All About the Syndesmosis Ligament (and Syndesmosis Injuries)

What Is Syndesmosis?

Syndesmosis is a term used to define a group of ligaments that surround the ankle joint. These ligaments are part of the plantar fascia, which helps stabilize your foot during walking or running. They act like shock absorbers for the leg when it’s moving through its full range of motion (ROM). When these ligaments become inflamed they cause pain and swelling in different parts of your body.

Symptoms Of Syndesmosis:

Pain in one or both legs due to swollen joints. Pain may radiate up your lower back, hips, shoulders and neck. If left untreated, syndesmosis can lead to arthritis of the knee joint and even osteoarthritis of the spine.

When To See A Doctor:

If you have any symptoms of pain or swelling in either leg, see a doctor immediately!

Causes And Risk Factors For Syndesmosis:

The exact causes of syndesmosis are not known. However, there are several risk factors that increase your chances of developing this condition:

Obesity – People with high levels of body fat tend to have a higher chance of having excessive pressure on their ankles and knees. This can lead to osteoarthritis later in life.

Age – As you get older, the risk of damage to syndesmosis ligaments increases. This is a natural part of the aging process and has nothing to do with your activity level.

Participating in high impact sports that involve a lot of jumping or abrupt changes in direction. Examples include basketball, football, tennis, and soccer.

Wearing shoes that don’t provide any ankle support, especially for people who participate in high impact sports.

Wearing high heels puts you at risk because it forces you to walk with an unnatural gait. This puts extra strain on your ankle, making the likelihood of injury much higher.

Symptoms Of High Ankle Sprain:

The following are the most common symptoms of syndesmosis injuries. However, each individual may experience varying combinations and intensities of symptoms. Symptoms usually go away within a few weeks, but rest and ice will help relieve the pain and swelling.

Pain and tenderness along the inside of the ankle

Tingling and numbness in your toes or foot



Loss of reflexes in your feet

Diagnosis Of Syndesmosis:

The doctor will ask you questions about your medical history and give a physical examination. In addition, you will undergo the following diagnostic tests:

An X-ray of your foot or ankle area to determine the extent of the injury and rule out a fracture

An ultrasound to determine if there is any internal bleeding in the area

Treatment For Syndesmosis:

The best treatment for syndesmosis involves rest, ice, compression, and elevation (RICE). You may also be given some anti-inflammatory drugs for pain and swelling. If the damage is minor, you will most likely need to wear an ankle brace for a few weeks. However, if the bones are misaligned or the ligaments are torn you may need surgery to repair the injury.

Surgery may involve suturing any torn ligaments, realigning your bones, and placing pins, screws or plates to stabilize your ankle. If surgery isn’t recommended, you may need to wear an ankle brace or a cast for up to 6 weeks. While your bones and ligaments heal, it is very important that you keep your ankle immobilized to allow proper healing.

Syndesmosis Treatment Options:

1. Rest, Ice, Compression, and Elevation:

This treatment involves doing the following to allow your body to heal itself:

Rest: This involves not putting any weight on your ankle or foot and taking anti-inflammatories or pain medication if needed.

Ice: Applying ice or cold packs to your ankle for 20 minutes every 3-4 hours.

Compression: Wrapping your foot and ankle in an elastic wrap will help prevent swelling.

Elevation: Keeping your foot raised above heart level will help prevent swelling.

2. Brace:

You may be given a brace to wear during recovery to prevent your foot and ankle from moving while healing.

3. Surgery:

Surgery may be needed if your bones are misaligned or the ligaments are torn. During surgery, your bones may be re-aligned and screws, plates or pins may be used to stabilize your injury.

A Word On Surgery:

Surgery is a common treatment option for syndesmosis injuries. While it is effective, it does come with some risks and will take you out of commission for at least a few weeks while you heal. This is something you and your doctor will need to discuss in more detail if surgery is an option for you.

Most Common Treatment Option: Rest, Ice, Compression, and Elevation

While many different treatment options are available for syndesmosis injuries, the standard treatment is rest, ice, compression, and elevation. While healing your ankle, you may be given a brace or cast to wear to help prevent your injury from getting worse while it heals.

Physical Therapy:

Another treatment option for syndesmosis injuries is physical therapy. During physical therapy, you will work one on one with a physical therapist. You will focus on improving mobility and flexibility while also building up strength in the ankle, foot, and lower leg area during physical therapy.

Home Remedies:

There are also some home remedies you can try to help relieve pain and swelli…

Sources & references used in this article:

Stabilization of ankle syndesmosis injuries with a syndesmosis screw by RA Kaye – Foot & ankle, 1989 –

Ankle syndesmosis injuries by FA Pena, JC Coetzee – Foot and ankle clinics, 2006 –

Intraoperative diagnosis of syndesmosis injuries in external rotation ankle fractures by RJ Jenkinson, DW Sanders, MD Macleod… – … of orthopaedic trauma, 2005 –