Syndesmosis Sprains: Why Rehab is Key and How It Differs from a Normal Ankle Sprain
Brooke Scheurer 06/05/25If you’ve hurt your ankle or felt a pop or pain higher up near the top of your ankle, you might be dealing with a syndesmosis sprain—a “high ankle sprain.” This injury differs from a typical ankle sprain. Proper rehab is key to recovery. Here’s what you need to know.
How Is It Different from a Normal Sprain? A regular ankle sprain affects the ligaments on the outside of the ankle, while a syndesmosis sprain involves the ligaments connecting the tibia and fibula above the ankle. This makes the injury more complicated and makes it slower to heal.
Where Will I Feel Pain? Pain is felt above the ankle, often on the top or outside of the leg. It worsens when twisting or rotating the foot and can hurt more when walking or running.
What Movements Will Be Difficult? You’ll struggle with activities like walking, running, twisting, or jumping—anything that requires your ankle to bend or rotate.
Why Is Rehab So Important? Rehab is crucial because a syndesmosis sprain affects the stability of your leg. Unlike a regular sprain, it requires more focused care to prevent long-term instability. Without proper rehab, your ankle may stay weak, and you’ll likely re-injure it.
What Should I Do Immediately?
Start with PEACE and LOVE:
- Protection: Rest and avoid weight-bearing.
- Elevation: Keep your ankle elevated.
- Avoid anti-inflammatory meds: Let your body do it’s own natural healing in the first 48 hours
- Compression: Wrap your ankle to reduce swelling.
- Education: Understand your injury and rehab plan.
Then, when cleared:
- Load: Gradually bear weight.
- Optimal loading: Start strengthening exercises.
- Vascularisation: Light movement, like walking, helps healing.
- Exercise: Work on mobility and strength.
What Rehab Exercises Should I Do? You’ll focus on strengthening the calf muscles, ankle stabilisers, and the lower leg. Balance exercises are also key to restoring movement and preventing future injuries. An osteopath can help guide you through these exercises at the right pace.
How Can an Osteopath Help? An osteopath helps with hands-on therapy to reduce pain and stiffness and works with you to improve mobility. They also provide a tailored rehab plan to ensure you recover properly.
What Are the Rehab Timeframes? Most mild syndesmosis sprains heal in 6-8 weeks, but severe injuries may take 3-4 months. Patience is important to avoid re-injury and get back to normal activities.
Final Thoughts – A syndesmosis sprain is considered more serious than a normal ankle sprain. With the right rehab, including help from an osteopath, you’ll get back on track. Be patient and follow the plan to ensure a complete recovery.