A high ankle sprain refers to a sprain of the ligaments that connect the two long bones in the lower leg, the tibia and fibula, together. These ligaments, along with other ligaments in the ankle, are important in maintaining proper alignment of the ankle joint. Injury to a ligament can be just a stretch, a partial tear or a complete tear. Complete tears are severe and, sometimes, require surgery. High ankle sprains are less common than normal ankle sprains, and, sometimes, both injuries occur at once. If you have any of these symptoms, you should seek out your physician for appropriate care.
Pain
Generalized pain in the ankle is always present. The pain is worse with weight-bearing on the affected ankle and can be extreme with pushing off the ground while walking. Pain can also be present when the ankle is turned to the outside. Typically, the pain is located just above the level of the ankle joint. Sometimes, the pain can radiate from the ankle toward the knee.
Swelling
Generalized swelling occurs with any type of ankle sprain and can be mild to severe. The swelling occurs from the bleeding and damage to the torn ligaments. The bleeding leads to the release of inflammatory mediators and inflammation begins. Ice and elevating the ankle above the level of the heart may reduce the swelling.
Bruising
When the ligaments tear, small blood vessels rupture, leading to bleeding in and around the ligaments. As time passes, the clotted blood surfaces to the skin and can be seen as a bruise. Sometimes, the bruising appears at a location different from the site of injury. It is not unusual to have bruising appear at the toes, even for a high ankle sprain.
Instability
With a high ankle sprain, the tibia and fibula are not held together well, and they may move apart. This disrupts the normal structure of the ankle, and the ankle becomes unstable. This instabilty may feel like your foot has no support, or it may seem heavy or difficult to move. Most commonly, the instability manifests as pain with weight-bearing.
References
- "Management of Ankle Syndesmotic Injuries in the Athlete"; "Current Sports Medicine Reports"; Cyrus M. Press, Asheesh Gupta and Mark R. Hutchinson; Sept/Oct 2009
- "DeLee and Drez's Orthorpaedic Sports Medicine, 3rd Edition"; Jesse C Delee, M.D., David Drez, Jr., M.D., and Mark D. Miller, M.D.; 2009
