A high ankle sprain is an injury to the syndesmosis ligaments that connect the tibia and fibula bones in the lower leg. This typically occurs from a forceful outward twisting of the foot.
Pain located above the ankle joint and radiating up the leg.
Pain that increases significantly when pushing off the toes to walk.
Tenderness when the lower leg bones are squeezed together.
Often shows less visible swelling than a standard sprain despite being more severe.
Physical Examination
X-rays: To evaluate for fracture and to see if the tibia and fibula gap apart when standing.
MRI: Used to see the extent of the soft tissue damage.
Protected weight bearing using crutches or a walking boot.
Immobilization to allow the leg bones to stabilize.
Gradual physical therapy focusing on calf strength and joint stability.
Surgical stabilization using screws or tightrope anchors if the bones have separated.
Longer recovery timeline compared to lateral sprains often lasting several months.