Differentiating ‘high’ and regular ankle sprains

Question: How is a high ankle sprain different from a regular ankle sprain?

Answer: Most ankle sprains occur from some type of twisting injury. The ligaments connecting the fibula bone to the foot on the outer aspect of the ankle are more commonly injured. A high ankle sprain involves injury to the ligaments above the ankle joint. These ligaments connect the tibia and fibula bones from the ankle to the knee. The mechanism of injury for both is similar.

Symptoms from a high ankle sprain may be similar to ordinary ankle sprains. However, patients may be more swollen and at times less able to weight bear on the affected extremity. Physical examination by your doctor may reveal tenderness higher up into the leg than the more common ankle sprain.

X-rays are important in evaluating high ankle sprains. They can often be associated with fractures around the ankle joint and in the area just below the knee. An MRI and/ or CT scan may also be necessary. It is important for your orthopedist to assess whether the proper anatomic relationship between the tibia and fibula is maintained.

Treatment of high ankle sprains can be similar to ordinary sprains. This may involve a period of immobilization which may include a walking boot or cast. Physical therapy is almost always necessary. These injuries often involve longer recovery periods – up to six to eight weeks.

At times surgery may be necessary to stabilize the connection between the tibia and fibula. This is often the case if the injury is associated with a fracture or if the normal alignment between the two bones is disrupted.