High Ankle Sprain (Syndesmosis Injury): Why Your “Ankle Sprain” Isn’t Improving

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Ankle Sprain Not Getting Better? This Might Be Why

If you’ve “rolled” your ankle but:

• It’s still painful after 1–2 weeks

• Pain sits above the ankle joint

• Walking or twisting feels unstable

You may not have a typical ankle sprain.

👉 You could have a high ankle sprain (syndesmosis injury) — a more serious injury that often gets overlooked.

At our East Auckland physiotherapy clinic, we regularly treat patients who were told it was a “minor sprain” — only to find the injury needed a very different rehab approach.

What Is a High Ankle Sprain?

A high ankle sprain involves injury to the syndesmosis, a group of ligaments that stabilise the two bones in your lower leg (tibia and fibula).

Unlike common ankle sprains, this injury affects how the ankle joint holds together, making it slower to heal and more prone to ongoing issues if not managed properly.

How It Usually Happens

This injury is caused by twisting or rotational forces, not just rolling your ankle.

Common situations include:

• Getting your foot stuck while turning

• Awkward landings from a jump

• Contact injuries in sports (rugby, football, basketball)

Key Symptoms to Watch For

High ankle sprains can feel different from a typical sprain.

Look for:

• Pain above the ankle joint

• Pain when twisting or pivoting

• Difficulty walking or pushing off

• A feeling of instability or weakness

• Slower than expected recovery

👉 A common clinical sign is pain when the foot is twisted outward.

Why This Injury Gets Missed

Many high ankle sprains are initially diagnosed as a standard ankle sprain.

The problem?

➡️ Standard rehab is often not enough➡️ Patients return to activity too early➡️ Symptoms linger or worsen

This is why proper assessment early on is critical.

Recovery Timeline: What to Expect

High ankle sprains take longer to recover than typical ankle sprains:

• Mild: 6–8 weeks

• Moderate: 8–12 weeks

• Severe: 3+ months

👉 Trying to “push through” or return too early significantly increases re-injury risk.

Do You Need a Scan?

Not always — but in some cases, imaging (X-ray or MRI) is needed to assess:

• Joint stability

• Severity of ligament damage

• Whether specialist referral is required

At our clinic, we guide you on whether imaging is necessary based on your presentation.

How Physiotherapy Helps (This Is the Key Part)

The biggest mistake we see is under-rehabilitation.

A proper rehab programme should include:

Early Stage

• Protecting the joint

• Managing pain and swelling

• Controlled weight-bearing

Mid Stage

• Restoring ankle mobility

• Strengthening calf and lower leg muscles

• Improving joint stability

Late Stage

• Balance and control training

• Running and change-of-direction work

• Return-to-sport progression

👉 Rehab needs to be progressive and structured — not just rest and basic exercises.

Do High Ankle Sprains Need Surgery?

Most cases are treated without surgery.

However, severe injuries with instability may require orthopaedic input.

👉 Early physiotherapy helps identify whether your injury can be managed conservatively.

Why Choose Our East Auckland Physiotherapy Clinic?

We focus on accurate diagnosis and results-driven rehab, not just symptom relief.

With us, you get:

• Clear diagnosis (not guesswork)

• Structured rehab tailored to your activity level

• Hands-on treatment and guided progression

• Return-to-sport planning to reduce re-injury

Our goal is simple:👉 Get you back to full activity safely and confidently.

When Should You Get It Checked?

You should see a physiotherapist if:

• Your ankle isn’t improving after a few days

• Pain is located above the ankle

• You’re struggling to walk or return to sport

• You want to avoid long-term issues

👉 The earlier you start, the better your outcome.

Book Your Assessment Today

If your ankle sprain isn’t improving, don’t wait and hope it settles.

Contact our East Auckland physiotherapy clinic today for a full assessment and personalised rehab plan.

FAQs

How is a high ankle sprain different?It affects the ligaments above the ankle that stabilise the lower leg bones, leading to longer recovery.

Why is my ankle sprain taking so long to heal?It may be a high ankle sprain, which requires more structured rehab.

Can I walk on a high ankle sprain?Yes, but it may delay recovery or worsen the injury if not properly managed.

Need expert help with your ankle injury in East Auckland? Our physiotherapy team is here to guide your recovery every step of the way.