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What’s the Difference Between a High and Low Ankle Sprain?

August 13, 2025

You know the drill: rest, ice, elevate, repeat. In many cases, ankle sprains may seem routine.

But are some types worse than others?

Here’s how you can tell whether you have a high or low ankle sprain, and what that means for your recovery.

What kind of ankle sprain do you have?

How your ankle sprain happened (and where it hurts) can tell you a lot. Jordan Gruskay, MD, an orthopedic surgeon at the Connecticut Orthopaedic Institute, shares a quick breakdown.

Low ankle sprain.

A low ankle sprain affects the ligaments outside your ankle – usually from rolling your foot inward.

“It’s the most common type of sprain,” says Dr. Gruskay. “It’s what we see when someone steps off a curb wrong, twists their ankle during a pickup game or even rolls it while walking the dog.”

It can also happen during everyday moves like:

• Running or walking: Rolling your foot on an uneven surface.
• Basketball or volleyball: Landing on another player’s foot.
• Dancing: Fast side steps or spins.

“These usually cause swelling and pain on the outer side of the ankle,” says Dr. Gruskay. “If it’s a higher-grade sprain, it may be hard to put weight on it at all.”

> Related: How Do I Know If My Ankle Is Sprained or Broken? 

High ankle sprain.

A high ankle sprain affects the ligaments that connect your two lower leg bones – the tibia and fibula – just above the ankle joint.

“This usually happens with a high-energy twist that forces the ankle to rotate outward,” says Dr. Gruskay.

It can happen in a few common ways:

• Football or soccer: Quick cuts or tackles twist the ankle out.
• Basketball: Awkward landings with the foot planted.

“You’ll usually see swelling above the ankle, more widespread pain and trouble walking,” says Dr. Gruskay. “These injuries take time and don’t heal as quickly as a typical sprain.”

When should you see a doctor?

Start with rest, ice, elevation and compression for the first 24 hours – but sprains need some time.

“A low ankle sprain might heal in a few days to a couple of weeks,” says Dr. Gruskay. “A high ankle sprain can take longer – sometimes a few months.”

Treatment may include rest, imaging, bracing, physical therapy or a walking boot. For chronic or recurrent sprains that aren’t improving with rehab, surgery may be an option.

“If the pain’s not going away or it’s starting to limit your life, come see us,” Dr. Gruskay adds. “We’ll help you figure out what’s going on and get you moving again.”