High Ankle Sprains: Why They Take Longer to Heal Than You Think
At a Glance: Not all ankle sprains are created equal. High ankle sprains, involving the ligaments above the ankle joint, tend to take significantly longer to heal than the more common rolled-ankle sprain, and treating them the same way often backfires.
If you've rolled your ankle before, you probably assumed you knew what to expect. Rest, ice, a little swelling, back to normal in a couple weeks. But a specific type of ankle sprain, involving the ligaments connecting the two lower leg bones just above the ankle joint, doesn't follow that same script at all.
What Makes a High Ankle Sprain Different
Most ankle sprains involve rolling the foot inward, stretching or tearing ligaments on the outside of the ankle. A high ankle sprain happens differently, often from a twisting motion where the foot gets planted and the lower leg rotates, common in sports with cutting, pivoting, or contact, like soccer, football, basketball, and skiing.
Because this injury involves the connection between the two bones of the lower leg rather than just the ankle joint itself, it affects a much more structurally important area, one that bears significant weight and rotational force with nearly every step.
Why It Takes So Much Longer to Heal
This is the part that surprises people most. A typical ankle sprain might sideline you for one to two weeks. A high ankle sprain often takes several weeks to a couple of months, sometimes longer for more severe cases. The ligaments involved simply see more ongoing stress during normal walking and weight-bearing than the ligaments in a standard ankle sprain, which slows the healing process considerably.
Why Misdiagnosis Happens
Because the swelling and pain pattern can look similar to a standard ankle sprain at first glance, high ankle sprains sometimes get initially treated the same way, which can actually prolong recovery. A proper evaluation, including specific tests that stress the area between the two lower leg bones, helps distinguish between the two so the treatment plan actually matches the injury.
What Recovery Actually Looks Like
Early treatment focuses on protecting the area and managing swelling, often with more restricted weight-bearing than a standard sprain requires. As healing progresses, restoring range of motion, strength, and eventually sport-specific movement patterns like cutting and pivoting becomes the focus, with return to full activity guided by actual functional testing rather than a fixed timeline.
The Bottom Line
If your "ankle sprain" is taking a lot longer to heal than you expected, or happened from a twisting rather than rolling mechanism, it's worth getting it specifically evaluated rather than assuming it'll follow the same timeline as sprains you've had before.
FAQs
How do I know if my ankle sprain is a high ankle sprain? A high ankle sprain typically results from a twisting rather than rolling injury and involves pain higher up near the shin bones rather than just on the outside of the ankle. A hands-on evaluation is the most reliable way to confirm this.
Why is my "ankle sprain" taking so much longer to heal than my last one? This is a common sign that you may be dealing with a high ankle sprain rather than a standard one, since the ligaments involved bear more ongoing stress during walking, which slows healing considerably.
Can I still walk on a high ankle sprain? This depends on severity. More significant high ankle sprains often require a period of restricted weight-bearing, which is part of why proper diagnosis matters early on.
When can I get back to cutting and pivoting sports after a high ankle sprain? This varies significantly based on severity, but it's generally later than people expect, and should be guided by functional testing of your strength and stability rather than a general timeline alone.