A rolled ankle might seem minor—but if your pain is higher than expected, more severe than usual, and doesn’t improve quickly, it could be ahigh ankle injury. These injuries are oftenmisdiagnosed or overlooked, which can lead to chronic instability and long-term joint damage if not treated properly.
AtAbacoa Podiatry & Leg Vein Center inJupiter, FL, we frequently see patients with untreated or poorly managed ankle injuries. Many of these turn out to behigh ankle sprains, a more complex and serious injury than a common low sprain.
In this blog, we’ll cover everything you need to know abouthigh ankle injury symptoms, how to recognize them early, and when to see a specialist to avoid long-term complications.
What Is a High Ankle Injury?
A high ankle injury—also known as a syndesmotic ankle sprain—affects the ligaments that connect the tibia and fibula, just above the ankle joint.
Unlike common ankle sprains, which damage the ligaments on the outside of the foot (such as the anterior talofibular ligament), high ankle injuries occur higher up and involve the syndesmosis. This tough tissue stabilizes the lower leg bones.
These injuries often occur in sports or twisting traumas and can be more severe than they initially appear.
Common Causes of High Ankle Injuries
- Suddentwisting or rotational motion of the foot
- Sports that involve cutting or pivoting (e.g., football, soccer, basketball)
- Direct trauma to the ankle or lower leg
- Falls or missteps that force the foot upward and outward
Unlike lower ankle sprains, these injuries maynot involve visible swelling at first, making diagnosis tricky.
High Ankle Injury Symptoms: Early Signs to Watch For
Recognizing the symptoms early can make all the difference in healing outcomes. Ignoring them may lead tochronic ankle instability, cartilage damage, or evenlong-term arthritis.
Here are the keyhigh ankle injury symptoms you should never ignore:
1. Pain Above the Ankle
This is the hallmark of a high ankle injury. Pain is typically located:
- Above the bony part of the ankle
- Between the shinbones (tibia and fibula)
- Sometimes radiating up the leg.
Unlike typical ankle sprains, the pain isn’t at the side of the ankle joint, but higher and deeper.
2. Pain with External Rotation
A telltale sign ispain when the foot is rotated outward (external rotation), especially while the leg remains still.
This movement stresses the syndesmosis and causes discomfort onlyin high ankle injuries, not standard sprains.
3. Inability to Bear Weight
While many people can still walk with a mild low ankle sprain, a high ankle sprainmakes walking very difficult or painful, especially when:
- Climbing stairs
- Pushing off with the foot
- Running or jumping
4. Minimal Swelling or Bruising
Unlike standard sprains, a high ankle injury maynot cause visible swelling or bruising, leading some people to underestimate the severity.
This “hidden” aspect is why early diagnosis is so critical.
5. Feeling of Instability
If your ankle feels like it’s “giving out,” weak, or unstable—especially with activity—it could be due to damage to thesyndesmosis ligament.
Without stabilization, this can lead to repeated injuries or long-term functional issues.
6. Pain That Doesn’t Improve After a Few Days
Low ankle sprains often improve with rest, ice, compression, and elevation (RICE). If your painpersists for more than 3–5 days or worsens, it may not be a simple sprain.
You may be dealing with apartial or complete tear in the syndesmosis.
Experiencing these symptoms? Book a diagnostic exam atAbacoa Podiatry in Jupiter, FL—we’ll determine the cause and help you heal fast.
Why Early Diagnosis Is Critical
If left untreated, a high ankle sprain can lead to:
- Chronic pain and swelling
- Instability during walking or sports
- Bone separation (diastasis)
- Cartilage damage
- Early-onset arthritis
Advanced imaging (likeX-rays, ultrasound, or MRI) is often needed toconfirm the diagnosis, especially in moderate to severe cases.
AtAbacoa Podiatry, we offer on-site imaging and expert interpretation to detect these injuriesbefore they worsen.
