Most commonly, an ankle sprain involves an injury to the ligaments on the outside of the ankle.
This can usually be managed with rehabilitation and does not require surgery.
However, some ankle injuries can damage the ligaments that join the tibia to the fibula (the two shin bones).
This is a more serious injury and can require surgery or a period of time immobilised in a cam boot.
A syndesmosis ankle injury can be picked up in a clinical examination through careful questioning and special ligament stress tests.
When it is suspected your physio or sports doctor will refer you for an MRI scan to assess the extent of ligament damage.
There are three ligaments holding the tibia and fibula together down at the ankle.
If only one of them is torn then the injury can usually be managed with immobilisation in a cam boot for a couple of weeks followed by strength and stability exercises, stretching and a graded return to sport with protection using taping or bracing.
If all three ligaments are injured then usually surgery is required to restore a stable syndesmosis.
This involves wiring or screwing the two bones to each other.
If you suffer an ankle injury remember your initial management with rest, ice, compression, elevation and consult your sports and exercise physiotherapist for further assessment.