Ankle sprains are one of the most common sports related injuries, especially in sports requiring running, cutting and jumping.


High ankle sprains occur less frequently than lateral ankle sprains and are often misdiagnosed. High ankle sprains occur just above the ankle joint and involve the ligaments that conjoin the Tibia and Fibula.


These injuries require longer treatment times compared to other ankle injuries. Average recovery time is 55 days which is almost twice as long as lateral ankle sprains.


Physical therapist use special clinical tests that can differentiate a lateral ankle sprain from a high ankle sprain in order to guide treatment.


Conservative treatment for high ankle sprains includes four phases;


Phase I includes protection of the injury using tb12athe RICEĀ method (rest, ice, compression and elevation). Depending on the severity of the injury you may be casted, or put on crutches to avoid bearing weight through the injured ankle. Your physical therapist will teach you how to walk with crutches and can help you maintain hip and core strength during this time while your ankle heals.


Phase II involves a phase of partial weight bearing. You will be taught how to safely put progressive amounts of weight back onto your ankle, re-establish ankle mobility and balance. Your therapist will use hands on techniques during this time to make sure your ankle moves properly in order to reduce compensation from other areas of your body. Depending on your progress you may start light strengthening with a theraband at this time.


Phase III involves a progression to walking without crutches and improving ankle strength. Your therapist may recommend a heel lift or ankle brace for support and comfort. During this time your therapist will guide you through a progressive strengthening program for your entire lower extremity.


Phase IV includes return to recreational activities of choice and sports. Your therapist will guide you through sport specific training that mimics your sport of choice. Before return to competition your therapist will use sport specific testing and functional movement screening to ensure you are physically prepared to return to sports.



By Dr Rob Gruttadauria DPT.


To contact Rob, email him at