A high ankle sprain is an injury that damages the ligaments connecting the leg bones to the talus or ankle bone and calcaneus or heel bone. It may also involve damage to the tendons and muscles that provide stability to the ankle.

Ankle sprain is one of the most common sports injuries in the United States, but most people damage the ligaments below the ankle. A high ankle sprain is less common than a low ankle sprain.

“Sports injuries” is a term that refers to injuries that are common among sports people but can happen to anyone. People can sprain their ankles doing everyday activities, such as walking or climbing stairs.

The ankle joint consists of three bones: the tibia and fibula in the leg, and the talus. Strong ligaments connect the bones and help stabilize the joint.

High ankle sprains usually damage the ligaments that hold the ends of the tibia and fibula together. These are called the syndesmotic ligaments.

This article explains high ankle sprain and how doctors treat it. It also considers the differences between high and low ankle sprains.

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A high ankle sprain is damage to the syndesmotic ligaments that support the ends of the leg bones at the ankle. The four ligaments are:

  • anterior inferior tibiofibular ligament
  • posterior inferior tibiofibular ligament
  • tibiofibular interosseous ligament
  • transverse tibiofibular ligament

These ligaments help keep the tibia and fibula together and allow for motion between the bones while a person is walking or running.

Most high ankle sprains occur when a person’s foot twists outward, and the ligaments stretch or tear. The anterior inferior tibiofibular ligament is the weakest and most prone to damage.

High ankle sprains are also associated with ankle fractures.

Sometimes, the impact can transfer up the leg and fracture the fibula near the knee. This type of injury is called a Maisonneuve fracture.

High ankle sprains occur when there is damage to the ligaments above the ankle joint, whereas low ankle sprains occur below it.

Most ankle sprains are low sprains, with tears in the ligaments on the outside of the foot. The ankle usually twists inward.

Most people with high ankle sprains feel pain, especially when they flex the foot upward. Climbing stairs can be particularly painful as it stretches the ligaments.

People with high ankle sprains may find that the pain spreads up the leg, away from the ankle. They may also feel ankle weakness, making them feel unstable when standing.

High ankle sprains do not usually cause much swelling or bruising but can cause pain around the knee.

Learn more about ankle sprains here.

Most people get high ankle sprains when their foot twists out from the leg.

People who play sports involving a lot of running and turning, such as basketball, football, or soccer, are more likely to encounter this type of injury, but it can happen to anyone.

Doctors rely on two tests to diagnose a high ankle sprain.

The squeeze test involves squeezing the person’s leg under their knee. If the person feels pain spreading down to the ankle area, it can indicate a high ankle sprain.

During an external rotation test, the doctor asks the person to bend their knee before slowly turning the foot away from the body. Again, if the ankle is painful, it can mean the person has a high ankle sprain.

Doctors may also recommend X-rays to rule out broken bones.

X-rays may show if the tibia and fibular have separated, indicating damage to the ligaments holding them together.

High ankle sprains heal slowly — recovery time may be longer than more common sprains.

Most doctors recommend R.I.C.E. as an immediate course of treatment if there are no broken bones. This stands for:

  • Rest: Doctors recommend not walking or putting any weight on the ankle. Depending on the severity of the injury, doctors may suggest wearing an ankle brace to keep the bones stable and allow the ligaments to heal.
  • Ice: Applying ice to the ankle can help reduce any swelling. Put the ice in a pillowcase or wrap it in a thin towel to protect the skin. Apply ice for around 20 minutes at a time.
  • Compression: Wrapping the injured ankle in bandages can also reduce swelling.
  • Elevation: Lifting the leg above the heart while sitting down may also help.

If a person has a severe injury, they may need to wear a cast to allow the ligaments to heal. If the person’s tibia and fibular have separated or if they have broken any bones, they may need surgery using plates and screws to repair the damage and reconstruct the ligaments.

Read some tips for healing a sprained ankle here.

Recovery times depend on the extent of ankle damage and whether there are also bone breaks. The American Orthopaedic Foot and Ankle Society says some people may be able to resume usual activities in 6–8 weeks, but it can take much longer.

Researchers suggest that as many as 40% of people with high ankle sprain still have instability symptoms after 6 months.

High ankle sprains are injuries that damage the ligaments above the ankle joint. They usually happen when a person’s foot twists outward from their leg.

People who play sports involving running and turning are most prone to a high ankle sprain, but they can happen to anyone.

Most injuries occur when a person’s foot twists outward from their body.

Sprains vary in severity depending on whether the ligaments are stretched or torn. People with torn ligaments may need surgery to repair the damage.

High ankle sprains are slow to heal, and full recovery may take up to 6 months.