How to Prevent High Ankle Sprains | STACK

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How to Prevent High Ankle Sprains

April 12, 2013 | Joe Giandonato

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Few injuries are more troublesome for athletes than ankle injuries, particularly high ankle sprains. They are painful and they limit your ability to accelerate, cut, pivot, change direction and even bear weight. (Learn high ankle sprain symptoms.)

Research indicates that high ankle sprains (i.e., tibiofibular syndesmosis) account for 17% of all ankle injuries. The injury may seem similar to a low ankle sprain, but it is more severe and recovery time is typically much longer.

Causes of High Ankle Sprains 

High ankle sprains commonly occur when an athlete plants her foot pointing slightly out while her body pivots in the opposite direction. This causes the ends of the tibia and fibula to move away from each other, stretching the ligaments that connect them and potentially causing a sprain.

Preventing High Ankle Sprains 

Like other injuries, high ankle sprains cannot be completely eliminated, especially those that result from contact. However, there are some things you can do to reduce the risk or limit the severity of a sprain. (Watch Dwyane Wade strengthen his ankles.)

Strengthen the Hip Muscles

The hip muscles determine what areas of the feet make contact with the ground. The human body is an interconnected chain of movement. If one link is weak, another area has to compensate. In this case, if the hips are weak, you may have flat feet due to ankle alignment issues. Fix it with:

Barbell Hip Thrusts with Banded Abduction

Muscles Targeted: gluteus medius, gluteus maximus, hamstrings, gastrocnemius

Equipment Required: Flat bench, barbell with plates, stretch or therapy band


  • Position a flat bench against a stack of plates or a small plyo box to ensure that it's secured in place.
  • Sit in front of the bench with your shoulders and upper back resting against the bench and your feet flat on the ground.
  • Wrap a resistance band around your legs, about an inch above your knees.
  • Position the barbell one to two inches below your waistline and hold it with a slightly-wider-than-shoulder-width grip.
  • Drive through your heels and extend yours hips to raise the bar, and simultaneously drive your knees outward against the band.
  • Keep your core tight throughout the movement.
  • Slowly lower the bar to the starting position.
  • Pause briefly on the ground before repeating.

Sets/Reps: 3x6-10 (start with 10- or 25-pound plates)

Strengthen the Ankles Locally

The ankle and foot are crossed by a web of muscles that dictate and prevent movement. As such, the musculature can be strengthened locally through traction exercises. Fix it with:

Ankle Alphabets

Muscles Targeted: Various muscles of the lower leg, including the tibialis, calf and peroneal muscles

Equipment Required: Flat bench and stretch or therapy band


  • Wrap the band around your foot below the ball of the foot. Wrap it around multiple times to adjust the tension if necessary.
  • Sit on the bench with your target ankle hanging off in front.
  • Pull the band toward your body to add tension.
  • Write the alphabet with your foot as if you were holding a pen between your big toe and second toe.

Sets/Reps: Two alphabets each leg

Refine Your Movements

Many athletes injure their ankles when they plant their foot and ankle while pivoting, shifting or rotating their body. Instead, they should initiate rotational movements at the shoulders, while opening up their hips to their destination. For example, a basketball player posting up with his back to the basket should turn his shoulders and open up his hips toward the rim to make a move inside.


Gerber JP, Williams GN, Scoville CR, et al. "Persistent disability associated with ankle sprains: a prospective examination of an athletic population." Foot Ankle Int. 1998:19(10):653-660.

Joe Giandonato
- Joe Giandonato, MS, CSCS, is the head strength and conditioning coach at Germantown Academy in Fort Washington, Pa. He has authored numerous articles on a...
Joe Giandonato
- Joe Giandonato, MS, CSCS, is the head strength and conditioning coach at Germantown Academy in Fort Washington, Pa. He has authored numerous articles on a...
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