If you’re a football fan, you've probably heard about players sidelined with a 'high ankle sprain.' These injuries can keep professionals—and everyday individuals—off their feet much longer than typical ankle sprains. So, what exactly is a high ankle sprain, and could you have one? This is a common concern among patients who hear the term or receive this diagnosis. Understanding the differences between a high ankle sprain and a regular ankle sprain is key to knowing why the treatments and recovery timelines vary.
What is a “Regular” Ankle Sprain?
A typical ankle sprain, also known as a lateral ankle sprain, involves injury to the ligaments on the outside of the ankle—usually the anterior talofibular ligament (ATFL) and sometimes the calcaneofibular ligament (CFL). This occurs when your foot rolls inward, commonly referred to as an inversion injury, according to AAOS OrthoInfo. Symptoms include pain on the outer ankle, swelling, bruising, and usually a clear memory of twisting or rolling the ankle.
What is a High Ankle Sprain?
A high ankle sprain affects ligaments situated above the ankle joint, specifically the syndesmosis—the connective ligaments between the two lower leg bones, the tibia and fibula. This injury typically occurs when the foot is planted and forcefully twisted outward, a scenario common in football or hockey, where the foot might be trapped and the body rotates over it. High ankle sprain pain often manifests higher up the leg, between the tibia and fibula.
Differences in Symptoms
Unlike regular sprains, high ankle sprains often cause pain higher up, above the ankle. You might notice less bruising around the foot but experience increased discomfort when bearing weight, as the syndesmotic ligaments stabilize the bones for proper weight transfer. Doctors commonly use specific tests, like the external rotation stress test (twisting the foot outward while stabilizing the leg), to diagnose these injuries accurately.
Why High Ankle Sprains Take Longer to Heal
The syndesmotic ligaments play a critical role in stabilizing the ankle during weight-bearing activities, making injuries to this area particularly challenging to heal. Additionally, high ankle sprains sometimes involve associated fractures or significant instability. In severe cases, surgical intervention with screws or specialized stabilization devices (such as an Arthrex TightRope-https://www.arthrex.com/foot-ankle/tightrope) may be necessary to restore proper alignment and stability, often seen in professional athletes.
Treatment Approaches
Mild high ankle sprains, without significant separation of bones, typically involve conservative treatment, including rest, immobilization in a walking boot, extended periods of limited weight-bearing, and physical therapy. However, recovery generally takes longer compared to regular ankle sprains. A typical ankle sprain might resolve in 2-4 weeks, whereas a high ankle sprain could require 6-8 weeks or longer. Imaging like MRI or stress X-rays may reveal instability in severe cases, necessitating surgical intervention.
How to Know Which You Have
Proper diagnosis by a specialist is essential. If you have an ankle injury that isn’t improving as expected, it might be a high ankle sprain that was overlooked initially. Our Monroeville clinic offers comprehensive evaluations and advanced imaging to accurately determine your injury type and appropriate treatment.
Local Pittsburgh Example
Remember when Pittsburgh Steelers running back Najee Harris dealt with a high ankle sprain, sidelining him for several critical games? Injuries like these aren’t exclusive to professional athletes—we regularly treat high ankle sprains for everyday Pittsburghers too.
Conclusion & Next Steps
Both types of ankle sprains involve ligament damage and cause significant discomfort, but high ankle sprains generally mean longer recovery times and potentially different treatment paths. If you suspect your injury may be more than a regular ankle sprain, don't delay getting professional care.
High or low, any ankle sprain should be properly evaluated. Don’t stay on the sidelines longer than necessary. Call 412-525-7692 or request an appointment with our clinic in Monroeville to ensure your ankle heals correctly.
