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High Ankle Sprain versus Low Ankle Sprain

An ankle sprain is a stretch or tear to the ligaments holding the ankle bones together. Characterized by pain and swelling, these ankle injuries are common among athletes who play sports that involve running and jumping. These include high-impact sports such as basketball, soccer, football, and dance.

When you sprain your ankle, you almost immediately know that something is wrong due to the pain. In fact, chances are you or someone you know has experienced an injured ankle. However, did you know that there are different types of sprains? Hear from Beacon Orthopaedics & Sports Medicine’s foot and ankle expert, Dr. Adam Miller, on the differences in these injuries as well as how to best recover from them.


What is a low ankle sprain?

In orthopedic foot and ankle care specialists define low ankle sprains as, “A low ankle sprain is your garden-variety sprain that affects the ligaments outside of the ankle. It is the most common type of sprain that involves rolling the ankle. The heel inverts underneath the foot, causing that twisting motion that leads to a tear or stretch in the ligaments.”

What is a high ankle sprain?

“A high ankle sprain occurs when the ligaments between tibia and fibula become torn or stretched. This type of sprain is more of a rotational injury rather than a roll of the ankle. Unlike a low ankle sprain, a high ankle sprain is more significant of an injury. This type often takes about twice as long to heal.”

Is there a difference in how high and low ankle sprains are treated?

Treating A Low Ankle Sprain

“Low ankle sprains are typically treated with an ankle brace first. If the patient continues to be in a lot of pain, they may go into a boot until they are able to move around a little better. As soon as they can walk, they will go into physical therapy and continue to ramp up the movement based on mobility.”

Treating A High Ankle Sprain

“With a high ankle sprain, every patient will go into a walking boot. They’re typically in a boot for multiple weeks, but the duration ultimately depends on the patient’s level of pain. Once they start feeling better, they can transition into an ankle brace that can fit into a shoe.

If the patient can’t transition into a brace because the injury isn’t healing, the focus then transitions to considering surgery. Some high ankle sprains obviously need surgery from the beginning, but those are less common. Most of the time, they fall into the in-between category of waiting to see if they heal without surgery.”

Treating Ankle Injuries With Physical Therapy

“Physical therapy focuses on building the range of motion and strength. We also work on proprioception, which is the ability of the body and the brain to react quickly to movements and actions. That way, the patient is more easily able to avoid future injury by having a quicker reaction time.

_Q6A0064Some people with multiple low ankle sprains develop instability where ligament cannot consistently support the ankle. This can lead to chronic pain, which ultimately results in consistent brace wearing and even surgery.”

The hallmarks of chronic ankle instability include repeated ankle sprains that have led to an altered patient activity level. Important factors include the number of injuries sustained, frequency of events, localization of pain, and prior treatment modalities.


Come to Beacon Orthopaedics & Sports Medicine 

If you have a foot or ankle injury, come to Beacon Orthopaedics. We specialize in all things orthopedics, from hip and knee injuries to spine surgery. Contact us today for more information! Click here to schedule an appointment with Dr. Miller for foot and ankle injuries.