High Ankle Sprain

Diagram from http://www.niams.nih.gov/Health_Info/Sports_Injuries/ April 2009

Ankle sprains are caused by excessive stress on the ligaments of the ankle. All the activities such as excessive external rotation, inversion or eversion of the foot due to external force, which cause the movement of foot beyond its range of motion, create excessive stress which puts ligaments on strain. If goes beyond the yield point as is great enough then this results in the damaged or sprained ligaments.

High Ankle Sprain is caused by the injury of large ligaments (Syndesmotic Ligaments) which lie above the ankle and join together the tibia and fibula which are the long bones of lower legs. This type of sprain usually occurs during sports like football, volleyball, baseball etc which involve a sudden and forceful outwards twisting movement of the foot.

This injury may result in severe pain, bruising which is significant, minor swelling, inability to rotate the ankle outwards and finally making it difficult or unable to walk.

Usually PRICE method is preferred for the treatment of mild to moderate cases of sprain. PRICE stands for Protection, Rest, Ice, Compression and Elevation. Protection of ankle is considered to be critical to the healing process. Icing should be done as per the advice of doctor, Compression should be done with the help of an elasticized bandage and its use should be discontinued if blood supply appears to be impaired. Final step is the elevation of foot above one’s heart level.

PRICE helps in getting relief from pain and Inflammation reduction. It should be followed by restricted weight bearing, ankle mobilizations, soft tissue massage, restricted ankle ROM exercises, stationary bike or upper extremity pedaling if unable to tolerate the stationary bike.


Attarian DE, McCrackin HJ, DeVito DP, McElhaney JH, Garrett WE Jr. Biomechanical characteristics of human ankle ligaments. Foot Ankle. (Oct 1985); 6(2):54-8.

Diagram from http://www.niams.nih.gov/Health_Info/Sports_Injuries/ April 2009

Scheyerer MJ, Helfet DL, Wirth S, Werner C. Diagnostics in suspicion of ankle syndesmotic injury. Am J Orthop. (2011); 40(4):192-197.