WHAT’S UP DOC? Where Do High Ankle Sprains Come From?

By Dr. PETE INDELICATO

Former Florida Gator Team Physician

Up until recently, ankle sprains were considered “mild, moderate or severe.” However, as our knowledge of the biomechanics of the ankle improved, it became obvious that a specific set of ligaments immediately above the ankle joint were critical for proper ankle function. 

When these ligaments were torn, usually as a result of a violent twist of the ankle, a “high ankle sprain” resulted.

Unlike injuries to the ligaments on either side of the ankle, when the ligaments above the ankle ( syndesmotic ligaments) are torn, they often require surgery to optimize the best outcome, both short and long term.

In the old days, we just called them “severe” ankle sprains. 

Today, the surgery usually consists of placing extremely strong sutures to reinforce these ligaments, thus allowing a rapid return of function. They can be placed through very small incisions, thus allowing a relatively aggressive rehabilitation program.  

The more common ankle sprains are still best treated with ice, compression and elevation. 

Sometimes, a walking boot is recommended to obviate the need of crutches. Irrespective of severity of the injury, a qualified athletic trainer and/or physical therapist specializing in sports medicine should be part of the health care team guiding the injured athlete to a full recovery. 

One of the most high profile cases we had at Florida was the high ankle sprain of All-American Percy Harvin, star of our national championship team, who scored 32 touchdowns on 194 rushes and 133 catches. His high sprain lingered a bit and took away some of his ability to cut. One wonders what his stats might have been without that high ankle sprain.

DR. PETE INDELICATO