Treating and Diagnosing High Ankle Sprains: Symptoms, Treatment, and When to Seek Medical Advice

Introduction to High Ankle Sprains

High ankle sprains, also known as syndesmotic sprains, are injuries that occur when the higher ligaments around the ankle joint tear. Unlike lateral ankle sprains, which affect the ligaments on the outside of the ankle, high ankle sprains impact the ligaments connecting the tibia and fibula bones. These injuries can be more complex and take longer to heal.

Symptoms of a High Ankle Sprain

The main signs of a high ankle sprain include pain, swelling, bruising, and difficulty standing or walking. If the injury is severe, you may not be able to bear weight on the affected foot. Additionally, you may notice a noticeable gap between the lower leg bones, which can be indicative of a more serious tear.

Initial First Aid for High Ankle Sprains

Upon sustaining a high ankle sprain, it is crucial to start with immediate first aid measures. Here are the steps you can take to manage your symptoms:

Medication: Over-the-counter anti-inflammatory medications such as Motrin or ibuprofen can help reduce inflammation and pain. The maximum recommended dosage for an adult is 800mg per dose. Elevation: Elevate the injured ankle above heart level using a stack of pillows. This helps with blood circulation and reduces swelling. Cold Therapy: Apply ice in a bag wrapped in a towel or use a frozen bag of peas on the injured area for 20 minutes every 2 hours, continuing for the first 48 to 72 hours. This procedure is essential for the initial 2-day period. Compression: Use an ACE wrap to provide compression and support. This is particularly important to prevent further swelling. Splint or Crutches: Depending on the severity of your injury, you may need to use crutches or an ankle-foot orthosis (AFO) boot to avoid putting weight on the affected area.

When to Seek Medical Attention

Though many mild to moderate high ankle sprains can be managed with at-home care, it is essential to seek medical evaluation if you experience severe pain, significant swelling, or immobility. Additionally, if you have difficulty bearing weight on the injured foot, you should consult a medical professional.

Medical Evaluation and Diagnosis

A healthcare provider will conduct a thorough evaluation, which may include physical examination, imaging studies such as X-rays or MRI, and sometimes blood tests. While MRI is commonly used for diagnosing high ankle sprains, it may not always clearly visualize a ligament tear. Other possibilities, such as repeated attacks of monoarthritis or enthesitis, must also be ruled out as these conditions can mimic the symptoms of a high ankle sprain and require specialized treatment.

Monoarthritis can be caused by various factors, including gout, reactive arthritis (such as from vasculitis), psoriatic arthritis, or conditions associated with inflammatory bowel disease (IBD) or spondyloarthropathy. It is crucial to consult a rheumatologist if these conditions are suspected, as they can offer the appropriate management to prevent permanent joint damage.

Prognosis and Recovery

Treatment for high ankle sprains often takes several months. Mild to moderate cases may resolve within a few weeks with proper care and rest. However, severe injuries can take up to 6 months to heal. During this time, you may need to work with a physical therapist to regain strength and flexibility in your ankle.

Conclusion

High ankle sprains are not to be taken lightly. While some can be managed at home, others require professional intervention. By understanding the symptoms, taking appropriate first aid measures, and seeking medical advice when needed, you can ensure a successful recovery and return to your activities as soon as possible.