High Ankle Sprain


As the upcoming 2021 NFL draft approaches and the excitement for the NFL season begins, I would like to take a minute to discuss a common injury sustained by NFL athletes, the “High Ankle Sprain”. This past football season Christian McCaffrey, a running back for the Carolina Panthers, sustained a high ankle sprain early last year devastating fantasy football owners.

A high ankle sprain is also known as a syndesmotic sprain which involves the tibia (shin bone) and the fibula (bone that runs along the outside of your lower leg). A “high” ankle sprain is different than the more common “low” ankle sprain. The high ankle ligaments, also called the syndesmosis, are located above the ankle as opposed to the more commonly injured ligaments on the outside and inside of the ankle joint. The high ankle ligaments connect the tibia to the fibula. There is a great force at the syndesmosis junction while running and this stability is vital. A high ankle sprain or a syndesmotic injury occurs when there is tearing to the high ankle ligaments.

A high ankle sprain most commonly occurs as a result of a high impact external rotation injury, which occurs when the foot is turned towards the outside with resect to the lower leg. Research shows that that the incidence of high ankle sprains in NFL football players to can be upwards of 29%.

High ankle sprains are usually diagnosed by a thorough physical exam as well as X-Rays to rule out any ankle fracture or widening of the tibia and fibula. Additional diagnostic imaging such as an MRI or a CT scan may be used to assess the relationship of the tibia with the fibula.

Treatments of high ankle sprains without any ankle fractures or significant widening between the tibia and fibula include the RICE protocol, where RICE stands for rest, ice, compression and elevation, or sometimes a walking boot is required if there is a significant amount of tenderness on examination. If a patient has a high ankle sprain and there is widening of the tibia and fibula or if there is a broken bone, surgery may be warranted. A high ankle sprain can take a longer amount of time to heal compared to “low” ankle sprains. High ankle sprains take approximately 6-8 weeks to return to normal activity. In the cases where surgery is warranted, patients will be placed in a cast and educated to be non-weight bearing on the operative extremity followed by a walking boot for approximately 12 weeks.

Regardless of Christian McCaffrey’s high ankle sprain and setback last season, I would still consider him a #1 overall draft pick in any fantasy draft next season.
Please visit Ortho Rhode Island for all your sports injuries and orthopedic needs! We are happy to help!


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