Sports Medicine: High Ankle Sprain
A high ankle sprain is the stretching and/or tearing of the ligaments (syndesmosis) that connect the shin bones (tibia & fibula) just above the ankle.
What Is a High Ankle Sprain?
A high ankle sprain is the stretching and/or tearing of the ligaments (syndesmosis) that connect the shin bones (tibia & fibula) just above the ankle. High ankle sprains are less common than other ankle sprains and typically more severe. Sprains are classified into three grades: Grade I – the ligament is stretched but not torn; Grade II - the ligament is partially torn; and Grade III – the ligament is completely torn.
What Are the Signs & Symptoms?
- pain, tenderness and swelling in the front of the ankle and lower leg that may spread to the whole ankle and foot
- popping or tearing feeling at the time of injury
- bruising that spreads to the heel or toes
- trouble walking after injury
- limited ankle range of motion, especially pointing outward
Increased Risk
- previous ankle sprain(s)
- poor physical conditioning (strength, flexibility and balance
- high impact or contact sports (football, hockey, lacrosse)
- shoes not having enough support
How Are High Ankle Sprains Treated?
- Medicine
- Anti-inflammatory medicines, such as ibuprofen (Motrin® or Advil®) or naproxen (Aleve®) may be recommended. Take these as directed by your health care provider.
- Other minor pain relievers, such as acetaminophen (Tylenol®), may be used.
- Use of cold and heat
- Cold should be applied for 10 to 15 minutes every 2 to 3 hours and after any activity that makes symptoms worse. Use ice packs or an ice massage.
- Heat should not be used on a new injury but may be used before doing stretching and strengthening activities prescribed by your health care provider or athletic trainer. Use a heat pack or a warm soak. Apply for 10 to 15 minutes.
- Compression and raising the foot may also help reduce pain and swelling.
- Orthopedic aids
- A walking boot may be recommended to provide support to the joint.
- Crutches may be used initially for more severe injuries.
After the swelling and pain improve, getting motion, strength, and balance back in the ankle is important for return to normal function. Rehab exercises are usually done under supervision of a physical therapist or athletic trainer.
High ankle sprains may take several weeks to several months to heal. Usually, the more pain and swelling, the more severe the ankle sprain and the longer it will take to heal. Surgery may be needed for a more severe injury.
How To Prevent
- Do correct warm-up and stretching before practice or competition.
- Balance training activities.
- Wear ankle support during activities following injury.
- Maintain good conditioning, ankle and leg flexibility, muscle strength, endurance and cardiovascular fitness.
When To Call the Doctor
Call your health care provider or the Sports Medicine team at 614-355-6000 if one or more of these happens:
- pain, numbness, coloring or coldness in the ankle, foot or toes
- pain, swelling or bruising get worse in spite of treatment
- new, unexplained symptoms develop
Helping Hands Patient Education Materials
Written and illustrated by medical, nursing and allied health professionals at Nationwide Children's Hospital, Helping Hand instructions are intended as a supplement to verbal instructions provided by a medical professional. The information is periodically reviewed and revised to reflect our current practice. However, Nationwide Children's Hospital is not responsible for any consequences resulting from the use or misuse of the information in the Helping Hands.
HH-I-507 ©2022, Nationwide Children’s Hospital
