HIGH ANKLE SPRAINS: CAUSES, SYMPTOMS, TREATMENT & RECOVERY
What Is a High Ankle Sprain?
A high ankle sprain, also called a syndesmotic ankle sprain, occurs when the ligaments that connect the tibia and fibula (the two lower-leg bones) are stretched or torn. These ligaments stabilize the ankle and lower leg, and injury to them results in pain that is typically above the ankle joint.
According to the American Academy of Orthopaedic Surgeons (AAOS), syndesmotic sprains are often more severe and slower to heal than common ankle sprains, requiring early and proper support to prevent long-term instability.
For common (lateral) ankle sprains, go to our ➡️ Ankle Sprains page.
Types & Severity of High Ankle Sprains
Grade 1 – Mild Syndesmotic Sprain
- Slight stretching of syndesmotic ligaments
- Pain above the ankle
- Minimal swelling
- Mild difficulty with weight-bearing
Grade 2 – Moderate Sprain
- Partial tearing of syndesmotic fibers
- Pain radiating upward between tibia and fibula
- Pain with external rotation
- Significant difficulty walking
Grade 3 – Severe Sprain
- Complete ligament disruption
- High risk of ankle instability
- Possible widening of the tibia-fibula joint
- May require surgery or advanced immobilization
Common Causes of High Ankle Sprains
High ankle sprains usually occur during twisting or rotational injuries, often where the foot turns outward while the ankle is planted.
Typical causes include:
- Sudden cutting or pivoting
- Twisting during contact sports
- Falling or slipping with outward foot rotation
- Direct impact from another player
- Landing awkwardly during jumping
If you struggle with repeated ankle issues, learn more about instability:
➡️ Ankle Instability
Signs & Symptoms of a High Ankle Sprain
Symptoms differ from standard ankle sprains and often include:
- Pain above the ankle joint
- Pain worsened by twisting or rotating the foot outward
- Difficulty pushing off or accelerating
- Trouble walking uphill or climbing stairs
- Tenderness between the tibia and fibula
- Mild or minimal swelling
If stiffness or swelling persist long-term, joint degeneration may be involved:
➡️ Ankle Arthritis
How High Ankle Sprains Are Diagnosed
Diagnosis includes:
- Palpation of syndesmotic ligaments
- External rotation stress test
- Squeeze test of tibia/fibula
- X-rays for fractures or widening of the syndesmosis
- MRI for ligament damage severity
Because these ligaments stabilize the lower leg bones, proper diagnosis early is essential.
Treatment Options for High Ankle Sprains
Rest & Protection
Limit weight-bearing activities and avoid running, pivoting, or sharp directional changes until pain improves.
Cold Therapy
Cold can help reduce discomfort during early phases. Traditional ice can be messy, but structured cold-compression wraps, like our Ultra CHILL, offer cleaner application and better contouring.
Support & Immobilization
High ankle sprains often need more protection than standard sprains. Early bracing or immobilization helps prevent the tibia and fibula from separating under load.
Rehabilitation & Preventing Re-Injury
Rehabilitation focuses on restoring strength, protecting the syndesmosis, and gradually returning to movement. The right brace selection plays a major role in recovery speed and long-term stability.
Which Brace Is Best for a High Ankle Sprain?
Ultra CTS Ankle Brace — Best for High Ankle Sprains With Weight-Bearing Pain
The Ultra CTS ankle brace (“Compression + Traction Support”) is the ideal choice for athletes experiencing weight-bearing pain after a high ankle sprain.
How it helps athletes recover faster:
- Unloads the ankle joint, reducing the separation forces on the syndesmosis when walking or pushing off
- Relieves weight-bearing pain, enabling earlier, more comfortable movement
- Controls rotation, the exact motion that aggravates high ankle sprains
- Supports early functional rehabilitation
- Gets athletes back to practice and playing faster, with reduced risk of reinjury
The semi-rigid framework and adjustable compression allow athletes to transition from acute protection to controlled mobility through each phase of recovery.
Ultra Zoom Hinged Ankle Brace — Best for Returning to Sport After a High Ankle Sprain
The Ultra Zoom hinged ankle brace provides maximum support with maximum mobility, making it ideal once pain decreases and athletes are ready to resume dynamic movement. Additionally, the cuff design around the top of the brace helps to prevent future high ankle injuries.
Key benefits:
- Allows natural up-and-down ankle motion for “protected movement.”
- Restricts harmful twisting and rolling motions
- Enhances stability during cutting, pivoting, and acceleration
- Ideal for the return-to-play phase of recovery
- Provides ongoing protection for previously injured syndesmotic ligaments
If you’re unsure which brace fits your stage of recovery, go to our ➡️ High Ankle Brace Selector Guide
When to Seek Medical Care
Seek evaluation if you experience:
- Pain above ankle that worsens with rotation
- Difficulty walking or standing
- A widening feeling between the shin bones
- Persistent swelling or redness
- Symptoms lasting more than one week
- A history of high ankle sprains
High ankle sprains take longer to heal, so proper early management is key.
FAQ: High Ankle Sprains
How is a high ankle sprain different from a regular sprain?
Regular sprains affect the outside ligaments. High ankle sprains affect ligaments between the shin bones, causing pain above the joint.
Why do high ankle sprains take longer to heal?
The syndesmotic ligaments stabilize major load-bearing bones. Every step stresses them, slowing recovery.
Can I walk on a high ankle sprain?
Often painful. The Ultra CTS ankle brace reduces weight-bearing forces, allowing more comfortable early walking.
Do I need a brace?
Typically, yes.
- Ultra CTS = treatment for high ankle sprains with weight-bearing pain
- Ultra Zoom = return-to-activity and long-term protection
How long does healing take?
Mild sprains: 4–6 weeks
Moderate/severe: 8–12+ weeks
Severe tears may require surgical consultation.
Can high ankle sprains lead to chronic problems?
Yes — untreated sprains can lead to instability, arthritis, and repeated injury.
External Resources
National Athletic Trainers’ Association (NATA) – Sports Injury Guidelines
https://www.nata.org
