Ankle Syndesmosis Injury in Contact Sports - What is it & How do We Rehabilitate It?

Ankle injuries are common in contact sports, and syndesmosis injuries are no exception. In this blog post, we will discuss what an ankle syndesmosis injury is, how to treat it with physiotherapy, and how to rehabilitate after syndesmosis surgery. We will also explore ways to prevent ankle syndesmosis injuries in contact sports and provide resources and assistance for parents of youth athletes with ankle injuries. By the end of this post, you will have a better understanding of ankle syndesmosis injuries and how to treat them.

Understanding Syndesmosis Injury in Athletes

Syndesmosis injury is a common orthopaedic injury among athletes, especially those who participate in contact sports like AFL, rugby, and hockey. Understanding syndesmosis injuries, their impact on an athlete's performance and health, and proper rehabilitation is crucial.

So what exactly is a syndesmosis injury? It's an ankle sprain that affects the ligaments connecting the tibia (shinbone) and fibula (calf bone). This type of ankle sprain is often referred to as a "high ankle sprain" due to its location on the leg. Syndesmosis injuries are typically caused by sprains or twists of the foot or lower leg, which result in the stretching or tearing of these ligaments. In severe cases, surgery may be required to repair the syndesmosis injury.

Common symptoms of this injury include pain along the outside of the ankle when walking or running, swelling, tenderness along the calf bone, difficulty bearing weight, and instability when turning sharply or jumping. If you experience any of these symptoms after activities involving twisting motions, such as cutting with your feet while playing soccer or basketball, it's important to seek medical attention immediately. A proper diagnosis and treatment plan tailored to your specific case can then be provided.

When it comes to rehabilitating from a syndesmosis injury, there are various techniques available depending on the severity. However, all treatment plans will involve rest, ice, compression, elevation (RICE), gentle stretching, muscle strengthening, range-of-motion exercises, bracing or booting if necessary, proprioceptive training, manual mobilization techniques, orthotic devices, crutches if necessary, nonsteroidal anti-inflammatory drugs (NSAIDs), physiotherapy modalities (electrotherapy, ultrasound, laser light therapy), taping, etc. The most important aspect is staying consistent with the prescribed program until full recovery is achieved.

Most importantly, athletes need adequate support throughout their rehabilitation process, including emotional, mental and physical. To ensure a timely and successful transition back to sport, it is essential for young athletes and their physio team to provide the necessary resources, tools, advice, and support.

Rehabilitation and Prevention to Reduce Ankle Syndesmosis Injury in Contact Sports

Ankle Syndesmosis injuries in contact sports are a common occurrence. Coaches and players must be aware of these injuries and know how to diagnose, treat, prevent, and rehabilitate them. This article discusses the basics of Ankle Syndesmosis Injury in Contact Sports: what it is, the signs and symptoms to look out for, diagnosis options, treatment options (including surgery if necessary), prevention strategies to reduce the risk of injury or reinjury, and clinical rehabilitation exercises that can aid in recovery.

Ankle Syndesmosis Injury occurs when the ligaments around the ankle joint become stretched or torn due to external rotation of the ankle, generally in a contact situation. The hip drop tackle in rugby league is one well known cause for these injuries. This type of injury, also known as a high ankle sprain, affects the upper part of the ankle joint. Symptoms may include pain, swelling, and tenderness in the area around the ankle joint. While it may not always be visible on immediate X-rays or MRI scans, an experienced clinician can diagnose the injury based on reported symptoms and examination findings.

Treatment for Ankle Syndesmosis Injury depends on its severity but generally includes a protective period of weight bearing until walking without limping is possible, icing and elevation therapy for inflammation relief, and the use of NSAIDs (e.g., ibuprofen) under a doctor's supervision. Physiotherapy exercises focusing on range of motion (ROM), strength building, proprioception training (balance), and flexibility improvements are also typically prescribed. Surgery may be necessary in the case of fracture or an high grade tear in one or more ligaments around the ankle joint.

Before returning to contact sports following an Ankle Syndesmosis Injury, preventive measures should be taken. These include strengthening exercises targeting balance and control at end ROMs using weights, bands, and bodyweight exercises. Gradual progression from low-intensity drills to higher-intensity drills over time is crucial in readiness for full contact again. Additionally, ensuring correctly fitting protective equipment and using proper footwear suitable for the specific sport being played further reduces the chances of injury.

Returning to sport should only occur once deemed "safe" by the responsible medical team. This typically involves successfully completing a rehab program without pain and without recurrent instability when tested with various movements before returning to full contact sport. Integration into practice sessions should follow, with eventual game play allowed only after successful progression through earlier stages.

