Common foot & ankle concerns we treat
- Pain that limits walking, standing, or sleep
- Stiffness, swelling, or reduced range of motion
- Sports injuries — acute or overuse
- Arthritis or post-traumatic joint changes
- Conditions other doctors couldn’t resolve
Foot & Ankle · Conditions A–Z
High Ankle Sprain syndesmosis injury
A high ankle sprain is an injury to the syndesmosis — the strong ligaments that hold the two lower-leg bones (tibia and fibula) together just above the ankle joint. Our board-certified foot and ankle specialists offer same-day or next-week evaluations with on-site X-rays across eight LA-area offices.
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Experts in foot & ankle care.
Surgical and non-surgical options at LAOSS.
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What sets LAOSS apart
- Same- or next-day appointments at eight Los Angeles–area offices
- On-site imaging; PT coordinated with your in-network provider
- Conservative-first care, surgery only when needed
- Board-certified specialists, not generalists
Key takeaways
- A high ankle sprain injures the syndesmosis — the ligaments above the ankle joint that bind the tibia and fibula together — and is different from a common lateral ankle sprain.
- Most stable high ankle sprains heal with a period of immobilization in a boot, protected weight-bearing, and a progressive physical therapy program.
- High ankle sprains typically take longer to recover than low ankle sprains, so early, accurate diagnosis helps set the right expectations.
- If the syndesmosis is unstable or there's an associated fracture, surgery to stabilize it with a screw or suture-button device may be recommended.
Overview
What is high ankle sprain?
A high ankle sprain is an injury to the syndesmosis — the ligament complex that connects the lower ends of the two leg bones (the tibia and fibula) just above the ankle. Because these ligaments sit higher than the ones injured in a typical ankle sprain, the pain is usually felt above the ankle joint rather than along the outside of it. It most often happens when the foot is planted and the leg twists or rotates outward, which is why it's common in football, soccer, hockey, and skiing.
Most stable high ankle sprains are treated conservatively first — a walking boot or short period of protected weight-bearing, activity modification, and a structured physical therapy program to rebuild strength and stability. Healing tends to be slower than a low ankle sprain because the syndesmosis is under load with every step, so patience and a clear timeline matter.
Below, we walk through how a high ankle sprain feels, what causes it, how we tell it apart from a routine sprain on exam and imaging, and the full range of treatment options — from a boot and therapy to surgical stabilization when the joint is unstable.
Patient education
Watch: High Ankle Sprain
This is a stretch or tear of one or more ligaments above the ankle. The ligaments form the syndesmosis. They connect the bones of the lower leg (the tibia and fibula) and give your ankle stability.
Animations licensed from ViewMedica · Swarm Interactive
Anatomy of the foot & ankle — tibia, talus, calcaneus, metatarsals, and the plantar fascia.
Anatomy
Inside the foot & ankle.
The foot and ankle have 26 bones, more than 30 joints, and over 100 ligaments and tendons. The plantar fascia spans the bottom of the foot, the Achilles tendon anchors the calf to the heel, and the ankle is a hinge that handles every step you take. Most foot and ankle problems trace back to overload, alignment, or footwear that doesn’t match the way your foot is built.
Self-orient
When high ankle sprain shows up.
Symptoms
Common symptoms
- Pain above the ankle joint, over the front and outer lower leg, rather than on the outer ankle
- Pain that worsens with pushing off, pivoting, or going up on the toes
- Swelling and tenderness over the front of the ankle and just above it
- Pain when the ankle is rotated outward or when the two leg bones are squeezed together
- Difficulty or hesitation bearing full weight, especially during walking
- A sense that the ankle is unstable or 'giving way' under load
Causes
Common causes
- A planted foot combined with twisting or outward rotation of the leg
- Sudden forced upward bending (dorsiflexion) of the ankle
- Contact and cutting sports such as football, soccer, hockey, and rugby
- Skiing injuries, where a fixed boot transmits rotation to the leg
- A fall or collision that forces the foot outward relative to the leg
- Higher-energy injuries that may also fracture the fibula or tibia
Diagnostics
How we diagnose high ankle sprain
You want answers, fast — and we’re built to give them. Most patients leave their first LAOSS visit with a clear diagnosis and a written plan, not another referral chain.
