Ankle Sprain vs. High Ankle Sprain: What’s the Difference?

by Mckinly Vazquez

What is an ankle sprain?

An ankle sprain is when there is soft tissue damage around the ankle. There are three different types of ankle sprains. A first-degree ankle sprain is when there is damage to a few ligament fibers, while a second-degree ankle sprain is when there is more damage to the ligament and there is swelling. Lastly, a third-degree ankle sprain is when the ligament is ruptured, there is swelling, and the joint could be dislocated.

What causes an ankle sprain?

An eversion injury or an inversion injury causes an ankle sprain. An inversion injury occurs when the ankle twists inwards; this is more common than an eversion injury, which occurs when the ankle twists outwards away from the body. When an inversion injury happens the lateral ligaments are damaged. The calcaneal fibular ligament, which connects the fibula to the calcaneus and the anterior talofibular ligament, which connects the talus to the fibula on the outside of the ankle, are the ligaments that are injured most often. On the other hand, an eversion injury is when there is damage done to the inside of the ankle to the Deltoid ligament. These types of injuries happen most often when athletes “roll” their ankles but can also happen if a person were to walk or run on uneven surfaces.

What is the treatment for an ankle sprain?

Ankle wrap Within the first 48-72 hours a person should rest, ice, use compression, and elevate their ankle. The ice should be on a person’s ankle for about 20 minutes every 2 to 3 hours. Walking should be avoided so the swelling in the ankle can be reduced. If a patient cannot bear weight, they are better treated in a removable walking boot. People with a second-degree sprain will usually use crutches. If an ankle is fractured or a person has a third-degree sprain, they should go to their doctor and get medical advice on how they should proceed with their ankle. Lastly, a patient should do physical therapy to strengthen the muscles around their ankle. To be on the safe side, one should always seek professional medical help with a sprained ankle to make sure they are healing it the correct way.

What is a high ankle sprain?

A high ankle sprain is when there is ligament damage to the joint that is between the tibia and fibula; this joint is called the ankle syndesmosis. The syndesmosis acts as a shock absorber between the tibia and fibula. So a high ankle sprain involves damage to a band of ligament tissue that connects the fibula and tibia called the Interosseous Membrane and damage to other ligaments such as the posterior and anterior Tibio-Fibular ligaments. Another part that can be damaged is the capsule that surrounds the ankle joint. These types of damages will cause bleeding in the tissues, and there will not be much swelling within the ankle, unlike a common ankle sprain. Also a first-degree high ankle sprain is when the interosseous membrane has a few ligament fibers that are damaged, while a second-degree sprain widens the tibio-fibula joint and has more extreme damage to the interosseous membrane. Lastly a third-degree high ankle sprain is when a joint is possibly dislocated and the interosseous ligament is completely ruptured.

What causes a high ankle sprain?

High ankle sprains are caused when people have twisting injuries, which most commonly come from playing sports that have a lot of cutting and contact involved.

For example, football is a high impact sport with a lot of cutting and contact involved that can cause a lot of high ankle sprains. These twisting injuries are caused by an extreme ankle dorsiflexion and an external rotation of the shin.

What is the treatment for high ankle sprain?

When this type of sprain first happens, a person should follow the same protocol as you do when you have a regular sprained ankle: rest, ice, use compression, and elevate their ankle. The amount of rest a person needs tends to be longer than a person who has a common ankle sprain. A person who has a third-degree ankle syndesmosis injury will need to have surgery to put their tibia and fibula back into place. So in this case in order for the ligament to heal a screw might need to be placed between the fibula and tibia to hold the bones in the correct positions. Again this step would be taken if the ligament were severely sprained.

In most cases, the ankle can be healed without surgery by giving it rest, following the advice of your doctor, and eventually by doing physical therapy to strengthen the muscles around the ankle once you can bear weight on your ankle.



“Ankle Sprain.” American Orthopaedic Foot and Ankle Society. N.p., 2017. Web. 18 June 2017.

Chehab, Eric. “The “High Ankle Sprain”: What’s the Difference?” HSS. N.p., n.d. Web. 18 June 2017.

“High Ankle Sprain in Depth AKA: Syndesmosis Sprain.” N.p., 2017. Web. 19 June 2017.

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