High Ankle Sprains

The Seattle Seahawks had such a dominating performance over the Denver Broncos in yesterday’s Super Bowl that the only thing that could slow them down was an injury to cornerback Richard Sherman in the fourth quarter.  After being helped off the field, he was carted back to the locker room for treatment.  He returned after the game wearing an immobilizing boot with crutches.  X-rays fortunately showed no broken bones, but he was diagnosed with a high ankle sprain.

What is a high ankle sprain?
As the name implies, a high ankle sprain is an injury to the supporting structures located above the ankle.  A typical ankle sprain involves the much more commonly injured structures supporting the outside of the ankle.

Sherman’s injury involves the high ankle ligaments which connect the two bones (the tibia and fibula) above the ankle joint.  The high supporting structures are comprised of several ligaments which include the anterior and posterior inferior tibiofibular ligaments, the deep transverse tibiofibular ligament, and the interosseous ligament.  These structures together provide stability and prevent excessive rotation of the ankle joint.

How is a high ankle sprain treated?
It is very important to rule out any broken bones or instability of the ankle.  Surgery is may be needed if a fracture is found.  Separation of the tibia and fibula is another finding that may require surgery to repair.

If it has been confirmed that no bones are broken and the ankle is stable, initial therapy begins with the PRICE treatment discussed in a previous blog.  Treatment continues with a cast or boot.  The duration of immobilization depends on the severity of injury.  Serious injuries may require up to six weeks of immobilization and crutches.  Once the initial inflammation has improved, physical therapy will be necessary to help with range of motion.

Recovery from a high ankle sprain will take longer than a typical ankle sprain.

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