Sharp Pain Above the Ankle? It Might Be More Than a Simple Sprain
That sharp, persistent pain above your ankle after a twist or tackle is not always a standard sprain. It may be a syndesmotic sprain, often called a high ankle sprain, which involves the strong ligaments that connect your two lower leg bones. These sprains heal slower than normal and may cause long-term instability if ignored.
At Perfect Balance Clinic Moorgate, our physiotherapists, osteopaths, and sports therapists specialise in diagnosing and treating syndesmotic ankle sprains.
Book your assessment today and begin your recovery with the guidance of experienced professionals who help patients return safely to activity.
Understanding a Syndesmotic (High) Ankle Sprain
Your lower leg bones, the tibia and fibula, are held together by a group of ligaments known as the syndesmosis. These include the anterior inferior tibiofibular ligament, posterior inferior tibiofibular ligament, transverse ligament, and the interosseous membrane. They make sure the ankle stays firm and supports your body when moving.
A syndesmotic injury occurs when these ligaments are stretched or torn, most often when the foot is forced upward and outward while the leg rotates inward. This motion can cause a small separation between the bones and injure the syndesmotic tissues. It’s seen most often in sports with fast turns or physical contact.
This injury can be mistaken for a mild strain as the pain lies higher up. Without guided recovery, you may face lasting weakness or arthritis.
Typical Symptoms
You may have a syndesmotic injury if you experience any of the following:
- Pain and tenderness above the ankle, between the tibia and fibula
- Swelling that spreads upward along the leg
- Pain when turning the foot outward or when bearing weight
- A deep, spreading ache instead of a localised pain
- Difficulty pushing off, climbing stairs, or running
- A feeling that the ankle separates or feels unstable when walking
This type of pain doesn’t go away quickly and feels more internal. Trying to play or train before full recovery can make the injury worse.
How We Diagnose the Injury
An accurate diagnosis is essential to prevent prolonged recovery. At Perfect Balance Clinic Moorgate, we use a combination of clinical tests, movement assessment, and imaging referral when needed.
Common Tests
- Squeeze Test: Light compression is applied to the tibia and fibula above the injured area. Pain near the ankle may indicate syndesmotic involvement.
- External Rotation Test: The foot is twisted outwards as the leg stays still. A deep ache higher up may mean the syndesmotic ligaments are involved.
- Crossed-leg Test: The affected leg is placed over the other to allow pressure testing. Pain above the joint area hints at damage to the syndesmosis.
- Palpation: Light pressing along these structures reveals where the injury is most painful.
Imaging
These scans are useful for confirming instability and understanding the injury’s extent. Getting scans early ensures athletes know how soon they can perform again.
Grades of Injury and Recovery Times
| Grade | Ligament Damage | Joint Stability | Typical Healing Time |
| Grade I (Mild) | Stretch or small tear of one ligament | Stable | 6–8 weeks |
| Grade II (Moderate) | Partial tear involving multiple ligaments | Mild separation possible | 8–12 weeks |
| Grade III (Severe) | Complete rupture with separation of tibia and fibula | Unstable, may need surgery | 3–6 months |
Stress from walking and running makes these ligaments slower to heal. Structured recovery ensures your ankle stays strong.
Our Step-by-Step Treatment Approach
The team at Perfect Balance Clinic Moorgate starts by fully assessing your injury before creating a plan suited to your goals.
1. Protection and Pain Control
- Short-term immobilisation using a boot or brace to prevent further strain
- Ice and compression to manage swelling
- Laser therapy for pain relief and faster tissue healing
- Gentle manual therapy to maintain joint flexibility around the ankle and foot
2. Early Movement and Controlled Strength
As your pain eases, movement is slowly improved.
- Range-of-motion exercises to prevent stiffness
- Isometric strengthening for the calf and lower leg muscles
- For soft-tissue pain that won’t go away, we may use shockwave or laser treatment
3. Balance and Neuromuscular Retraining
Syndesmotic injuries affect coordination and balance.
- Single-leg balance training and wobble board work to improve control
- We study your movement to find and fix poor walking or running habits.
4. Sport-Specific and Functional Rehabilitation
When strength and stability return, therapy becomes more dynamic.
- Plyometric and agility drills designed to replicate your sport
- Directional changes and cutting movements to rebuild confidence
- Progressive loading until you can safely return to training
5. Return-to-Performance Testing
Before discharge, you will undergo tests for:
- Strength balance between both legs
- Range of motion
- Agility, jumping, and landing control
- Endurance specific to your sport or activity
Final testing makes sure your ankle won’t give way again.
Additional Treatments Offered at Moorgate
- Shockwave Therapy: Effective for chronic soft-tissue pain and stubborn swelling
- Sports Massage: Relieves tension and promotes circulation for faster healing
- Osteopathy: Restores alignment and reduces compensatory strain
- Acupuncture: Supports pain control and muscle relaxation
- Rehabilitation Pilates: Builds long-term strength and joint stability
You may receive one or several therapies, depending on how you’re healing.
Rehabilitation Roadmap
| Phase | Goals | Example Activities | Typical Duration |
| Phase 1 – Protection | Reduce pain and swelling | Boot or brace, rest, laser therapy | 0–2 weeks |
| Phase 2 – Early Motion | Restore gentle movement | Mobility exercises, light band work | 2–4 weeks |
| Phase 3 – Strength and Balance | Rebuild control and power | Step-ups, calf raises, balance drills | 4–8 weeks |
| Phase 4 – Sport Conditioning | Prepare for dynamic movement | Jumping, direction change drills | 8–12 weeks |
| Phase 5 – Performance and Prevention | Maintain strength and prevent recurrence | Sport simulation, gait correction | 12+ weeks |
Timeframes vary depending on injury grade, age, and adherence to your exercise plan.
Why Choose Perfect Balance Clinic Moorgate
- Experienced team skilled in sports and ankle rehabilitation
- Integrated approach using physiotherapy, osteopathy, and sports therapy
- Advanced technology including laser, shockwave, and gait analysis
- Open communication with your GP, surgeon, or coach if needed
- Flexible scheduling for busy professionals and athletes
We at Perfect Balance Clinic Moorgate help you regain full function without fear.
What to Expect at Your First Visit
During your initial appointment, you will receive:
- A detailed clinical assessment and explanation of your injury
- A clear diagnosis and treatment outline
- Your first therapy session to reduce pain and improve mobility
- A realistic recovery plan with weekly progress goals
We make sure you leave with clarity and confidence from day one.
Book Your Appointment
Let’s help you recover properly and return to the activity you enjoy. Fill in the form below and one of our team members will reach out shortly to arrange your assessment.
Moving Forward with Confidence
Syndesmotic ankle sprain can slow your activity, but not stop your success. You’ll regain control and prevent new damage with care at Perfect Balance Clinic Moorgate.
Our focus at Perfect Balance Clinic Moorgate is helping you trust your body again.
Book your appointment today and start your path towards long-term ankle health and confidence in every step you take.
Finding Us in Moorgate
Perfect Balance Clinic – Moorgate
Centrally located near Moorgate and Liverpool Street stations, our clinic is easy to reach by Underground, bus, or train.
Please note: There is no on-site parking at the Moorgate clinic. We recommend nearby public car parks, including:
- Finsbury Square Car Park
- London Wall Car Park
We offer early morning and evening appointments to suit your schedule, making it easier to fit your recovery around work, training, or daily commitments.
Book a Consultation Today
Perfect Balance Clinic at Moorgate
