📝 Part 2: How We Rehab Syndesmosis Injuries (The Return-to-Sport Framework)

In Part 1, we covered what a syndesmosis injury is and why it’s more complex than a standard ankle sprain.

Now let’s break down how we approach rehabilitation at Pivot Sports Performance — using a framework built for athletes.

🚦 Phase 1: Protect & Maintain

In the early stages (especially post-surgery or during boot use), the focus is on:

• Managing swelling and pain
  
  

• Preventing stiffness in the ankle and toes
  
  

• Maintaining strength in the opposite limb, hips, and upper body
  
  

• Starting safe isometric exercises for the ankle and calf
  
  

• Preserving aerobic conditioning (e.g. off-legs bike or ski erg)
  
  

🦵 Phase 2: Restore Range & Begin Loading

Once cleared for weight-bearing:

• We focus on regaining ankle mobility, especially dorsiflexion
  
  

• Begin progressive strength work (e.g. calf raises, banded peroneals)
  
  

• Introduce modified gym programs and pool-based loading
  
  

• Assess pain-free walking, balance, and single-leg tolerance
  
  

🏋️ Phase 3: Strength, Power & Control

This is where generic rehab falls short. For athletes, we:

• Load both linear and multi-directional strength
  
  

• Incorporate power development (e.g. sled pushes, box jumps)
  
  

• Use unilateral drills to challenge control
  
  

• Reintegrate field or court-based drills in a controlled setting
  
  

• Address footwear and bracing needs where appropriate
  
  

🎯 Phase 4: Return-to-Sport Testing

Athletes don’t return to play based on time — they return based on criteria.

At Pivot, we assess:

• Hop testing (distance, symmetry, quality)
  
  

• Agility and change of direction under fatigue
  
  

• Strength ratios and single-leg control
  
  

• Sport-specific movements — e.g. cutting, jumping, contact prep
  
  

We collaborate with your coaches or medical team to ensure your return is not only safe — but also sustainable.

🏆 Why It Works

Our framework blends physiotherapy with performance-level strength and conditioning. That’s why our athletes return faster, stronger, and with lower risk of reinjury.

This approach works for:

• Non-surgical syndesmosis sprains
  
  

• Tightrope or screw fixation surgery recovery
  
  

• Athletes in field, court, or endurance sports
  
  

🔁 The Mistake We See Most Often?

Trying to “rest it out” and then jump back into sport without proper testing or load progression.

✅ Our Takeaway

If you’ve had a syndesmosis injury and your rehab plan doesn't include testing, sport-specific progressions, and strength work — it’s not enough.

📍 Based in Ringwood or Bundoora?
✅ Book your syndesmosis consult at Pivot Sports Performance today.