A high ankle sprain affects the high ankle ligament, connective tissue strands that attach the tibia (shinbone) to the fibula (outside leg bone). Because the ankle offers the stability you need to walk or run, injury to this ligament may lead to instability of the ankle joint. A high ankle sprain results when these ligaments are torn or damaged, usually from a forcible outward twisting of the foot and ankle, in sports such as football, soccer, wrestling, ice hockey, rugby and lacrosse.
Patients often report pain above the ankle that increases with outward rotation of the foot, pain felt upon walking, and significant bruising and swelling across the higher ankle rather than around the bony knobs on both sides of the ankle. There are three grades of high ankle sprains:
- Grade 1: mild
- Grade 2: moderate
- Grade 3: severe
These ligaments are directly involved in leg movement; thus, any weakening or injury to the ligament will affect its ability to bear the normal load and will inhibit normal maneuvering. The most conservative treatment is the RICE method—Rest, Ice, Compression and Elevation. If needed, a walking boot can further stabilize the ankle and limit its movement to allow for proper healing.
During the healing period, therapy interventions and exercise will improve joint range of motion, muscle length and nerve function. Weight-bearing and resistance loaded exercises will strengthen your foot, ankle and calf muscles. And to prevent reinjury, we will assess your balance and proprioception (the sense of knowing where your body is in space) and retrain you to manage both by using a balance or wobble board.
If a fracture has occurred, screws will be inserted to stabilize the tibia and fibula and, by association, the high ankle ligaments. After the screws are removed, physical therapy will help restore joint range of motion, flexibility and strength.
A high ankle sprain does not have to mean an end to your athletic participation. We can start a physical therapy program to alleviate your pain and teach you how to prevent a high ankle sprain in the future.
