A high ankle sprain, known medically as a syndesmotic sprain, involves a specific group of ligaments that stabilize the lower leg bones just above the ankle joint. This injury differs significantly from the more common lateral ankle sprain, requiring a specialized taping approach to provide effective support. The goal of syndesmotic taping is to compress the two long bones of the lower leg, the tibia and fibula, thereby limiting the separation and rotational forces that aggravate the injury. Understanding this unique mechanism is the first step in properly applying the necessary supportive technique.
Understanding the High Ankle Sprain
A high ankle sprain is an injury to the syndesmosis, a fibrous joint complex composed of several ligaments that connect the distal ends of the tibia and fibula. These ligaments are responsible for maintaining the integrity and stability of the ankle mortise. Unlike a regular ankle sprain, which typically results from the foot rolling inward, a high ankle sprain most often occurs when the foot is planted and forced into excessive external rotation and dorsiflexion. This motion forces the talus bone upward, driving the tibia and fibula apart and stressing the syndesmotic ligaments.
The pain associated with this injury is generally felt higher up the leg, above the ankle joint, rather than directly on the outer ankle bone. Because the syndesmosis is tasked with resisting rotational forces, these injuries can be more debilitating and often require a longer recovery period compared to simple lateral sprains. The specialized taping technique is designed to mechanically “squeeze” these two bones back together, mimicking the stabilizing function of the damaged ligaments.
Materials and Pre-Taping Preparation
Effective syndesmotic taping requires specific materials and careful preparation of the skin. You will need pre-wrap, an adhesive spray to ensure tape adherence, and rigid, non-elastic athletic tape, typically 1.5 inches wide.
Begin by cleaning the skin thoroughly and applying an adhesive spray to the area, extending up the calf. Next, cover the skin from the mid-foot to approximately 6 to 8 inches above the ankle with a single layer of pre-wrap. This covering prevents irritation and blisters from the adhesive tape. The foot must be positioned correctly, held at a neutral 90-degree angle to the lower leg for maximum joint stability.
Step-by-Step Syndesmotic Taping Application
The specialized syndesmotic taping technique focuses on applying a compressive force to the distal lower leg, pulling the tibia and fibula together. Start by applying two to three anchor strips of rigid tape around the leg approximately 6 to 8 inches above the ankle, ensuring they are snug but not constricting circulation. These anchors provide a solid base for the primary compression strips.
The most crucial step is the application of the compression strips, often called the “syndesmotic squeeze.” Begin one strip on the back of the leg and pull it across the front with a strong, intentional force to compress the bones. This strip should angle downwards, wrapping just above the ankle joint. Do not apply this strip in a full circle, as this can impede circulation; leave a small gap on the back of the leg.
Repeat this compression strip two to three times, overlapping each strip by about half its width and maintaining the strong compressive force. These strips are the primary mechanism for reducing the separation of the tibia and fibula. Supplement the compression strips with stirrups and heel locks if the sprain also involves the lateral or medial ligaments.
Finish the application by applying closing strips, which cover the exposed pre-wrap and secure the compression strips in place. These strips should be applied without excessive tension, serving primarily to hold the underlying structure firm. The entire taping should extend high enough up the calf to effectively stabilize the injury. Always ensure the tape does not crease, especially over the Achilles tendon or the front of the ankle, to prevent blistering and discomfort.
Post-Taping Checks and When to Seek Medical Attention
Immediately following the application of the tape, several checks must be performed to ensure safety and comfort. Ask the individual if they experience any numbness, tingling, or excessive pressure, particularly in the foot or toes. These symptoms suggest the tape is too tight and must be immediately removed and reapplied.
A visual check of circulation is also necessary by performing a capillary refill test on the toes. Press gently on a toenail until it blanches white, then release; the pink color should return in under two seconds. A delayed return of color indicates restricted blood flow. The individual should be able to comfortably bear weight and move the ankle through a limited range of motion without a significant increase in pain.
Taping a high ankle sprain should only be done temporarily for support after a medical professional has cleared the injury. A suspected high ankle sprain carries a risk of associated fractures or severe instability that requires professional imaging for accurate diagnosis. Taping is a management tool, not a definitive treatment. Attempting to play or train on a severe, undiagnosed injury can lead to chronic instability or further damage. If severe pain, an inability to bear any weight, or significant swelling is present, immediate medical evaluation is required.