Have you ever twisted your ankle stepping off a curb? Recently watched your favorite athlete limp off the field after someone landed on their ankle? Ankle sprains are one of the most common injuries we treat, but why does it take so much longer for a high ankle sprain to heal? The answer: Different ligaments are affected.

The ankle joint is complex and made up of 3 bones in your lower leg, which are the tibia, fibula and talus. Connecting those bones together is a tissue called ligaments, whose job is to offer stability to the joint. In a high ankle sprain, the ligaments affected form the syndesmosis, which connects your tibia and fibula. These account for about 14% of all ankle sprains and usually take longer to recover from. Often, rehab can take months and surgery is often elected. In “traditional” ankle sprains, more commonly a ligament called the ATFL is injured. This ligament connects your talus to your fibula. Depending on the severity of your injury and the ligaments involved, it can take about 10 days to 6 weeks to return to your prior level of function.

Physical therapy is very important when recovering from either type of ankle sprain. It is important to have full motion, ability to know when the ligaments are being stretched (proprioception) and strength before returning to sports or other strenuous activities. Your physical therapy sessions will include reducing swelling, regaining pain free range of motion, increasing strength, and balance and coordination training. Ensuring that all of these elements are addressed puts you in the best possible place to avoid re-injuring your ankle in the future and keep you on the playing field!