Here’s what your initial visit for high ankle sprain typically looks like:
- Detailed history — when it started, what makes it better or worse, what you’ve already tried
- Focused exam of the foot & ankle — range of motion, stability, strength, specific provocation tests
- On-site imaging at most offices: X-ray for bone, ultrasound or MRI when soft-tissue detail is needed
- A written plan with options ranging from conservative care to surgical procedures, in plain English
Schedule your evaluation with a trusted Greater Los Angeles orthopedic expert today.
Treatment options
How we treat high ankle sprain at LAOSS
Once we’ve confirmed the diagnosis, the next step is matching the right treatment to your situation. We start with the least-invasive option that fits — and escalate only when it doesn’t.
Conservative care
Step 1Conservative care first
Non-surgical options designed to relieve pain, restore movement, and avoid the OR when possible.
- Immobilization in a walking boot or cast to protect the healing syndesmosis
- Protected or non-weight-bearing for a period in more significant stable injuries
- Rest, ice, elevation, and anti-inflammatory medication to control early pain and swelling
- A progressive physical therapy program rebuilding range of motion, strength, and balance
- Gradual, criteria-based return to running, cutting, and sport
- Bracing or taping during the early return-to-activity phase when appropriate
Surgical care
When neededSurgical options when needed
Procedures performed by board-certified foot & ankle surgeons when conservative care isn’t enough.
- Syndesmotic screw fixation to hold the tibia and fibula in correct alignment while the ligaments heal
- Suture-button (flexible) fixation, such as a TightRope device, to stabilize the syndesmosis
- Ankle arthroscopy to inspect the joint and confirm the degree of instability
- Open repair or fixation of an associated fibula or ankle fracture (ORIF)
- Reduction and stabilization of a widened or unstable ankle joint (diastasis)
Surgeon expertise
Why experience matters.
Why experience matters
Foot & Ankle care is highly technique-dependent. Volume, training, and judgment together determine the outcome you actually feel six months later.
- Precise diagnosis from imaging and exam
- Conservative-first care that avoids unnecessary surgery
- Surgical technique refined over thousands of cases
- On-site imaging + coordinated PT through your in-network provider
The LAOSS approach
Our foot & ankle specialists move stepwise — start with the least-invasive option that fits your situation, escalate only when it doesn't.
- Same-day imaging at most offices
- PT coordinated in your insurance network
- Board-certified surgeons performing the procedures themselves
- Direct access to your specialist between visits
Candidacy
Am I a candidate?
If most of these match your situation, an evaluation with a foot & ankle specialist is the next step.
You may be
You may be a candidate if
These signs typically point toward an in-person evaluation with a foot & ankle specialist.
- Pain located above the ankle joint, over the front and outer lower leg, after a twisting injury
- Pain that flares with push-off, pivoting, or climbing stairs and is slow to settle
- Difficulty bearing full weight days after the injury, or a feeling of instability
- An ankle injury from a contact, cutting, or skiing sport that isn't improving as expected
- A previous 'ankle sprain' that was diagnosed but never fully recovered
Evaluation
What evaluation includes
Your first visit is built to give you an answer the same day, not just another referral.
- Detailed history — onset, mechanism, what makes it better or worse
- Hands-on exam focused on the affected joint or region
- On-site imaging at most offices (X-ray, ultrasound)
- Clear plan with options ranging from conservative to surgical
- Same-day or next-day scheduling for any follow-up tests
ImportantSeek urgent evaluation for sudden severe pain, an open wound or exposed bone, foot or ankle deformity after trauma, loss of sensation, or any sign of infection (fever, spreading redness, or swelling).
Recovery
Your foot & ankle recovery roadmap.
Recovery is rarely a straight line — but a clear plan with measurable milestones makes the path predictable.
01Days 0–14
Right after care
In the first two weeks we focus on protecting the foot & ankle, calming inflammation, and restoring basic motion.
