What Is A "High Ankle" Sprain?! - Paul Gough Physio Rooms

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What Is A “High Ankle” Sprain?!

Ever wondered what exactly a “High Ankle” sprain is?…

Well, don’t worry if that term has confused you! Our Physiotherapist Jonny has written a post all about it – so by the end of this, you’ll never be wondering again!…

What Is 'High Ankle Sprain?!'

Here’s Jonny…

There’s been a few clients come in to see me recently who have explained they have been diagnosed with a “high ankle sprain”.

Each client had significantly varied understandings of what this actually is so I have decided to write this blog to offer some clarity.

What do you think of when someone says “high ankle”?

This term was confused by most of my clients…

Many thought it was simply a shin injury.

Others thought it was an injury at the top of the ankle ligaments on the side – well… it actually means you have injured the ankle syndesmosis.

A syndesmosis is simply a term for a slightly moveable joint, held together very tightly by ligaments and fibrous tissue (connective tissue).

First we need a bit of an ‘Anatomy Lesson’…

The ankle joint is made up of 3 bones, the tibia, fibula and talus.

The tibia and fibula are the pointy bones that seem to stick out either side of the ankle. The talus is the same shape as a horses saddle and the tibia (shin bone), sits on top of this, allowing movement. These bones make up what we now know as the ANKLE SYNDESMOSIS.

The ankle syndesmosis is held together by 3 ligaments and an interosseus membrane – It’s best to think of ligaments as a tent’s guide ropes; they fasten the tent down to the ground and stop it blowing away in the wind. Ligaments in the ankle play a similar function, keeping the ankle joint together and in a stable, functional position.

The interosseus membrane really looks like a spiders web. It’s a band of strong fibrous tissue that runs between the tibia and fibula bones helping to hold them closely together.

Damage to any one of these structures that make up the ankle syndesmosis, can lead to significant instability. One of the most common ways this is injured, or at least from what I have seen, is when the ankle is forcibly externally rotated (rotated too far out to the side).

For example when your foot is planted on Astro-turf and you suddenly try to change direction to chase after that annoyingly tricky winger, your body turns without your ankle moving with it.

To diagnose this injury the physiotherapist will perform some simple tests that can highlight whether you have a common ankle sprain, or a high ankle sprain.


The physiotherapist will decide whether you can proceed with treatment or if you will need a referral for an X-ray if this has not already been done, to check the bones have not moved too far apart.

It’s important that treatment starts immediately. For the first 3 days following this injury – rest, ice, compression and elevation is important to reduce swelling and speed up the healing process. After this the physiotherapist will perform specific mobilisations to the joint – deep tissue work to reduce the chance of stiffness occurring and affecting the function of your ankle, and go through specific movement and strengthening exercises as well as balance work to ensure you fully recover.

High ankle sprains usually take longer to heel than common ankle ligament sprains. Typically they take a minimum of 8 weeks therefore it is vital to start physiotherapy as soon as possible or the instability in the ankle will continue to affect your movement and activities at home/work, and as well as your hobbies.

Jonny Corner

(P.S: If you’d like to get your hands on more tips like this, click here to download your FREE ankle pain tips guide: www.paulgoughphysio.com/foot-ankle-pain)


Paul Gough
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