Updated: Oct 3, 2020
Every Fall at the beginning of football season the incidence of high ankle sprains begins to rise. A significant number of players who sustain high ankle sprains stop playing sports for a longer period of time than those with common ankle sprains. Why are high ankle injuries so debilitating and what is the difference between a high ankle injury and an ankle sprain? The differences lies in the anatomy of the ankle and its relationship to the rest of the lower extremity.
A high ankle sprain is an injury that involves a different set of ligaments than in other more common ankle sprains. A high ankle sprain involves the ligaments connecting the two bones of the lower leg (the tibia and fibula) at the ankle joint. The connection of these two bones (tibia and fibula) are formed by four ligaments called the syndesmosis. This is the area that is frequently injured in high ankle sprains. One or more of these four ligaments can be partially or completely ruptured (torn). High ankle sprains usually result from a sudden twisting, turning or pivoting motion when running, jumping or planting and rotating the foot to the outer side of your leg in a cut back or spin and therefore are also can occur in similar sports.
A medial ankle sprain injures the inside ligaments, collectively referred to as the deltoid ligament. A low ankle sprain involves the ligaments supporting the subtalar joint, also known as the talocalcaneal joint which is made up of the calcaneus (heel bone) and the talus a bone of the lower part of the ankle joint. A low ankle sprain occurs when the foot is turned inward (inversion) stretching the connecting tissue within the ankle joint. Low ankle sprains represent 80% of all ligament injuries to the ankle and are what most people think of when they picture the classic ankle sprain.
Each time an ankle sprain happens, the affected ligaments loosen, increasing the odds of a subsequent injury. Approximately 9.8% of high ankle sprains that occur are recurrent injuries. Proper practitioner identification of the injury is critical to identify the extent of disruption to avoid degenerative arthrosis of the ankle. Depending on severity (the degree of the injury) treatment for high ankle injuries can improve with conservative care but may need surgical intervention. Depending on the type of treatment recovery can range from 6-8 weeks to 4-6 months with follow-up interventions up to a year or more.