The Dreaded “High” Ankle Sprain

By Dr. Murali Moorthy

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Dr. Moorthy explains the difference between a high ankle sprain and a standard sprain?

We hear about it all the time in our favorite sports. Rather than just a sprain and he/she will be back soon, the term high ankle sprain gets mentioned and you know the athlete is out for an extended period of time.

Recently, Adrian Peterson, arguably the best pure running back in professional American football was the victim of such an injury. And, uh-oh, it’s going to be awhile to get back in the game.

So what’s a high ankle sprain? What’s the mechanism and why does it take so much longer to recover from? Check out my “Ask the Doctor” segment from Cal-Hi Sports video above and read below!

Usually with a sprain the ankle is inverted. The toes roll inward, the outer ankle moves outward. The lateral (outer) ligaments connecting the talus and calcaneus bones to the fibula bone may be sprained or completely torn.

In general, with a high ankle sprain, the ankle gets twisted the other way. The inner ankle ligament complex (the deltoid ligament) may be stretched, and the talus pushes up against the lateral malleolus on the outer part of the ankle. This puts a stretch on the ligaments binding the outer fibula bone to the main tibia bone. A stretching or tearing of these ligaments is termed a high-ankle sprain.

The rehab from these sprains generally takes much longer than a typical ankle sprain. These ligaments take a lot of stress with weight bearing and need sufficient time to rest prior to starting any major weight bearing rehab. Oftentimes, immobilization with a walking boot or cast can be helpful, followed by a structured rehab program. But return to play generally takes 4-8 weeks with the high ankle sprain vs. the 1-4 weeks with a more typical lateral ankle sprain.

In the case of Adrian Peterson, the injury looked relatively minor but he has missed a lot of time so far. This is particularly problematic for athletes who need to do a lot of quick change of directions. Look to see him back soon with plenty of tape on that ankle.