High Ankle Injury Grades
Just like regular ankle sprains, high ankle injuries are graded by severity:
- Grade I: Mild overstretching of the ligament; slight pain
- Grade II: Partial ligament tear; moderate pain and dysfunction
- Grade III: Complete ligament rupture; severe pain, instability, and swelling
Grades II–III typically requireimmobilization or surgery to heal fully.
Diagnosis: What to Expect During an Exam
AtAbacoa Podiatry & Leg Vein Center, our podiatrists conduct a detailed evaluation that may include:
- External rotation test to provoke pain
- Squeeze test (compressing the tibia and fibula together)
- Palpation of the syndesmosis area
- X-rays to check for widening between the tibia and fibula
- MRI or ultrasound for detailed soft tissue imaging
We’ll explain everything step by step so you feel confident in your diagnosis and treatment plan.
Treatment Options for High Ankle Injuries
Treatment depends on the grade of injury and your activity level.
Non-Surgical Treatment (Grades I–II)
- Immobilization: Walking boot or brace for 4–6 weeks
- Physical therapy: Strengthening and proprioception exercises
- Anti-inflammatory medications
- Taping or compression therapy
Returning to activity too early can delay healing or cause re-injury.
Surgical Treatment (Grade III or Diastasis)
For complete ligament tears or cases where the tibia and fibula have separated, surgery may be necessary. Surgical options include:
- Syndesmosis screw fixation
- TightRope® technique (suture button system)
- Arthroscopic debridement if scar tissue is involved
Recovery time after surgery ranges from8 to 12 weeks, depending on the extent of damage.
Recovery Timeline: What to Expect
| Phase | Time Frame | What Happens |
| Acute Phase | Week 1–2 | Rest, boot or brace, non-weight bearing |
| Rehabilitation Phase | Weeks 3–6 | Gradual return to walking, start physical therapy |
| Return to Activity | Week 6–10+ | Running, jumping, sports-specific movements |
Every patient heals differently, and we customize your plan based on age, health, and activity level.
How Abacoa Podiatry Can Help
AtAbacoa Podiatry & Leg Vein Center, we specialize in diagnosing and treating all types of foot and ankle injuries, includingcomplex high ankle sprains.
You’ll benefit from:
- On-site diagnostics (X-ray, ultrasound)
- Advanced bracing and orthotics
- Minimally invasive surgical options
- Experienced foot and ankle surgeons
- Customized rehab plans
We serve patients acrossJupiter, Abacoa, and Palm Beach County, and we’re committed to helping youreturn to pain-free movement—quickly and safely.
Final Thoughts: Don’t Wait on Ankle Pain
An ankle injury thathurts higher up and doesn’t improve after a few days isn’t something to brush off.High ankle injury symptoms are severe and require expert care to avoid long-term problems.
Whether you’re an athlete, runner, or someone recovering from a fall, we’re here to help you heal with confidence.
Call Jupiter Laser at 888-457-1970 for more information or book an Appointment.
Frequently Ask Questions
- How is a high ankle injury different from a regular sprain?
A high ankle injury affects the syndesmotic ligaments above the ankle, whereas a regular sprain involves the ligaments on the outside of the ankle joint. - How long does it take for a high ankle injury to heal?
Mild sprains may heal in 4–6 weeks with conservative treatment, but more severe injuries may take up to 12 weeks to heal or require surgery. - Can I walk on a high ankle sprain?
It’s not advised. High ankle sprains usually make walking painful and unstable. Walking too soon can worsen the injury and prolong recovery. - Do high ankle injuries require surgery?
Only severe sprains (Grade III) with complete ligament rupture or bone separation usually require surgical repair. - What happens if I ignore high ankle injury symptoms?
Ignoring the symptoms can lead to permanent instability, chronic pain, and increased risk of ankle arthritis. - Where can I get expert care for a high ankle injury in Jupiter, FL?
VisitAbacoa Podiatry & Leg Vein Center for accurate diagnosis, advanced treatment, and a personalized recovery plan.