Treating Ankle Syndesmosis Injuries With Physiotherapy

Fortunately, physiotherapy can provide significant relief for those dealing with ankle syndesmosis injuries. In this section, we will discuss what ankle syndesmosis is, how it occurs in contact sports, its symptoms, treatment options available including physiotherapy rehabilitation strategies, and preventative measures that can be taken to minimize the risk of experiencing a syndesmosis injury.

How Is It Diagnosed? A diagnosis is usually made after a physical examination where your physio will check for tenderness around specific points on your ankle associated with a syndesmosis tear/injury; they may also order imaging tests such as weight bearing X-rays if needed to confirm their suspicion before beginning treatment options, including booting or physiotherapy rehabilitation plans, which are highly recommended for successful recovery outcomes from these types of injuries!

What Are The Treatment Options? Treatment options vary depending on severity but typically involve rest/immobilization in order to allow time for healing, followed by physiotherapy which focuses on strengthening exercises specifically tailored towards improving mobility within affected areas while also restoring proper function back into daily activities without too much stress being placed onto them initially so as not to aggravate any existing issues further than necessary during recovery periods. This could include things like calf raises, balance or rotation strength depending upon individual needs assessed beforehand by professional medical personnel who understands exactly what needs need addressing firstly before progressing onward through more complex exercises later down the line once initial stages have been managed accordingly properly!

Strengthening Exercises to Optimize Recovery from Syndesmosis Injuries

As athletes become larger and more powerful, syndesmosis injuries have become increasingly common in contact sports. If not treated properly, a syndesmosis injury can lead to long-term mobility issues and chronic pain.

In this section, we will discuss how to identify a syndesmosis injury, how to rehabilitate from it using detailed strengthening exercises, and what coaches, players, and parents should consider when dealing with an ankle syndesmosis injury.

Once a diagnosis has been made, physiotherapy with a tailored exercise program is usually recommended as part of rehabilitation for this type of injury. Exercises focusing on strengthening the muscles around the ankle, such as calf raises, balance drills, and proprioceptive exercises, should be included in the rehabilitation program, which helps optimize recovery. These exercises also help increase flexibility, stability, and strength, which prevents recurrence. It's important to remember that early intervention is key; if you wait too long before seeking treatment for your injured ankle, it may lead to chronic pain or mobility issues down the road.

Finally, coaches, players, and parents should take into account broader considerations when dealing with a syndesmosis injury, such as proper warm-up before activities that involve jumping or running, appropriate footwear for sports activities, and related risks associated with any given sport. These considerations are essential to ensure a safe playing environment while preventing any further damage or reinjury due to a syndesmosis injury.

Overall, a low to moderate grade syndesmosis injury can be effectively rehabilitated through physiotherapy using a tailored exercise program, along with taking into account broader considerations by coaches, players, and parents, while ensuring safety while playing their respective sports activities.

Rehabilitating After Syndesmosis Surgery

Rehabilitation after syndesmosis surgery can be a difficult process, especially for athletes involved in contact sports. The tightrope procedure is a common method for fixation of the syndesmosis and has a relatively short recovery period if no fracture is involved.

Postoperative care and rehabilitation guidelines following syndesmosis surgery can vary and need to be followed to ensure proper healing. Early weight bearing (if allowed) and range of motion exercises should be done to enhance recovery from this type of ankle injury. These exercises should focus on increasing strength, flexibility, balance, and stability around the ankle joint while protecting it from further damage or reinjury. Proper nutrition and adequate rest are also key components of successful rehabilitation after syndesmosis surgery. It is recommended to speak with your doctor for advice on managing these aspects during your recovery period.

Ultimately, taking the necessary time for rehabilitation after syndesmosis surgery is important to safely return to contact sports without complications associated with this type of ankle sprain or strain. Regular follow-up with your doctor throughout the rehabilitation process is essential to ensure appropriate progress.

Safe Return After Syndesmosis Injury for Athletes

Athletes participating in contact sports are susceptible to syndesmosis injuries, which are high ankle sprains that often necessitate surgery and a lengthy rehabilitation period. Understanding the causes, risk factors, symptoms, diagnosis, and treatment of syndesmosis injuries, as well as prevention strategies, is crucial for ensuring the safe return of youth athletes after such injuries.

The key to safe return to sport is completion of a full rehabilitation and strength program, followed by a gradual re-integration into your running, change of direction, agility and training. If contact is part of your sport, this will also need to be carefully integrated to ensure success in your return to sport.

