High Ankle Sprain Vs Regular Ankle Sprain: What’s the Difference?

An ankle sprain is an injury at the level of the ankle joint, which may involve inversion and a rotational element, resulting in a degree of symptoms that may involve bone or soft tissue, ligament injury, as well as tendon injury.

What is a Regular Ankle Sprain?

A regular ankle sprain is a typical inversion sprain where you come off a curb or an uneven surface, or whilst playing sports such as tennis or football, and you sprain the outer ligament of the ankle joint, resulting in swelling and pain requiring investigation and treatment.

Which ligaments are usually affected?

The ATF, or the anterior talofibular, and the calcaneofibular ligament are usually affected. There are various degrees of these sprains: grade one being just a sprain where there is mild stretch of the ligament; grade two, where there is partial tear of these ligaments; and grade three, where there is complete rupture of the ankle ligaments.

Common causes and symptoms

Common causes and symptoms are high impact sports, rotational injuries, falling off a curb, or sometimes associated with high arched foot type or hypermobility.

What is a High Ankle Sprain?

A high ankle sprain is usually a rotational problem where the rotation of the tibia and fibula, the long bones of the leg, results in injury to the anterior inferior tibiofibular ligament that holds those two bones together near the ankle joint.

Understanding the Syndesmosis Ligaments

The syndesmosis ligament is mostly comprised of deep and superficial anterior inferior tibiofibular ligament. This ligament gets injured due to rotational deformity and can result in chronic pain and instability between the tibia and fibular bone.

Symptoms of High Ankle Sprain

Symptoms of a high ankle sprain are usually pain deep in the ankle joint, especially on rotation of the leg. They are generally diagnosed through MRI scan or from squeezing together the tibia and fibula at the distal ankle region.

Why are high ankle sprains more serious?

High ankle sprains can result in chronic instability and leg problems that persist for a lot longer. You may not be able to return to sports. They cause gross instability of the ankle mortise joint, resulting in early arthritis.

High Ankle Sprains Vs Regular Ankle Sprains: Key Differences

The key difference is that the area affected is different. The high ankle sprain affects the anterior inferior tibiofibular ligaments, whereas the normal ankle sprain usually affects the anterior talofibular ligament and the calcaneofibular ligament. The location of the pain is usually on the outside of the ankle with a normal sprain, whereas this is deep in the ankle joint with high ankle sprains. The recovery is much longer in high ankle sprains and often requires surgical intervention.

How are High and Regular Ankle Sprains Diagnosed?

Clinical Examination Tests

The clinical examination tests predominantly with a regular ankle sprain involve an anterior draw or a talar tilt test. Essentially, the ankle is stressed in two planes, and if there is excessive movement, then the ligaments are not competent. With the high ankle sprain, you do an abduction test at the ankle where you dorsiflex the ankle and abduct, which would reproduce the pain. Furthermore, compressing the distal tibia and fibula would also reproduce pain down the leg, which would identify the problem.

Imaging

X-rays may show a space spreading between the tibia and fibula in high ankle sprains. MRI is probably more suited to be able to look at the ligament integrity.

When to see a specialist

If you have any instability or pain that persists after five to seven days, then you should see a specialist. The initial treatment should always be rest, ice, compression and elevation, followed by physiotherapy to try to strengthen the ankle tendons. However, if symptoms persist, then surgery may be indicated.

How long does each Ankle Sprain take to heal?

The healing of the ankle sprain will very much depend on the type and degree of the injury. For conservative treatment, it may be a couple of weeks to a couple of months. However, if surgery is required, then it depends very much on the surgery. A typical Brostrom procedure for a normal ankle sprain will take an initial two weeks in a cast, followed by four weeks in a boot and rehabilitation over a couple of months. Syndesmosis injury may require four to six weeks in a cast with a tightrope surgery and then careful mobilisation over a couple of months again.

Tips to Prevent Ankle Sprains

Use good shoes and perform exercise on a stable surface. Exercise the ankle so you can have better proprioception with wobble board training as well as lateral muscle strengthening.

Why Choose Us for Ankle Injury Treatment?

We specialise in sports injury. We have extensive experience in treating patients both conservatively and surgically. We try to optimise results so that patients can have a smooth recovery and try to reduce complications as much as possible.
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Frequently Asked Questions

1. What is the difference between a high ankle sprain and a regular ankle sprain?
   A regular ankle sprain affects the ligaments lower down the ankle on the lateral side, known as the ATF and the CF, or the anterior talofibular or the calcaneofibular ligament, whereas a high ankle sprain involves the anterior inferior tibiofibular ligaments between the leg bones.
2. How do I know if I have a high ankle sprain?
   Generally, it requires specialist examination. If there was a rotational injury of the lower leg and there is pain that radiates down the leg, then you will need to be examined.
3. Are high ankle sprains more serious?
   Yes. High ankle sprains are more serious and can cause progressive arthritis of the ankle joint.
4. Can you walk on a high ankle sprain?
   Generally, you can walk, but you would feel unstable and would sometimes have clicking instability.