Ankle sprains are one of the most common injuries we see at Sole-Lution Podiatry. However, not all ankle sprains are the same. In fact, there are two main types, and the treatment for each one is quite different. So understanding which type you have is the first step toward a full recovery.
What Is a Low Ankle Sprain?
A low ankle sprain is the most common type. It occurs when your foot rolls inward suddenly. This movement overstretches or tears the ligaments on the outer side of your ankle. These ligaments are called the lateral ligaments, and they connect your fibula to the bones of your foot.
Low ankle sprains happen frequently during sport. They also occur on uneven surfaces, or simply by stepping awkwardly off a gutter. Because they are so common, many people underestimate how serious they can be. As a result, they often go untreated and become a recurring problem.
Common symptoms of a low ankle sprain include:
- Swelling on the outer side of the ankle
- Bruising that develops within a few hours
- Pain when putting weight on the foot
- Tenderness when pressing on the outside of the ankle
- Reduced range of motion
What Is a High Ankle Sprain?
A high ankle sprain is less common but generally more serious. Instead of affecting the ligaments below the ankle joint, it involves the ligaments above it. Specifically, it affects the syndesmosis. This is the fibrous joint that connects your tibia and fibula together, just above the ankle.
This type of injury typically happens when the foot is planted and the body rotates. It is common in contact sports such as football and rugby. It can also occur in skiing or other activities that involve sudden twisting forces through the lower leg.
Because the syndesmosis is responsible for keeping your lower leg stable, a high ankle sprain can take significantly longer to heal. In some cases, it takes two to three times as long as a standard low ankle sprain to recover from.
Common symptoms of a high ankle sprain include:
- Pain above the ankle joint rather than below or beside it
- Discomfort when squeezing the lower leg bones together
- Pain when rotating the foot outward
- Difficulty walking, even without significant swelling
- A feeling of instability through the lower leg
How Are They Treated Differently?
Treatment depends on which type of sprain you have sustained and how severe the injury is. For both types, the initial approach follows the RICE method. This stands for Rest, Ice, Compression, and Elevation. However, the recovery process beyond that point is quite different.
For a low ankle sprain, treatment typically involves:
- Bracing or taping to support the ankle during recovery
- A structured rehabilitation program to restore strength and balance
- Gradual return to activity as symptoms improve
- Footwear assessment to reduce the risk of reinjury
For a high ankle sprain, treatment is more involved. Because the syndesmosis is under constant load during walking, it needs more protection. Treatment often includes:
- A longer period of immobilisation or use of a boot
- Targeted strengthening of the lower leg muscles
- Orthotics to control foot mechanics and reduce load through the joint
- In severe cases, a referral for imaging or specialist review
Why Does It Matter Which Type You Have?
Many people treat ankle sprains at home and assume the pain will settle on its own. While mild low ankle sprains can resolve with basic care, high ankle sprains almost always require professional assessment. Getting the wrong treatment for the wrong injury can slow your recovery significantly.
Furthermore, an untreated ankle sprain, regardless of type, increases your risk of chronic instability. This means your ankle may keep rolling in the future. Over time, repeated sprains can cause cartilage damage and long-term pain. Therefore, getting a proper diagnosis early is important.
When Should You See a Podiatrist?
You should book an appointment if your ankle pain is not improving after a few days of rest. You should also come in if you are struggling to walk normally, if there is significant swelling, or if you have rolled the same ankle before. Early treatment leads to better outcomes and a faster return to activity.
At Sole-Lution Podiatry, we assess both the injury and the underlying biomechanics that may have contributed to it. This helps us put a plan in place to treat your current injury and reduce the risk of it happening again.
If you are dealing with an ankle sprain or any other sports-related foot injury, our sports podiatry team is here to help. Visit our sports podiatry page to find out more about how we treat lower limb injuries, or book an appointment with our team today.
For more information on ankle sprains and how they affect you, the Better Health Channel provides a helpful overview of ankle sprain management.