High vs Low Ankle Sprains

By Grant Uyemura, DPT

High ankle sprains are more common in high impact sports and usually occur when the
foot is forced into external rotation with a planted, dorsiflexed foot. This mechanism of injury will cause the talus to widen the ankle mortise which can injure or tear the syndesmosis. The syndesmosis is made up of the anterior inferior tibiofibular ligament, interosseous ligament, interosseous membrane, posterior inferior tibiofibular ligament, and transverse ligament.

Lateral ankle sprains also known as inversion sprains are the most common orthopedic
injury and account for 85% of all ankle injuries. Lateral ankle sprains usually happen when the foot is point down, plantarflexed and rolls inward. The anterior talofibular, calcaneofibular, and posterior talofibular ligaments are the most common ligaments to get injured during a lateral ankle sprain.

High ankle sprains will take longer to heal and are more likely to create long-term
dysfunction compared to lateral ankle sprains. However, high ankle sprains are less common than lateral ankle sprains. Both injuries can be treated through physical therapy with conservative treatments.

The first phase will be protecting the joint while minimize pain, inflammation, weakness, and loss of motion.

The second phase will focus on normalizing joint mobility, strength, neuromuscular control, and return to activities of daily living.

The last phase will prepare the athlete for return to sport activities.

Blog post written by Grant Uyemura, DPT Student from University of St. Augustine. At the time of publishing Grant was in a clinical rotation with me at Catz PTI.

References:

1. Williams GN, Allen EJ. Rehabilitation of Syndesmotic (High) Ankle Sprains. Sport Heal A Multidiscip Approach. 2010;2(6):460-470. doi:10.1177/1941738110384573.

2. Hunt K. J, Phisitkul, P Pirolo J, Amendola A. High Ankle Sprains and Syndesmotic Injuries in Athletes. Journal of the American Academy of Orthopaedic Surgeons. .
2015;23(11):661-673. doi:10.5435/jaaos-d- 13-00135

3. Albin, S. Rehabilitation of the Athlete Following Ligamentous Injury. Oral Presentation at: 12 th Annual CU Sports Medicine Fall Symposium. Meeting; September 22. 2017; Boulder,
CO.