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  • Writer's pictureKevin Kapka, PT, DPT

High Ankle Sprains

Updated: Oct 24, 2023

High ankle sprains are often overlooked in comparison to their more common counterpart, the lateral ankle sprain, high ankle sprains can be equally debilitating and require thorough understanding for effective treatment.


High ankle sprains, also known as syndesmotic injuries, occur when there is damage to the ligaments connecting the tibia and fibula bones above the ankle joint. This type of injury is typically caused by sudden twisting or rotational forces, resulting in excessive separation of these bones. Athletes who participate in sports requiring quick changes in direction, such as basketball or soccer, are particularly susceptible to high ankle sprains.


One of the primary challenges in treating high ankle sprains lies in their accurate diagnosis. Unlike lateral ankle sprains, where swelling and tenderness are more evident, high ankle sprains can initially present with subtle symptoms. It is crucial for healthcare professionals, especially physical therapists, to conduct a comprehensive examination to correctly identify this condition. This may involve using specific tests and imaging studies, such as X-rays or MRIs, to rule out associated fractures and to assess the severity of the injury.


Once diagnosed, a structured rehabilitation program is essential to promote optimal healing and restore function. Physical therapists play a vital role in guiding patients through this process, tailoring interventions based on the individual's unique needs and goals. The cornerstone of high ankle sprain rehabilitation typically involves immobilization with a walking boot or cast, followed by a gradual transition to weight-bearing activities. Alongside this, therapeutic exercises are incorporated to strengthen the ankle and surrounding muscles, improve range of motion, and restore balance and proprioception.


Additionally, certain adjunct treatment modalities, such as manual therapy techniques, electrical stimulation, and cryotherapy, may be employed to further support the recovery process. The duration of rehabilitation can vary depending on the severity of the injury, and close monitoring by both the therapist and the patient is paramount to ensure progression and prevent reinjury.


While recovery from a high ankle sprain can be a time-consuming process, it is crucial not to rush the rehabilitation timeline. Premature return to sports or physical activities without appropriate healing and adequate rehabilitation can increase the risk of re-spraining the ankle or developing chronic instability. Therefore, patience and adherence to the proposed treatment plan are essential.


High ankle sprains can pose significant challenges for both patients and healthcare professionals. However, with proper diagnosis and an individualized rehabilitation program under the guidance of a skilled physical therapist, patients can achieve a successful recovery and regain their previous level of function. As always, it is advisable to consult a healthcare professional for a comprehensive evaluation and personalized treatment plan. If you are in the Mission Viejo area and think you, or someone you know, might benefit from physical therapy, please don’t hesitate to reach out!

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