To keep inflammation, swelling and pain to a minimum. A high ankle sprain may be suspected if you feel that your ankle isn't stable and you are having difficulty walking, not just because of pain. A high ankle sprain takes twice as long to heal compared to a lateral ankle sprain. Typically the foot has been twisted forcefully away from the lower leg. It is particularly common in sports such as football and hockey and also in skiing injuries. These ligaments link the two bones of the lower leg (tibia and fibula). A high ankle sprain (a syndesmotic sprain) is one in which the ligaments above the ankle joint are stretched or torn. This is partly because of the shape of the bones and partly because the band that goes across the inner side of the ankle joint (deltoid ligament) is much stronger than the ligaments on the other side of the ankle joint. It is much less common to damage the ligaments that attach across the ankle on the inner (medial) side of the foot: for every 10 people who have a lateral ankle sprain, one or two will have a high ankle sprain. This and other types of ankle fractures are discussed below. Sometimes you can break a small bit of bone off the very end of the fibula (where the ligaments are attached) at the same time. The lateral ligaments can stretch and be sprained when you 'go over' on your ankle and your foot turns inwards under you and points downwards. The most common ligaments to damage when you sprain your ankle are the ones on the outer side of the ankle joint (a lateral sprain): the anterior talo-fibular ligament and the calcaneo-fibular ligament (lateral ligaments). Grade III - a severe sprain: complete rupture of the ligament with instability of the joint. Grade II - partial tear (rupture) of the ligament but without joint instability (or with mild instability). Grade I - mild stretching of the ligament without joint instability. The joint can become unstable when the damaged ligament is no longer able to give it the normal support: The severity of a sprain is graded according to how badly the ligament has been damaged and whether or not the ankle joint has been made unstable. 
The bottom illustration shows the foot and ankle looking from the outer side (lateral). The top illustration shows the foot and ankle looking from the inner side (medial). Anatomy of the ankleĪs you can see from the picture below, showing bones and ligaments of the ankle, it is a complicated joint. You can read more about these in the separate leaflets called Arthritis, Gout and Achilles Tendinopathy. Ankle pain may arise from many other conditions, including arthritis, gout or Achilles tendinopathy. This leaflet considers ankle sprains and ankle fractures. Stress fractures are smaller cracks in the bone which also cause intense pain but with less dramatic swelling. Fractures cause sudden pain and usually cause significant swelling. Depending upon the exact cause of the fracture, one or more bones may be involved. These are the leg bones (the tibia and fibula) and the hindfoot bones (the calcaneus and talus). A broken ankle means one of the bones which make up the ankle joint has broken. To find out more about sprains, see the separate leaflet called Sprains and Strains.Ī fracture is a break in a bone. To read more about different types of sports injuries, see the separate leaflet called Sports Injuries. A sprained ankle is the most common sports injury. A severe sprain may look and feel like a fracture, and it can be difficult for health professionals to tell the difference between the two.
A sprain is usually caused by the joint being forced suddenly outside its usual range of movement.
It's perhaps not surprising that the ankle is prone to being sprained or broken.Ī sprain is an injury to the band which connects two or more bones to a joint. When we evolved to walk on just two legs the ankle was given a lot of extra work to do, both in weight bearing and in balance. For most of our evolution, animals with a backbone and skeleton (vertebrates), such as human beings, have walked on four legs.
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