What is a High Ankle Sprain?

You sprained your ankle and you treat it similarly to your last ankle sprain. Yet this time, it seems to not be getting better and you continue to have pain and swelling. The culprit may be a high ankle sprain. You may have heard sport commentators discussing athletes suffering from high ankle sprains. These type of ankle injuries are not as common but are more disabling than your typical ankle sprain. What exactly are high ankle sprains and why do they take longer to recover from?

The ankle joint is formed by four main bones. At your lower leg, a thin outside bone (fibula) and the lower end of your shin bone (tibia) join together to form a socket that the ankle bone (talus) fits inside. The bottom of the ankle bone sits on top of your heel bone. All of these bones are held together by various ligaments that can be damaged when you roll or sprain your ankle. A high ankle sprain occurs when these higher ankle ligaments that connect the two shin bones are injured. Think of a wishbone with a sheet of Saran wrap between the two bones. A high ankle sprain is when a tear in the Seran wrap occurs.

What causes a High Ankle Sprain?

A high ankle sprain commonly occurs when your foot is excessively forced out to the side or towards the shin. These forces can cause your two shin bones to separate and tear the connection between them. When this connection is damaged or torn, this can weaken the joint and result in pain with walking or putting weight through your foot. Your body’s weight may try to separate the two shin bones apart because they no longer have that strong bond.


  • Pain or tenderness to touch above the ankle, between the two shin bones.
  • Pain when you turn your foot outwards (eversion).
  • Pain at the end of movement when you bring your foot up towards your shin.
  • Pain with walking or weight-bearing
  • Swelling around the ankle joint

The severity of your symptoms will depend on how badly you damaged the ligaments, or grade of the ankle sprain. It is best to have a sports physical therapist examine your ankle to determine an accurate diagnosis and provide proper treatment.


Proper treatment is important as returning to your daily activities too quickly can put you at higher risk for further ankle injuries. A high ankle sprain is different from your typical ankle sprain and will take longer to heal. Seeing a physical therapist will ensure your ankle heals properly and allow you to get back on your feet safely.

Initially, treatment will focus on reducing swelling and controlling pain. An X-ray is also recommended to rule out a fracture. If a high ankle sprain is suspected, walking with crutches for the first 3-4 weeks is recommended to reduce weight-bearing and protect the ankle joint. A physical therapist can properly fit you with crutches and instruct you on appropriate use. Applying ice and compression for 15-20minutes several times a day may also reduce pain and swelling in the beginning. Always make sure to place a layer, such as a towel, between your skin and the ice. Gentle movement can prevent further issues of joint tightness and limited movement, and also help to diminish swelling. Crutches will no longer be needed as your ankle heals and weight-bearing is more tolerated. More severe high ankle sprains may require a walking boot after crutches, in order to protect the joint further and gradually increase weight-bearing. It is extremely important to progress exercising and activity carefully. Your physical therapist will help you with this by assessing which muscles require strengthening, and properly progress exercises to safely strengthen your ankle. Also, your therapist can assess your balance and prescribe exercises that will help you regain your position sense and increase stability. Hands on treatment such as massage or manual therapy is also important to promote healing and increase mobility. A physical therapist can apply this hands on treatment and carefully progress you towards higher level activities such as running or sports.

Improper treatment of an ankle injury can lead to greater instability and higher risk for injury. Seeing your physical therapist for this type of injury will ensure you can return to your prior activities and also prevent further injuries.

How long until my ankle heals?

Full recovery of a high ankle sprain may take anywhere from 4-12 weeks or more. This is longer than your typical ankle sprain because everyday activities such as walking, taking stairs, and squatting can cause continued separation of the “Seran wrap” or the higher ankle ligaments.  As with a majority of injuries, early treatment increases your chances for a better recovery. Don’t wait!

For more information visit www.totalperformancept.com.


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