From the Guidelines
High ankle sprains typically present with pain above the ankle joint, specifically in the area where the tibia and fibula meet (syndesmosis), and are associated with a higher risk of long-term unresolved injury-associated symptoms, including pain, recurrent sprains, and instability 1. The symptoms of a high ankle sprain can be severe and long-lasting, with up to 46% of patients still experiencing pain and 55% reporting instability at a follow-up of 1-4 years 1. Common symptoms include:
- Pain when rotating the foot outward
- Difficulty bearing weight on the affected leg
- Swelling and bruising that extends higher up the leg compared to a regular ankle sprain
- Pain when squeezing the calf or when performing activities that require ankle stability like climbing stairs or walking on uneven surfaces
- Pain that worsens with dorsiflexion (pointing the foot upward) Unlike regular ankle sprains, high ankle sprains typically take longer to heal, often 6-8 weeks or more, because they involve damage to the ligaments that connect the two leg bones 1. Treatment should focus on addressing modifiable risk factors, such as workload and level of sports participation, and may include supervised exercise-based programs, ankle braces, and physical therapy to stimulate the recovery of functional joint stability 1. It is essential to note that the treatment of high ankle sprains should be individualized, taking into account the patient's specific needs and circumstances, and that further research is needed to identify the most effective treatment strategies 1. In terms of prevention, ankle braces should be considered as an efficacious option for preventing recurrent lateral ankle sprains 1. Overall, the management of high ankle sprains requires a comprehensive approach that addresses the patient's current level of pain, workload, and level of sports participation, as well as their individual needs and circumstances 1.
From the Research
Symptoms of High Ankle Sprain
The symptoms of a high ankle sprain are not explicitly mentioned in the provided studies. However, the studies do discuss the symptoms of ankle sprains in general.
- Acute ankle sprains are usually accompanied by swelling, pain, and difficulty walking 2
- Chronic ankle instability is diagnosed when a person continues to have problems with tasks like walking or playing sports 1 year after the original injury 2
- People with chronic ankle instability say their ankle feels unstable or like it "gives way" 2
- The symptoms of ankle sprains can include pain, swelling, and functional limitations 3, 4
Treatment and Prevention
The treatment and prevention of ankle sprains are discussed in the provided studies.
- There is strong evidence for bracing and moderate evidence for neuromuscular training in preventing recurrence of an ankle sprain 3
- For the combined outcomes of pain, swelling, and function after an acute sprain, there is strong evidence for non-steroidal anti-inflammatory drugs and early mobilisation, with moderate evidence supporting exercise and manual therapy techniques 3
- Exercise therapy and bracing are supported in the prevention of chronic ankle instability (CAI) 3
- The clinical practice guidelines recommend the use of Ottawa rules, manual therapy, cryotherapy, functional supports, early ambulation, short-term NSAIDs, and rehabilitation for ankle sprain management 4