Anterior-Inferior Tibiofibular Ligament Injury / Syndesmosis injury
An AITFL sprain / syndesmosis sprain (or high ankle sprain) is an injury to the ligamentous tissue that lies between the distal fibula and the distal tibia (the two leg bones).
- Early stages:
- Crutches required if difficulty walking or walking with abnormal gait (minor sprains)
- Bracing ankle (especially when returning to sport and in early stages when walking) – bracing minimum 6 weeks with benefits up to 6 months
Professional Medical Treatments
- Treatment of syndesmosis injuries will depend on stability of the joint complex. Syndesmosis injuries without instability should be treated conservatively with a period of immobilisation (usually with a CAM walker or brace) and protected weight-bearing. This is generally for 4 – 6 weeks. This is then followed by progressive rehabilitation.
- Unstable syndesmosis injuries (rupture of all syndesmosis and deltoid ligaments) can be treated with reconstructive surgery.
- Self-mobilisations / stretching/ strength program as prescribed by physiotherapist (secondary to non-operative or operative options)
- Physical therapy and exercises
- Ankle mobilisation to ensure joints restore to full range of motion
- Soft tissue massage through muscles that become tight as a compensation mechanism
- Exercises to prevent DVT (Deep Vein Thrombosis)
- Strength and proprioception (joint position awareness) exercises to restore function and prevent re-injury (these often include calf raises, squats, resisted ankle TheraBand exercises, single-leg balance exercises, stretches and mobility exercises to self-manage
- Eventual return to high level exercises including bounding / jumping / directional changes and sports drills
- Exercise techniques to prevent injury
- Dynamic balance training
- Ankle mobility exercises
- Lower limb proprioception and strength exercises