A high ankle sprain is a sprain in the upper ligaments of your ankle, above the ankle itself. These ligaments are attached to the fibula and the tibia, stabilizing the entire area for activities like running and walking.

When you damage or tear those ligaments — often due to rotating or twisting your ankle — you’re experiencing a high ankle sprain. This type of sprain doesn’t occur as often as a sprain in the lower part of the ankle.

Low ankle sprains are the most common type of ankle sprain. They happen when you rotate or twist your ankle toward the inside of your leg, which causes the ligaments on the outside of your ankle to tear or stretch.

High ankle sprains can happen when you have a fractured ankle bone. Sometimes, these can happen when the deltoid ligaments, the ligaments on the inside of your ankle, have been torn. You might feel pain in the deltoid area, in the ligaments of the high ankle, or even in the fibula.

High ankle sprains are also called syndesmotic ankle sprains after the bone and ligaments involved.

High ankle sprain location

This model shows the area of bone and ligaments affected in a high ankle sprain.

Along with typical symptoms of an ankle sprain like pain and swelling here are specifics to look out for in the case of a high ankle sprain.

If you’ve experienced a high ankle sprain, you might be able to put weight on your foot and ankle, but you’ll probably have pain above your ankle, between your fibula and tibia.

You’ll likely experience more pain when climbing up or down stairs, or engaging in any activities that cause your ankle bones to flex upward.

A high ankle sprain can also result in a fractured fibula.

If you’ve fractured one of the bones in your ankle along with a high ankle sprain, you won’t be able to put weight on that foot.

It’s common for high ankle sprains to happen when you twist or rotate your ankle. Most of the time, rotating your foot toward the outer side of your leg is what causes a high sprain.

These types of sprains tend to happen during contact or high-impact athletic activities and sports, so athletes are at the highest risk of developing them.

If you think you’ve experienced a high ankle sprain, see your doctor. They can diagnose the type of sprain you’ve sustained.

Your doctor will ask you to show them where you’re experiencing the pain in your ankle. Then, your doctor will examine you to determine whether your pain is referred to another area of your foot, ankle, or leg.

They might squeeze your leg underneath your knee or rotate your leg and ankle toward the outside.

The location of your pain will help your doctor determine where the sprain actually is. Pain in the upper ankle ligaments tend to mean that you have a high ankle sprain.

Your doctor will also want to take some X-rays of your ankle and leg to rule out broken bones or other injuries. In some cases, you might have a fractured tibia, fibula, or bone in your ankle.

If your doctor suspects you may have further injury to the ligaments in your upper ankle area, they may order an MRI or CT scan.

High ankle sprains tend to take longer to heal than the more common strains. Here are steps you can take during the healing process.

  • Ice. First, your doctor may advise you to ice your ankle every few hours for about 20 minutes at a time.
  • Compression. Wrapping your leg with a light compression bandage and elevating it, in addition to icing, can also help relieve pain and swelling.
  • Anti-inflammatory and pain medication. Taking anti-inflammatory over-the-counter medicines like naproxen (Aleve) or ibuprofen (Advil) can help reduce inflammation and pain at the injury site.
  • Rest. You’ll need to keep weight off your injured ankle and tape or splint the injured area. Sometimes, high ankle sprains can mean you need to use crutches or wear a boot that allows you to walk on your foot while also properly positioning the ankle and foot for healing.
  • Strengthen. Physical therapy is also needed in many cases. Therapy can help make your tendons stronger to help prevent a recurrence of this type of injury.

Healing from a high ankle sprain can take anywhere from six weeks to three months — sometimes even more. Healing time depends on how badly you’ve injured the soft tissue and if there was any bone damage.

To determine whether your ankle has healed enough for you to return to athletic activities, your physical therapist or doctor will evaluate your walking and weight bearing ability. They may also ask you to hop on that foot.

You may need an X-ray or other diagnostic imagery to determine whether healing is complete.

If there’s too much separation between your tibia and fibula, for example, your doctor may recommend corrective surgery. In that case, you’ll have to wear a cast or a boot for around three months while you recover, then return to physical therapy.

Usually, the long-term outcome is good for a high ankle sprain. Your ankle might be stiff and difficult to move for a prolonged period of time — more so than the typical, more common sprains. Arthritis can also set in if further separation of the bones isn’t treated.

High ankle sprains are a more complicated injury than typical ankle sprains, which occur lower and on the outside of the ankle.

They can take longer to heal and sometimes require longer than three months to resolve with treatments like splinting, wearing a boot or a walking cast, and physical therapy.

With the proper treatment, however, your high ankle sprain can heal completely. If you’re an athlete (or even if you’re not), you may need to continue to brace or tape your ankle to avoid recurrence of the injury.