The King of Sprain – A Dark Crown Atop the Ankle Joint

The King of Sprain – A Dark Crown Atop the Ankle Joint

Certain injuries can sneak up on you and a high ankle sprain serves as a perfect example. Although ankle sprains are one of the most common injuries in the U.S., high ankle sprains are far less common. Even though they can be quite painful, high ankle sprains generally do not produce the same kind of swelling and bruising compared to their more frequent counterpart, “the common ankle sprain.” For this reason, high ankle sprains are sometimes passed off as “not that bad,” when in reality, they do need to be treated.

At OrthoAspen, our elite-grade orthopedic physicians are skilled and practiced in sophisticated orthopedic care—but that’s not all. Our board-certified doctors also participate in many of the same Roaring Fork Valley recreational activities that you do. As a community, we are intimately connected by the twists and turns of living life in motion. Our philosophy is to focus on conservative, patient-centered care, before considering surgery. Indeed, our shared goal is to get you—and even our own colleagues—back into action safely and effectively.

How Do High Ankle Sprains Differ From Common Ankle Sprains?

Isn’t an ankle sprain an ankle sprain? While there are similarities in types of ankle sprains there are also considerable differences, especially between common ankle sprains and high ankle sprains. A common ankle sprain involves the partial or complete tear of the anterior talofibular ligament located on the outer portion of the ankle. A high ankle sprain affects the ligaments located above the ankle joint. These ligaments are referred to as syndesmosis ligaments and are found between the tibia and fibula.

Common Causes and Symptoms of High Ankle Sprains

A young athlete overlooks the mountains at sunrise on an off-season jaunt to Moab.Data reflects that high ankle sprains, albeit less common, account for 25% of ankle sprains associated with collision sports—like ice hockey, football, soccer, lacrosse and basketball.

When individuals experience syndesmotic injuries in the form of a high ankle sprain, they typically have pain that radiates from the ankle up towards the knee. It will also likely be difficult to move the ankle without experiencing pain and discomfort.

How Your OrthoAspen Doctor Diagnoses a High Ankle Sprain

In addition to going over your symptoms, your OrthoAspen foot and ankle specialist may conduct what’s called a “high ankle sprain test.” The test consists of an examination in which your doctor uses his/her hands to squeeze both sides of your injured leg near the tibia and fibula. If pain radiates down the leg, the diagnosis will likely be a high ankle sprain.

An MRI or x-ray may be ordered to rule out a fracture or additional injury of the ankle.

High Ankle Sprain Treatment

Whenever possible, OrthoAspen doctors address orthopedic injuries with conservative treatment methods. Usually, a treatment plan for a high ankle sprain involves three stages: acute (I), subacute (II), and integration to sport (III). During these phases, the following may be prescribed:

  • RICE Method. Rest, ice, compression and elevation are the most frequently used protocols for both common and high ankle sprains to help reduce pain and inflammation.
  • Immobilization. A non-weight-bearing cast or boot (that can be taken on and off) are helpful in stabilizing the ankle.
  • Exercises. Once your doctor feels that your pain and discomfort have subsided enough to allow for physical therapy, special exercises may be recommended to strengthen the ankle and restore range of motion.

In the event that a high ankle sprain is severe and the ligament has been torn, surgical intervention may be necessary. During the surgical procedure, an orthopedic surgeon inserts a screw between the tibia and fibula. This helps alleviate pressure on the ligaments so they can heal properly.

While healing times vary, patients have been known to return to sports within six weeks. However, some cases may take closer to six months to heal.

Our OrthoAspen foot and ankle specialists will work with you to find the best, personalized treatment plan to return you to the sports and activities that you love.

If you’re concerned that you may have injured your ankle, OrthoAspen is here to help. We serve athletes and active individuals from all over the Roaring Fork Valley and the Western Slope. Schedule your appointment now, or contact us today at 970-544-1289 for any questions.


Visit OrthoAspen in two convenient locations
Aspen Clinic
Aspen Valley Hospital
0401 Castle Creek Rd., Suite 2100,

Aspen, CO 81611
+(970) 544-1289
+(970) 544-1400
Basalt Clinic
Midvalley Medical Center
1450 E. Valley Rd., Suite 201,

Basalt, CO 81621
+(970) 544-1289
+(970) 544-1400