Injury types
Ankle Sprains: Lateral Sprains vs. High Ankle Sprains
This article is general information, not medical advice. For any individual player’s return date, follow the club’s official announcements.
Ankle sprains turn up on injury reports in almost every sport. A basketball player lands on an opponent’s foot after a rebound; a footballer rolls an ankle avoiding a tackle. Yet two players listed with an “ankle sprain” can have very different outlooks — one back in a few days, the other gone for over a month. The difference comes down to which ligament was hurt, and how badly.
What a sprain is
A sprain is a stretch or tear of a ligament, the tough tissue that connects one bone to another. That is different from a strain, which affects a muscle or tendon (a hamstring “pull” is a strain). In ankle injury reports, “sprain” almost always means ligament damage.
Ankle sprains fall into two broad families:
- Lateral (outside) ankle sprains — the classic “rolled ankle.”
- High ankle sprains — injuries to the syndesmosis, the ligaments that bind the shinbone (tibia) and the smaller fibula together just above the ankle joint.
Lateral ankle sprains: the common kind
According to the American Academy of Orthopaedic Surgeons (AAOS), about 90% of ankle sprains are inversion injuries, where the sole of the foot turns inward. That stretches or tears the ligaments on the outside of the ankle, mainly the anterior talofibular ligament (ATFL) and the calcaneofibular ligament (CFL). Landing on someone else’s foot or stepping on uneven ground are typical causes. Sprains on the inner side of the ankle, from the foot turning outward, also happen but are much less common.
Lateral sprains are usually graded on a three-step scale:
| Grade | Ligament damage | Typical signs | Typical time out (rough) |
|---|---|---|---|
| Grade 1 | Slight stretch, microscopic tearing | Mild pain and swelling, can bear weight | A few days to about 2 weeks |
| Grade 2 | Partial tear | Moderate swelling and bruising, some looseness | Several weeks |
| Grade 3 | Complete tear | Severe swelling and pain, clear instability | Up to about 6–12 weeks |
AAOS notes that nearly all isolated lateral sprains — even complete grade 3 tears — heal without surgery when the ankle is protected and properly rehabilitated. Rehab runs through three phases: controlling pain and swelling while restoring motion, rebuilding strength and balance, and gradually returning to sport-specific movement. It estimates about two weeks for minor sprains and six to twelve weeks for more severe ones. The NHS similarly says most sprains improve within about two weeks, but advises avoiding strenuous activity such as running for up to eight weeks.
High ankle sprains: similar name, longer road
A high ankle sprain is damage to the syndesmosis, the group of ligaments holding the lower ends of the tibia and fibula together. The usual mechanism is the foot being forced to rotate outward while the ankle is bent upward — for example, when a player’s foot is planted and the body turns over it, or an opponent falls across the back of the leg.
These injuries are thought to make up roughly 10–20% of ankle sprains in athletes overall, but the share is much higher in ice hockey, where a stiff skate boot holds the ankle rigid. One review of two NHL teams over about ten years found that 74% of their ankle injuries were syndesmosis injuries.
The difference in recovery time is striking:
- In a study of US Military Academy cadets, high ankle sprains took about 55 days on average to recover, nearly double the 28 days for grade 3 lateral sprains.
- In NHL players, high ankle sprains had an average return of about 45 days (range 6–137), compared with 1.4 days for lateral sprains.
If the two leg bones have separated enough to make the joint unstable, surgeons may stabilise them with an operation, which lengthens the timeline further. So when the words “high ankle” appear in a report, it is reasonable to expect a longer absence than a routine rolled ankle.
How teams describe ankle injuries
Because ankle sprains vary so much, team announcements use a range of phrases. Some of the most common in English-language leagues:
- Day-to-day: the team will check the player each day before deciding. Often used for mild sprains.
- Walking boot: the player is wearing a protective boot that limits ankle movement. It often accompanies grade 2 or high ankle sprains — AAOS lists a removable boot or brace as an option for grade 2 injuries. Players sometimes wear one briefly as a precaution, though, so the boot alone does not prove an injury is serious.
- Week-to-week: the absence is expected to be measured in weeks rather than days.
- Re-evaluated in X weeks: the player will be examined again after a set period. The re-evaluation date is not necessarily the return date.
Re-injury is the other thing to keep in mind. AAOS identifies incomplete rehabilitation as the most common cause of chronic ankle instability after a sprain, and poor balance and an early return both raise the risk of spraining the same ankle again. That helps explain why some players seem to tweak the same ankle repeatedly during a season.
On Daily IL
On Daily IL, each injury is recorded by body part and injury type — for example “left ankle · sprain” — together with the status the team has announced: OUT, DOUBTFUL, QUESTIONABLE, PROBABLE, IL (injured list), SUSPENDED or RETURNED. Our status guide explains each one.
Phrases like “day-to-day” usually mean the decision for the next game has not been made yet. Daily IL does not translate such phrases into a status on its own; we show the status given in the club’s or league’s official report.
Sources
- Sprained Ankle — OrthoInfo (American Academy of Orthopaedic Surgeons)
- Sprains and strains — NHS
- High Ankle Sprains in Professional Ice Hockey Players: Prognosis and Correlation Between Magnetic Resonance Imaging Patterns of Injury and Return to Play (Mollon et al., Orthopaedic Journal of Sports Medicine, 2019)