A high ankle sprain is also called a syndesmotic injury. This name refers to the syndesmosis, or high ankle ligaments. Your healthcare provider will do certain tests like the syndesmosis squeeze test when diagnosing this sprain.
A high ankle sprain is when you tear or damage the high ankle ligaments that connect the tibia to the fibula. These ligaments are known as syndesmosis, even though that word refers to the joint itself. You might hear your high ankle sprain called a syndesmotic injury.
Our ankles connect the leg bones to the foot bones. There is an upper ankle and a lower ankle. The upper ankle is the tibia and fibula. In between the upper ankle and lower ankle is the talus, which fits into the arch of the other two bones.
Ligaments are tissues made up of fibers (threads) that connect bones to other bones.
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The differences between a high ankle sprain and a low ankle sprain aren’t just location. High ankle sprains involve turning inward or outward while your foot is flexed up. Most low ankle sprains happen when the ankle rolls inward, while other low ankle sprains happen when the ankle rolls outward. The low ankle sprains don’t involve the high ankle ligaments. Low ankle sprains are what most of us think of when we hear someone has a sprained ankle.
The ligaments that can be damaged or torn in a high ankle sprain include:
Any of these ligaments can be stretched, torn partially or torn completely in a high ankle sprain.
A high ankle sprain is less common than a low ankle sprain. High ankle sprains often happen in athletes who play:
Symptoms of high ankle sprain include:
A high ankle sprain happens when your ankle is hurt when your foot is flexed upward and then twisted either inwards or outwards. It almost always happens as a result of some type of collision, not simply the rolling motion that causes other ankle sprains. High ankle sprains almost always happen when you’re running or jumping.
The first thing your provider will do is to ask questions about why you’re there and get your medical history. Then they’ll do a physical examination.
To diagnose a high ankle sprain, your provider is likely to:
You can begin treating your ankle injury by following the R.I.C.E. advice: rest, ice, compression (bandaging) and elevation (keeping your foot up) for about three to five days. You might need to use crutches when you need to move.
You can use over-the-counter non-steroidal anti-inflammatory drugs (NSAIDS) to help with pain and swelling. NSAIDs are available in oral forms like pills and tablets, or topical forms like lotions, creams or sprays.
Your provider might recommend a brace, tape, or even some type of cast to help you avoid bending your ankle up toward your body.
Your provider might also recommend physical therapy, including the use of therapeutic bands or exercising in water. Being in water will lessen the amount of weight your ankle has to bear.
You’re unlikely to need surgery to treat a high ankle sprain unless the damage is very severe or if your ankle continues to be unstable.
It might take you six to eight weeks to recover from a high ankle sprain. If you’re an athlete, your return to play might take an even longer time. Low ankle sprains generally heal quicker than this.
Ankle sprains are accidents, and there’s no way to prevent accidents completely. However, there are some things you can do that may make a high ankle sprain less likely to happen. You can:
The outlook is good for recovering from a high ankle sprain, most often using only non-surgical methods. However, you’ll probably be more prone to injuring your ankle again. Also, you may have stiffness in the joint later on.
If you’ve hurt your foot and you can’t put any weight on it, you should call your provider or go to an emergency room. You’ll want to find out if you have any broken bones. You’ll need to follow your provider’s instructions on the best way to take care of the injury.
A note from Cleveland Clinic
Most of us have probably twisted a foot and ended up with a sprained ankle. If you have been participating in an activity that involves jumping or running and you hurt your ankle, you might find you have a high ankle sprain. Make sure that you follow your healthcare provider’s instructions so that you heal completely.
Last reviewed by a Cleveland Clinic medical professional on 12/08/2021.
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