Your skate got twisted outwards in a collision with another player and you immediately feel pain above your ankle. You’ve had ankle sprains before but this feels different.
High ankle sprains occur most commonly when the ankle is twisted laterally, or outwards. A high ankle sprain occurs when there is a stretch or tear to the ligaments connecting the two bones in your leg, the tibia and fibula. The joint between the tibia and fibula is known as a syndesmosis. This joint allows for a small amount of motion between the two bones when subject to high stresses and forces such as during running or skating. With injury to the joint and these ligaments, instability occurs.
Although high ankle sprains are treated very similarly to low ankle sprains, they are more complex and most times, require a longer recovery period before return to sport. First, x-ray should be done as soon as possible to rule out fractures. Following x-ray, initial treatment should incorporate the RICE protocol (rest, ice, compression, elevation). Once pain and inflammation decreases, ankle strengthening, balance and proprioception exercises should be incorporated to ensure safety and decrease risk of re-injury with return to sport. With a high ankle sprain, you may be able to walk or even jog without much pain, which may make you feel like you are ready to go back to hockey earlier than you actually are. The stresses and twisting forces placed on the ankle with skating should be avoided until you demonstrate no pain and a strong, stable ankle.
By: John Gallucci Jr., MS, ATC, PT, DPT
President & CEO, JAG Physical Therapy