A high ankle sprain requires a longer time to heal than a low ankle injury. The focus of treatment is to move the tibia and fibula with respect to each other and facilitate healing in those positions, which would be performed by a doctor.
The treatment of a high ankle sprain uses the standard "RICE" protocol, which includes:
- Rest: The weight is kept off the affected leg to provide the time required for healing.
- Ice: Application of ice for about 15 minutes every few hours to reduce inflammation and swelling.
- Compression: Wrap the affected area with an elastic bandage to minimize swelling.
- Elevation: Sit or lie down with the foot elevated above the level of the heart to reduce swelling and pain.
Surgery, taping, or braces
For severe high ankle sprains or in cases of ligament tear, surgery (high ankle sprain taping) or braces may be required. The doctor will advise appropriate treatment based on the extent of the surgery. Depending on the recovery progress, the doctor will advise physical therapy and exercises.
What causes a high ankle sprain?
A high ankle sprain or syndesmotic sprain is an injury that involves the set of ligaments that are located above the ankle joint, between the tibia and fibula (the two bones of the lower leg). These ligaments together form a fibrous joint called syndesmosis. The primary function of the ligaments of syndesmosis is to serve as shock absorbers, preventing the tibia and fibula from getting separated from each other.
A high ankle sprain is caused mainly by activities, such as running, jumping, or during a quick change in direction (for example, a sudden twisting, turning, or cutting motion). During the quick change in direction, these ligaments experience very high forces, and the sudden inversion or dorsiflexion of the foot can cause trauma to the syndesmosis. These injuries are mostly noticed in athletes who play high-impact running sports, such as football, soccer, basketball, and lacrosse.
What are the symptoms of a high ankle sprain?
A high ankle sprain can impair the activity of individuals, especially an athlete, for much longer than a typical ankle sprain. These injuries are often associated with severe lateral or medial ankle sprains or fibular fractures. They form approximately 10 percent of all acute injuries that are treated by physicians in clinics.
The main site for a high ankle sprain to occur is on the lateral side (outer side) of the ankle. An individual affected may experience the following symptoms:
- Tenderness over the ankle joint
- Pain while weight-bearing
- Pain with passive and active movements of the joint
- Pain while rotating the joint
- Mild to moderate swelling above the ankle in the lower leg
When a high ankle injury is suspected, the individual’s lower leg, ankle, and foot must be immobilized and the person should be transported for immediate emergency medical investigation.
How is a high ankle sprain diagnosed?
The orthopedic will diagnose the high ankle sprain after assessing the symptoms and conducting a physical exam. Two main tests are performed: the squeeze and external rotation test.
- Fibular compression test: also called a high ankle sprain or squeeze test, is performed by squeezing the leg just below the knee to see if the pain radiates to the ankle area. If the test is positive, it suggests a high ankle sprain.
- External rotation test: is performed by bending the knee and placing the ankle in neutral or 90 degrees with the foot in relation to the leg. Then, the foot is turned to the outside. If the patient experiences pain at the ankle area on bending the knee, this suggests a high ankle sprain.
Additional tests such as X-rays and magnetic resonance imaging may be conducted to exclude fractured fibula or other complications.
SLIDESHOW
See Slideshowde-Las-Heras Romero J, Alvarez AML, Sanchez FM, et al. Management of Syndesmotic Injuries of the Ankle. EFORT Open Rev. 2017;2(9):403-409. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5644422/
WebMD. Picture of the Ankle. https://www.webmd.com/pain-management/picture-of-the-ankle
Top How Do You Fix a High Ankle Sprain Related Articles
Ankle Pain (Tendonitis)
Ankle pain is commonly due to a sprain or tendinitis. The severity of ankle sprains ranges from mild (which can resolve within 24 hours) to severe (which can require surgical repair). Tendinitis of the ankle can be caused by trauma or inflammation.capsaicin topical
Capsaicin topical is a pain-relieving (analgesic) medication available as over-the-counter (OTC) as topical creams, gels, and liquids used for the temporary relief of minor joint and muscle pains due to muscle strains, sprains, or cramps, bruises, arthritis, and backache. Capsaicin is also used off-label to relieve nerve pain (neuralgia) caused by certain nerve conditions (neuropathies). Common side effects of capsaicin topical include redness, pain, transient increased pain at the application site, raised bumps in the skin (papules), itching (pruritus), nausea, vomiting, swelling (edema), dryness, high blood pressure (hypertension), bronchial inflammation (bronchitis), sinus inflammation (sinusitis), skin odor, skin peeling (exfoliation), headache, dizziness, taste perversion (dysgeusia), and cough.Dislocated Ankle (Ankle Dislocation)
Symptoms and signs of a dislocated ankle include pain, swelling, bruising, ankle deformity, and possible numbness and tingling in the foot. Treatment of an ankle dislocation involves putting the ankle bones back in their normal positions, possibly using gentle traction. The blood and nerve supply to the foot will be evaluated and the ankle will be checked for any related fractures. The ankle will be fitted with a splint or a cast.How Do You Get Rid of Swollen Feet and Ankles?
Learn what medical treatments can help with swollen feet and ankles and speed up your recovery from swollen feet and ankles.How Do You Treat Tendonitis in the Ankle?
Learn about the causes and symptoms of tendonitis in the ankle and treatment options.How Long Should It Take for a Sprained Ankle to Heal?
Depending on the severity of the sprain, a sprained ankle generally heals within 2 to 12 weeks of home management with proper treatment.Is My Muscle Pulled or Strained?
A pulled muscle is sometimes used as a colloquial term for a strain of moderate severity. A muscle becomes strained when it’s twisted, pulled, or torn in two.menthol topical
Menthol is a medication topically applied for temporary relief from minor joint or muscle pain. Menthol can be used to treat bursitis, arthritis, tendonitis, backache, muscle strains, muscle sprains, cramps, and bruises. Common side effects of menthol topical include redness (erythema), warmth, irritation, stinging or burning sensation, tingling, and hypersensitivity reactions. Consult your doctor if pregnant or breastfeeding.Recovery From Ankle Arthroscopy
After surgery, pain killers and antibiotics are administered. Patients are usually discharged between one and three days after surgery.Sprains and Strains
An injury to a ligament is called a sprain, and an injury to muscle or tendon is called a strain. Sprains and strains may be caused by repetitive movements or a single stressful incident. Symptoms and signs include pain and swelling. Though treatment depends upon the extent and location of the injury, rest, ice, compression, and elevation are key elements of treatment.trolamine salicylate
Trolamine salicylate is a medication used for temporary relief from mild to moderate aches and pains of muscles and joints, associated with conditions such as arthritis, rheumatism, lower back pain, muscle sprains and strains, muscle soreness from exercise, cramps, bruises, and tendon or ligament pains. Common side effects of trolamine salicylate include blistering, peeling, redness, irritation, nausea, diarrhea, vomiting, fast breathing (hyperventilation), ringing in the ears (tinnitus), confusion, and drowsiness. Do not take if pregnant or breastfeeding.What Are the Benefits of Ankle Taping and Bracing?
The concept of prophylactic (preventative) ankle wrapping was introduced more than 60 years ago to prevent or reduce the severity of ankle injuries. Tape or a brace may be applied before practice or a competition. Ankle bracing and taping should be done under the guidance of a sports medicine physician or a training athletic staff.When Are Ankle Splints Used?
Splints are primarily used to stabilize injuries to bones until the patient can be evaluated by a consultant, such as an orthopedic surgeon. Ankle splints are applied to minimize movement and provide support and comfort by stabilizing an injury at the ankle joint. Immobilizing the joint reduces pain and helps the injury heal faster.