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Syndesmosis, High ankle sprain help

post #1 of 3
Thread Starter 

http://www.eorthopod.com/content/ankle-syndesmosis

 

Looking for any insight regarding up to date protocol on this. I was diagnosed as having a high ankle sprain. MRI with Contrast did not show any overt tears or damage to bones/joint.  Still swollen around outside of ankle and over instep and at base of tib/fib and foot, pain up both outside of calf. Peritoneal ligament flops over ankle but only when my leg is bent.  When flexing foot, ligament on right instep side bulges out. It's been over 5 months it recovered to a point then worsened.  Walking is difficult, pain ranges from deep strong deep ache to sharp biting.  Driving is also challenging as the foot when flexed has littel strenght or control (yeah, holding the brake down at a light; I put car in park) Occured when I crashed in December, had signifcant swelling and blood pooling at base of ankle and across top and sides of foot with most to the outside. 

 

If any Dr.s or PT guys can offer help on this- appreciated. Currently only able to do passive external/internal rotation and flex/extension of foot. I can ride stationary bike and do squats for PT on knee but need to keep foot from flexing or twisting.  Doctor wants to do cortisone. I understand it will take a long time but looking for anything that will help.

post #2 of 3
A high ankle sprain has really little to do w the ankle. More, it is a laxity in the structures that hold the tib & fib together. This is considerably worse in standing / weight bearing & takes a long time to heal.

The pain felt is literally that 2 bones shearing away from each other in stance. Non weight bearing activity : bike, one leg scooter push on the treadmill, active range open chain are best at first.

We have a body wt supported treadmill & this is great for return to partial activity.

I tend to strap / tape my clients & go by symptoms.... Linear running to start & progress to cutting drills!

Good luck & keep us posted!
post #3 of 3
Thread Starter 

thanks! starting to see some results in the past week now that the quad can support weight better. Keep in mind this is on the same leg as the ACL recon.  should also note pain at just below outside knee where Fibula  joint is. I started to wear a stiff soled hiking shoe and it seems to help as I don't have to flex the foot when walking. I can't do any cutting stuff and can't do treadmill yet due to knee.  trying to find basic exercises for this. doesn't seem to be much of anything . My ortho suggested the ankle internal/external flex/extensions. 

 

can you pm or post taping instructions? 

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