5 Unmistakable High Ankle Sprain Symptoms And Their Treatments

Written by on May 20, 2022 — Medically reviewed by Mich Torres (PT)

Early detection is an important step for most injuries to heal quickly. But this may be easier said than done when recognizing high ankle sprain symptoms.

Both low and high ankle sprains occur from excess and unrestrained movements. This leads to a damaged ligament which can result in ankle pain, swelling, and bruising, to name a few.

But unlike a typical ankle sprain, they may either be too spread out or too subtle to notice. So to get you going with your recovery, I’ll help you in recognizing each of the symptoms.

Here are the topics we’ll cover. Tap on any of the links below to quickly head on to that section:

5 Symptoms of a high ankle sprain

1) Pain in the front of your ankle joint

Pain is like your body’s alarm system. It helps bring immediate attention that there is something wrong with your body. (1)

In this case, it may indicate that you may have an overstretched or torn ligament. Specifically, right where your tibia and fibula (shin and calf bone) connect to your ankle joint. (2)

So, if you’re experiencing pain in that area, try not to move your foot upwards or outwards. These two movements can ramp up the pain level. (3)

Also, if you’re having difficulty weight-bearing on your injured ankle due to pain, go to the hospital. This may be a sign that you also have a fracture. (3)

2) Swelling

Swelling is a common response of your body to jumpstart the healing process. This usually looks and feels like a small, warm pocket of fluid on top of your skin.

For high ankle sprains, the inflammation will likely be found right on top of your ankle joint, along your shin bone. (3)

Sometimes, the size of the swelling isn’t as huge as you might expect. Scientists aren’t sure why that’s the case, but this means you have to be extra careful. See, this lack of significant swelling can lead to an inaccurate diagnosis of an otherwise severe high ankle sprain. (2)

3) Bruising

You may also notice bruising or a dark purple area right in front and/or the sides of your ankle joint. This can mean that blood has leaked out underneath your skin from damaged blood vessels.

4) Tenderness around your ankle bones

Feeling around the front of your ankle may cause some pain or discomfort. (3) This is what we call tenderness.

In some cases, this may reach as high as your shin bone, indicating the severity of your high ankle sprain. (4)

If what you felt is a sharp, stabbing pain, then you might also have a fracture. In this case, as with pain, get your ankle injury checked in an emergency room right away.

5) Difficulty walking

Ask a friend to record the way you walk. You may notice that you’re unconsciously avoiding your injured heel from touching the ground. (2)

This happens because your body will instinctively refrain from movements that can cause more pain. For a high ankle sprain, your body will avoid tipping your toes upwards. (2)

As a consequence, this leads to a heel-raised pattern. It may affect the way you push off on your injured ankle, thus making you walk with a hitch in each stride.

What can cause a high ankle sprain?

A high ankle sprain occurs when your planted foot is pointed up and forced to rotate outward. This mechanism of injury usually comes from sporting activities such as (5):

  • American football, where you can get tackled violently on your planted leg.
  • Alpine skiing, from a skiing boot getting stuck in the snow while you’re going downhill.

What are the treatment options for a high ankle sprain?


Taking it easy for a few days helps avoid unnecessary stress on your still fragile yet healing ligament. (6)

Yet, this may be a bit harder to do if you’re a competitive athlete. You can probably work on your upper body as long as you’re not putting your full weight on your injured foot.

Cold therapy

Much like typical ankle sprains, icing will be your best companion for the first 4 to 5 days of your injury. Using an ice or cold pack aids in dialing down to a few notches your pain level, swelling, and bruising. (6)

This will help: Here’s how to ice your ankle the right way.

Ankle brace

An ankle brace is a wearable device that can help stabilize your ankle joint.

For your high ankle sprain, a double upright hinged brace may particularly be helpful. This type of brace prevents rotational stress to your ligament while still allowing other ankle motions. (7)

Ankle exercises

Ankle-specific exercises can provide the necessary stimulus to regain back the strength and function of your lower leg.

It doesn’t have to be as intense as in the gym. Just some strengthening with an exercise band and a rolled towel to help stretch tight muscles.

But like a traditional ankle sprain, wait until your symptoms have cleared out to avoid reaggravating your injury.

Try this: 12 exercises to maximize your ankle sprain recovery.

Physical therapy

Physical therapists are skilled movement experts in providing nonsurgical care to injuries.

With different hands-on and exercise approaches, they can help you transition from being in pain to moving like nothing even happened.

Aside from helping you rehabilitate, they can also assess and correct other subtle weak links to prevent future sprains and complications.


For this injury, there are three reasons why surgery may be necessary (8):

  • When you have tried and failed non-surgical treatments.
  • If you have a severely unstable ankle.
  • You suffered from a lower leg fracture.

If you are a surgical candidate, your surgeon will explain all the necessary details of the procedure.

This may include the risks/benefits of certain techniques compared to others and the length of your post-surgical physical therapy.

Learn more: 7 evidence-based treatments for high ankle sprains.


What are the symptoms of high ankle sprains?

Ankle pain, swelling, tenderness along your shin, and heel avoidance when you walk.

Can you walk with a high ankle sprain?

You probably need a walking boot first to help protect your injury when you walk. But with severe high ankle sprains, it may be best to get your ankle checked to rule out fractures.

How long does it take to heal from a high ankle sprain?

Depending on the severity of your injury, it may take 2 to 6 months of rehabilitation for a high ankle sprain to recover. (3)

Conclusion: What does a high ankle sprain feel like

A high ankle sprain feels the same as other types of sprains. However, each of the symptoms is located much higher and indistinct compared to a common ankle sprain.

To get your high ankle sprain diagnosed and properly treated, consult your doctor or physical therapist.


  1. Prescott S.A. et al. “Somatosensation and Pain”. Conn’s Translational Neuroscience 2017, Chapter 23 Pages 517-539. https://doi.org/10.1016/B978-0-12-802381-5.00037-3
  2. Lin CF, Gross ML, Weinhold P. Ankle syndesmosis injuries: anatomy, biomechanics, mechanism of injury, and clinical guidelines for diagnosis and intervention. J Orthop Sports Phys Ther. 2006 Jun;36(6):372-84. DOI: 10.2519/jospt.2006.2195
  3. Porter, David A et al. “Optimal management of ankle syndesmosis injuries.” Open access journal of sports medicine vol. 5 173-82. 5 Aug. 2014, doi: 10.2147/OAJSM.S41564
  4. Dubin, Joshua C et al. “Lateral and syndesmotic ankle sprain injuries: a narrative literature review.” Journal of chiropractic medicine vol. 10,3 (2011): 204-19. doi: 10.1016/j.jcm.2011.02.001
  5. Norkus, S A, and R T Floyd. “The anatomy and mechanisms of syndesmotic ankle sprains.” Journal of athletic training vol. 36,1 (2001): 68-73. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC155405/
  6. van den Bekerom, Michel P J et al. “What is the evidence for rest, ice, compression, and elevation therapy in the treatment of ankle sprains in adults?.” Journal of athletic training vol. 47,4 (2012): 435-43. doi: 10.4085/1062-6050-47.4.14
  7. Liu, George et al. “Mastering the treatment of high ankle sprains”. Podiatry Today January 2011. https://www.hmpgloballearningnetwork.com/site/podiatry/mastering-treatment-high-ankle-sprains
  8. Williams, Glenn N, and Eric J Allen. “Rehabilitation of syndesmotic (high) ankle sprains.” Sports health vol. 2,6 (2010): 460-70. doi:10.1177/1941738110384573

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