Sketch inhibition is regularly alluded to by educators as a phenomenon within design higher education, and one having increasingly marked effects on industry - but has garnered little attention from academics. This paper provides a meta-analysis of the literature and evaluation of the anatomy and functions of sketching during design ideation across a variety of disciplines. It demonstrates the importance of sketching for cognitive support, as a language, a means of reflection, and storage of information. It presents initial findings from the literature related to symptoms; from avoidance to an over reliance on digital tools and considers its causes, ranging from psycho-social, to technological. Fine art exercises have proven beneficial to its management, however further investigation is recommended to establish depth and enable a framework for its management within HE.