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A high ankle sprain is also known as syndesmosis sprain. The syndesmotic ligament is a strong and fibrous connective tissue that links the tibia (shin bone) and fibula (outside bone) of the lower leg. This injury is known as "high" ankle sprain because the syndesmotic ligament is actually located above the ankle. A regular or "low ankle" sprain occurs when the ligaments connecting the fibula to the foot are stretched or torn. This injury happens when you "roll over" on your ankle. This is the most common type of ankle sprain, and the recovery period is between 4 to 6 weeks. A high ankle sprain, on the other hand, is a more severe type of ankle sprain because it may take between 2 to 6 months to recover. In most cases, this injury happens when you twist out your lower leg and foot. The signs and symptoms of a high ankle sprain are more or less the same as a regular sprain, however, the pain and swelling will be located slightly higher on the ankle. To identify a high ankle sprain, look for the following: Pain: Following an ankle sprain, the tissue surrounding the injury will release chemicals that stimulate the pain receptors. Swelling: Swelling occurs at the site of the injury due to internal bleeding. Additionally, swelling occurs because more blood is being pumped to the area to aid healing. Warmth: The skin surrounding the injured ankle is warm to touch, as the body tries to heat the area to kill potential bacteria that may cause infection. Redness: The skin covering the ankle becomes pinkish-red in color. This is evidence of increased blood supply to the area. High ankle sprains are divided into three different categories grade one, grade two and grade three according to the severity of the injury. Recovery time will vary depending on what grade sprain you have. Grade I: Grade I is the mildest type of ligament injury, as the syndesmosis is usually only stretched or slightly torn. Symptoms of a grade I injury may include swelling, tenderness, and stiffness. Though the ligament is injured, walking is still possible. Grade II: Grade II sprains occur when the syndesmosis ligament is partially torn. The ankle is still somewhat stable but walking may be painful. There is tenderness, bruising, and swelling around the ankle. Grade III: A Grade III sprain occurs when the syndesmosis ligament is completely torn. The ankle is no longer stable and feels wobbly. Walking is impossible or very difficult and may be accompanied by intense pain. If you have already suffered a high ankle sprain, you are more likely to re-injure yourself in the future. Therefore it's important to be aware of the risk factors for a high ankle sprain, so you can take preventative measures to avoid re-injury. Sports are the most common risk factor when it comes to high ankle sprains. Injury may occur as a result of sudden and forceful motion, or when external force is applied to the leg. The sports that most commonly cause high ankle sprains include football, soccer, wrestling, hockey, basketball, and lawn tennis. Certain medical conditions can make you more likely to sustain an ankle injury. For example, being overweight or obese puts greater strain on the legs for a prolonged period of time, making the ankles more prone to injury. Conditions which cause decreased muscle strength and bone integrity are also a risk factor for high ankle sprains.

summary: Understand the difference between a high ankle sprain and a regular sprain. Learn to recognize the signs and symptoms of a high ankle sprain. Identify the different grades of high ankle sprain. Familiarize yourself with the risk factors.

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No is pronounced khong. To say "No, thank you" in Vietnamese you would say, Da Khong Cam on which is pronounced "Ya'a kohng gam uhhn." The respectful way to say yes in Vietnamese is to say, da pronounced ya'a. Another way to give an affirmative is vang pronounced vuhng. Vietnamese is the official language of Vietnam and is spoken by approximately 70 million people. The dialects in Vietnamese do not differ much more than those of the various parts of the United States except for two rural dialects, Hue and Vinh. Standard Vietnamese is the dialect of the educated near Hanoi, the capital. As a language, much of Vietnamese vocabulary has been borrowed from Chinese. A quote with Khong is, iec khong so sung and it means that he who knows nothing doubts nothing.

summary: Say khong to say no in Vietnamese.

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Some dogs are nervous about car travel because they feel nauseous and associate journeys with feeling ill and travel sickness. Recognize the signs of motion sickness, the most obvious of which is heavy drooling. Strings of saliva hanging from the dog's lips is a sure sign of motion sickness. In addition, all dogs react differently but some hang their heads and look troubled, others may try to pace, and some will whimper. Those dogs who suffer from motion sickness will need medication to travel well. You will need to speak to your vet about a safe medication to counteract the nausea. It might be that the dog always needs medication for long journeys, but you may well be able to retrain it to accept short journeys without illness. Do not shout or chastise the dog if it vomits. It cannot help being sick and being chastised only adds to its apprehension and increases the trauma of the experience, which will make it even more anxious. If you know your dog gets travel sick but have to make a journey, such as to the vet to get travel sickness meds, then seat it on a puppy pad so that the mess can be easily cleaned. It usually helps a dog if it can see out of a window. If you have a toy or small dog, consider getting a travel pod which raises it up off the seat in a safe way, so it can see out. For medium sized dogs, have a certified crash-tested harness and seat the dog on a back seat so it can see out. For large dogs, consider putting the dog in a crate, so they are safe and can see out. You can also put a blanket underneath where the dog will be sitting. It should be a blanket that the dog uses regularly, so its smells will be familiar to the dog. Avoid using human anti-motion sickness medications unless you have checked it out with your vet first. These are not approved for use in dogs, so the side effects have not been fully tested, and the possible reactions with other drugs is unknown. On a practical level, dogs metabolize drugs differently than people, so there is a distinct possibility that those human drugs won't be effective. The best medication for motion sickness is a prescription drug called Cerenia (maropitant) which is available as an injection (given by the vet) or tablet. Both forms work for 24 hours. This medication is superior to others because it acts on the nausea center in the brain, and switches off all feelings of nausea and sickness. Some owners find giving their dog Bach flower remedies, commonly known as Rescue Remedy, helps, but this is anecdotal. This is a liquid and you place a few drops on the dog's tongue. The Bach flowers are dissolved in alcohol and one possible explanation that some dogs seem to benefit is that they are given the equivalent of a small alcoholic drink.
summary: Assess whether your dog has motion sickness. Be prepared for the dog to be sick. Place your dog in a spot in the car where it can see out. Consult with your vet about whether your dog needs medication to prevent nausea. Consider alternative treatments.