle is particularly painful, one or two crutches may be used so that only partial weight is born by the ankle. Icing the ankle is performed with ice packs. These can be purchased commercially or made at home. Some individuals find a bag of frozen peas useful. These conform well to the ankle, and, when thawed, can be put back in the freezer and used again. It is important not to fall asleep while icing the ankle, as this could potentially lead to frostbite-like injury. Generally, a regimen of 10 minutes of ice per hour several times a day is recommended. Compression is accomplished with an elastic bandage (e.g. Ace®). Care should be taken, though, not to wrap the ankle too tightly, as this can compromise blood flow. Lastly, elevation is achieved by keeping the ankle above the level of the heart. This is best accomplished by lying flat on a bed or couch with two or three pillows under the injured ankle. If at work, sitting with the ankle elevated on an adjacent chair or stool is also useful.

 

Most high ankle sprains are initially treated with a walking boot or even a cast. The decision to use either a walking boot or cast depends on the severity of the injury and the preference of the treating physician. Both devices will restrict motion of the ankle as well as motion between the tibia and fibula, allowing the injured ligaments to heal. Again, it is important that injured individuals be informed that these injures take roughly twice as long to heal as lateral ankle sprains. In one large study, the average recovery time for these injuries was more than 40 days. As such, physical therapy may not be initiated for several weeks.

 

High ankle sprains that are associated with widening between the tibia and fibula (figure 18) usually require surgery. In these cases the widening between tibia and fibula is manually "reduced" and then held together with one or two screws (figure 19). The screws are inserted a few inches above the ankle joint and will prevent motion from occurring between the tibia and fibula as the ligaments heal.