- Activity modification with clear do/don’t guidance
- Ice, elevation, and pain control as needed
- Gentle range-of-motion within safe limits
- Follow-up scheduled to track healing
02Weeks 2–8
Rehabilitation
Targeted physical therapy rebuilds strength, mobility, and confidence in the foot & ankle.
- Progressive strengthening and neuromuscular work
- Manual therapy and soft-tissue treatment
- Sport- or job-specific movement re-training
- Coordinated PT through your in-network provider
03Months 2+
Long-term care
Once function is restored, the focus shifts to keeping you there — and catching any recurrence early.
- Return-to-activity plan with measured benchmarks
- Home program tailored to your sport or job
- Maintenance visits or imaging if symptoms change
- Direct line back to your specialist if needed
Risks & considerations
What to weigh before you decide.
We talk through the risks and benefits with every patient — informed consent is a conversation, not a form.
General
General considerations
Every orthopedic intervention carries a small set of standard risks. We screen, prepare, and monitor for these on every patient.
- Infection (rare with modern technique and prophylaxis)
- Bleeding or bruising at the treatment site
- Reaction to anesthesia or medications
- Need for additional procedures in some cases
Specific
Foot & Ankle-specific considerations
Some risks are tied to the structures we're treating in the foot & ankle. We discuss these in detail at your visit so you can weigh them against the benefits.
- Temporary stiffness or weakness during recovery
- Incomplete pain relief in a small percentage of cases
- Nerve or vessel irritation near the treatment area
- Need for follow-up therapy to fully restore function
Your care team
Meet our foot & ankle doctors in the Greater Los Angeles area
At LAOSS, our foot & ankle specialists combine advanced surgical expertise with a patient-first approach. From minimally invasive arthroscopic techniques to reconstruction, fracture care, and arthritis management, our physicians bring decades of experience to every case. Trusted across Los Angeles, our team is dedicated to restoring mobility, relieving pain, and helping you return to the activities you love.
Specialists
Meet your foot & ankle specialists.
4 providers
About this care
Reliable high ankle sprain care starts here
A high ankle sprain is easy to mistake for an ordinary ankle sprain, and getting the diagnosis right early makes a real difference in how smoothly you recover. At LAOSS, our board-certified foot and ankle specialists examine the syndesmosis directly, use on-site X-rays — including weight-bearing or comparison views when needed, and MRI for soft-tissue detail — and tell you in plain English whether the injury is stable or whether it needs more than a boot and time.
With same-day or next-week appointments at eight Los Angeles–area offices, you won't wait weeks for answers on an injury that's already slowing you down. We start with the least-invasive plan that fits your injury and escalate to surgical stabilization only when the joint is unstable — coordinating physical therapy through your in-network provider every step of the way.
Patient reviews
What patients say about us.
★★★★★4.97,500+ Google reviews
Wonderful staff. The MA was so kind to my elderly mom and the doctor explained everything twice so she’d remember. Felt like we were treated like family.
Patricia Aguilar
Cerritos, CA · 6 January 2025
FAQ
Common high ankle sprain questions
- A regular (low) ankle sprain injures the ligaments on the outside of the ankle, usually from rolling the foot inward. A high ankle sprain injures the syndesmosis ligaments above the joint, typically from a twisting or rotational force, and it usually takes longer to heal.
- Stable high ankle sprains often take longer to recover than low ankle sprains — frequently several weeks to a few months — because the ligaments are loaded with every step. Your timeline depends on the severity, and we'll give you specific milestones at your visit.
- Most stable high ankle sprains heal without surgery, using a boot, protected weight-bearing, and physical therapy. Surgery is reserved for unstable injuries or those with a fracture, where a screw or suture-button device is used to hold the bones in place while the ligaments heal.
- We use specific exam maneuvers like the squeeze and external-rotation tests, along with X-rays — sometimes weight-bearing or comparison views, and MRI when needed — to check whether the tibia and fibula stay properly aligned. That distinction guides whether you need a boot and therapy or surgical stabilization.
Ready when you are
Don’t wait on pain.
Book a visit with a foot & ankle specialist at any of our eight Los Angeles–area offices.
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