High Ankle Sprains in Athletes

April 1, 2019

A high ankle sprain is a common sports-related injury and gets its name from the location of the injury – a little bit above the area injured in a common ankle sprain. A high ankle sprain occurs when there is a sprain to the ligaments that hold the two leg bones, the tibia and fibula, together at the ankle, said Dr. Norman Waldrop, an orthopaedic surgeon foot and ankle specialist at Andrews Sports Medicine and Orthopaedic Center in Birmingham.

Waldrop provided this year’s lecture of the Ernest Cole Brock III Continuing Medical Education Lecture Series, which is hosted by the College of Community Health Sciences.

He said a high ankle sprain “occurs when the foot is forcefully rotated outward. Because of the shape of the bones, this force pulls the two leg bones away from each other and can injure the ligaments that hold them together.”

Swelling and bruising are common symptoms and the injury leaves athletes unable to bear weight on the injured leg and to push off on the ankle, and with pain during an external rotation exam.

Waldrop said the goal is to restore stability and motion and that aggressive treatment, such as surgery, should be considered. He said putting the injured ankle and leg in a cast is not preferred. “Immobilization of the joint can lead to muscle atrophy, osteoporosis and ligament effects.”

He spoke about using an ankle tightrope, not screws, during surgery to repair the injury. A tightrope system anchors the ends of the tibia and fibula together with a braided polyethylene cord, rather than with a rigid surgical screw, to restore the original position of the bones and to allow for proper healing.

During rehabilitation, work is done to normalize the athlete’s gait. “Once the gait is normal, the athlete can move to land activities and do strength and weight bearing,” Waldrop said.