High Ankle Sprain Recovery Time

High Ankle Sprain Recovery Time: Learn how long it takes to come back from a high ankle sprain. Then make it much faster!

What Is A High Ankle Sprain:

This is also known as a syndesmotic ankle sprain.

  • The syndesmotic ligament holds the tibia & fibula together in the lower leg.
  • The ligaments are just above the ankle joint.
  • So it is not really the ankle being sprained, but the lower leg.
  • If this ligament ruptures, the ankle mortise widens & the foot can literally come loose!



How Does It Differ From Normal Ankle Sprain:

1)Normal Ankle Sprain Causes:

High Ankle Sprain Recovery Time
An inversion ankle sprain damages the lateral ankle ligaments. But as ou can see the anterior & posterior tibiofibular ligaments remain undamaged.


  • A normal ankle sprain is the turning inward of the foot.
  • This damages the lateral ankle ligaments.
  • This does not cause stress between the tibia & fibula.
  • There is no damage to the ligaments holding the tibia & fibula together.


2) High Ankle Sprain Causes:

High Ankle Sprain Recovery Time
As the foot turns out, it torques the fibula and tibia into separating slightly. This can stretch or rupture the ligaments holding the two leg bones together.
  • This occurs as the ankle is at 90 degrees to the leg.
  • The foot is planted on the ground and turns out.
  • This causes stretching of the ligaments between the fibula & tibia.
  • If strong enough the ankle can fracture & the ligaments can rupture.
High Ankle Sprain Recovery Time
If severe enough, this outward motion can do more than just rupture the ligaments! The most severe high ankle sprains are actually broken ankles! An inversion ankle sprain rarely breaks the ankle.




What Causes A High Ankle Sprain?

A high ankle sprain occurs when your foot turns out while still planted firmly on the ground at 90 degrees.

  • This is damage of the ligaments within your leg, rather than on the outside of your ankle.
  • These occur between the tibia and the fibula of your lower leg.
  • The ligaments of your syndesmosis are damaged.



High Ankle Sprain Tendons & Ligaments:

High Ankle Sprain Recovery Time
There are 3 ligaments involved in high ankle sprains.

There are 3 ligaments routinely stretched or damaged:

  1. The anterior inferior tibiofibular ligament
  2. The interosseous tibiofibular ligament
  3. The posterior inferior tibiofibular ligament.

High Ankle Sprain Grades:

From Shortest To Longest:


Grade 1 Sprain: Stretched Syndesmosis.

The joint is stable upon testing stress testing (performed by the physician under imaging).

  • Injury should heal in a few short days or weeks.
  • The athlete is likely still able to stand on the foot.
  • No gross dislocation or disruptions.
High Ankle Sprain Recovery Time
A stretch of the ligaments will not lead to any instability. It will be painful to walk on for a few days or weeks.

Recovery Time: 3 days – 2 weeks!

  • Improve this but using with rest, ice, compression & elevation!



Grade 2 Sprain: Partially Torn Syndesmosis.

This is a partial tear & injury of the ligaments.

  • There may or may not be some loosening on stress testing by the podiatrist.
  • An MRI may be necessary to diagnose the extent of the injury.
  • The athlete may have difficult bearing weight on the ankle.
  • There likely will not be widening.


High Ankle Sprain Recovery Time
A grade 2 sprain will lead to partial tearing of the ligament. It is important to guard the injury and stay partial weight bearing. The goal is to prevent further damage, but otherwise it will heal!


Recovery Time: 2-4 weeks Minimum!

  • Improve this but using with rest, ice, compression & elevation initially.
  • Time off until it heals is usually necessary.
  • Accommodation braces may be necessary early on until healing.




Grade 3 Sprain: Fully Torn Syndesmosis.

Complete dislocation of the talus from between the tibia and fibula.

  • This is obvious and it looks very gruesome.
  • It will require many months to get better.
  • This will require physician treatment immediately to relocate and assess the injury.


High Ankle Sprain Recovery Time
If there is syndesmotic widening of the fibula & tibia, a transmalleolar screw may be necessary to allow the ligaments to heal in the proper position.


Recovery Time: 2-3 Months+ !

  • This type of ankle sprain will require a visit to your podiatrist for evaluation.
  • Depending on the situation or the damage, you may need surgery to avoid future damage.


High Ankle Sprain Recovery Time
A severe high ankle sprain can frequently result in a broken ankle. This is an example of a trimalleolar fracture with a high ankle rupture of the ligaments!




High Ankle Sprain Treatment:

Now that you know what a high ankle sprain is, it’s time to treat it!

 The Twisted Ankle Treatment Guide.