Building a Strong Foundation for an Injury-Free Exercise Program

The importance of building a strong foundation for an injury-free exercise program cannot be overstated, especially in contact sports. Ankle syndesmosis injury is a prime example, particularly for contact athletes.

Rehabilitation programs usually involve stretching exercises to restore joint flexibility and strengthening exercises targeting the muscles surrounding the ankles. Balance exercises are also included to enhance coordination and minimize the risk of future injuries caused by repeated stress on the ankles during activities like running and jumping. Nutrition and hydration should not be overlooked either, as athletes require proper sustenance to recover adequately after vigorous activities. Optimal performance and reduced likelihood of further injuries can be achieved by consuming adequate amounts regularly throughout the day.

In dealing with any sports-related injuries, it is vital to understand what is happening in the body and identify associated risk factors that make an athlete more susceptible to sustaining such injuries. Seeking professional medical attention is always the best option to receive the right diagnosis and a treatment plan tailored to the needs and preferences of the patient, ensuring the quickest and most successful recovery. With the right approach and necessary knowledge, nothing should stop anyone from achieving their maximum potential on the playing field!

Resources and Assistance for Parents of Youth Athletes with Ankle Injuries

If you have questions about rehabilitating from an Ankle Syndesmosis Injury, there are resources available! There are various organizations designed specifically for families dealing with youth athlete physio such as The American Physical Therapy Association (APTA). These organizations provide access to materials on rehabilitation techniques, support services for parents/caregivers who need assistance navigating through their child’s recovery process, plus more general information about preventing future injuries altogether – so don't hesitate to reach out if needed!

Additionally – some tips that will help prevent your youth athlete from sustaining this sort of traumatic event include: warming up properly before sports activities, wearing appropriate footwear suited towards contact sports, using proper form when playing any sport, ensuring children take regular breaks throughout practice sessions, and monitoring any potential signs indicating something might not feel right physically during playtime too!

In conclusion, an Ankle Syndesmosis Injury is something no parent ever wants their child to experience. However, knowing what steps need to be taken if faced with such a traumatic situation could make all the difference between quick recovery versus a delayed one! With correct identification and diagnosis followed up by appropriate treatments plus utilizing all resources available – both short-term and long-term goals of completing a successful rehabilitation journey are possible!

A Guide to Educating Parents About the Risk of Syndesmosis Injury in Contact Sports.

As a youth athlete physiotherapist, it is important to educate parents on the risks of ankle syndesmosis injury in contact sports. This type of injury is most commonly seen in athletes who participate in activities such as football, soccer, basketball, and rugby.


It is vital for parents to understand that ankle syndesmosis injuries are common in contact sports and can be serious. Educating themselves about how they can prevent these injuries from occurring through proper warm-up, stretching programs, etc., as well as how to recognize them if they do occur, will help them better understand this type of injury. They should also educate themselves about how ankle syndesmosis injuries should be effectively treated with RICE, immobilization, physical therapy, medications, or even surgery depending on severity. Lastly, understanding what type of rehabilitation plan needs to be implemented afterwards for optimal recovery will ensure that their child returns safely back onto the court, field, pitch, etc.

Bottom Line

In this blog post, we discuss what ankle syndesmosis injury is, how to treat it with physiotherapy, and how to rehabilitate after syndesmosis surgery. We also explore ways to prevent ankle syndesmosis injuries in contact sports and provide resources and assistance for parents of youth athletes with an ankle injury. It is important for athletes, coaches, trainers, therapists, and parents of young athletes to understand the seriousness of this type of injury. The key takeaway from this post is that through proper treatment strategies, such as rest, ice therapy, compression bandaging or taping techniques, alongside rehabilitation exercises, such as calf raises or lateral movements using resistance bands, can help reduce the risk of an ankle syndesmosis injury and improve recovery times when an injury does occur. To ensure a successful return to sport following a severe ankle sprain or tear, it is important to seek medical attention immediately, followed by consistent completion of the prescribed program tailored specifically for your case until full recovery has been achieved.

Josh Weight

Josh Weight | Founder of Gravity Physio

APA Titled Sports Physiotherapist

Josh is an expert sports and exercise physiotherapist, strength and conditioning coach and clinician, working with elite athletes and everyday clients of all ages and ability to bridge the gap in care. He has helped numerous people recover from injury and return to wellbeing. He has both a Bachelor's and Master's degree in Physiotherapy from Sydney and Latrobe University, respectively.

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