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Tel: 239-430-3668Baltimore Ravens quarterback Lamar Jackson — a two-time NFL MVP and one of the most dynamic athletes in professional sports — has now missed three straight games with a left ankle injury, and the diagnosis explains why the recovery is taking longer than fans expected: a high-ankle sprain. High-ankle sprains look minor from the sideline. They are not. They injure the ligaments that hold the two bones of the lower leg together just above the ankle, and they heal on a timeline measured in weeks, not days. Here is what was reported, what a high-ankle sprain actually is, and how these injuries are diagnosed and treated.
What happened to Lamar Jackson?
According to reporting from The Athletic, NFL.com and FOX Sports, Jackson twisted his left ankle awkwardly while being sacked late in the second quarter of the Ravens’ Week 4 win over the Tennessee Titans. He left the stadium in a walking boot, and early reports called the injury day-to-day.
It did not stay that simple. Jackson missed Week 5 and Week 6, and although he returned to practice as a limited participant, the Ravens ruled him out for Sunday’s Week 7 matchup against the Cincinnati Bengals — his third consecutive game on the sideline.
Jackson himself gave the clearest public description of the injury. He told reporters the Ravens’ athletic training staff had identified it as a high-ankle sprain, and described the pain bluntly: “It hurt bad… it was very, very, very painful.” He said his recovery so far has centered on icing the ankle and getting the swelling down, and he made clear he would not return until his mobility was back — the one quality a running quarterback can least afford to lose.
What is a high-ankle sprain?
Most ankle sprains stretch the ligaments on the outside of the ankle — the familiar injury from rolling an ankle on a curb, a trail or a pickleball court. A high-ankle sprain is a different injury in a different place. It damages the syndesmosis, the strong ligament complex that binds the tibia (shinbone) and the fibula (the thinner outer bone of the lower leg) together just above the ankle joint.
The classic cause is a twist with the foot planted — precisely what happens when a defender takes a quarterback’s legs out while his foot is stuck in the turf. The rotation forces the tibia and fibula to spread slightly, stretching or tearing the ligaments that tie them together.
That location is why the injury is so disruptive. The syndesmosis stabilizes every push-off step, so walking, climbing stairs, running, cutting and pivoting all load it. A high-ankle sprain can make even plain walking painful, and that is why these injuries typically sideline athletes longer than ordinary ankle sprains — commonly four to eight weeks depending on severity, and longer when the ligaments are fully torn.
Symptoms of a high-ankle sprain
Because the injured ligaments sit above the ankle joint, the symptoms differ from a typical sprain:
- Pain and tenderness above the ankle joint, toward the front of the lower leg, rather than at the bony bump on the outside of the ankle
- Swelling and bruising that may extend up the shin
- Pain with push-off, stairs, and any pivoting or cutting motion
- Pain when the two leg bones are gently squeezed together (a standard clinical test)
- A feeling that the ankle is unstable or may “give way”
How a high-ankle sprain is diagnosed
Diagnosis starts with a hands-on examination. A foot and ankle specialist checks for tenderness directly over the syndesmosis and performs stress tests — including the squeeze test (compressing the tibia and fibula toward each other) and the external rotation test (rotating the foot outward with the knee bent) — to reproduce the pain and gauge instability.
Imaging confirms the picture. Weight-bearing X-rays rule out a fracture and show whether the space between the tibia and fibula has widened — a sign the syndesmosis has torn through. An MRI grades the ligament injury when the examination is inconclusive or when recovery stalls. Sprains are typically graded from Grade I (stretched, minimally torn) to Grade III (complete tear with instability), and the grade drives both the treatment plan and the return-to-activity timeline.
Treatment: what recovery actually looks like
The overwhelming majority of high-ankle sprains — Jackson’s included, based on everything publicly reported — heal without surgery. Treatment progresses in phases:
- Phase 1 — protect and settle. A walking boot or brace, protected weight bearing with crutches if needed, ice and elevation to control swelling, and usually short-course anti-inflammatory medication. This is the same approach Jackson described — icing to bring the swelling down.
- Phase 2 — restore motion and strength. Once weight bearing is comfortable, structured rehabilitation rebuilds ankle range of motion, strength and balance. Custom orthotics can help stabilize the foot and reduce stress on the healing syndesmosis as activity resumes.
- Phase 3 — return to activity. Sport-specific work — jogging, then cutting, then full-speed push-off — comes last, because the syndesmosis is loaded most heavily by exactly these movements.
A Grade I sprain may settle in two to four weeks. Grade II injuries commonly take four to eight weeks. Grade III sprains — where the leg bones separate on stress X-rays — can require surgery to hold the tibia and fibula together while the ligament heals, followed by roughly three months of recovery.
Returning too early is the risk that turns a treatable sprain into a chronic problem. An incompletely healed syndesmosis can produce lingering pain, repeated episodes of the ankle “giving way,” and over time, early ankle arthritis. That caution — not a lack of toughness — is why a player like Jackson sits out even when he is back at practice.
When ankle pain needs a specialist
Plenty of ankle sprains settle at home with ice and rest, but a few signs mean the ankle should be examined promptly:
- You cannot bear weight, even briefly, without significant pain
- Swelling and bruising are severe or worsening after 48–72 hours
- Pain sits above the ankle joint rather than on the bony bump outside it
- The ankle buckles or “gives way” repeatedly
- Pain persists beyond a couple of weeks despite rest
Ankle sprains are among the most common injuries we see across Southwest Florida — on pickleball courts, golf courses, running paths and playing fields from Naples to Sarasota. Getting the diagnosis right early, including a proper grading of the injury, is the single biggest factor in a fast, complete recovery.
High-ankle sprain and ankle injury care at FFLC
Family Foot & Leg Center, PA (FFLC) is a team of board-certified podiatric physicians and surgeons who specialize exclusively in the foot and ankle — from sports sprains and fractures to reconstructive rearfoot and ankle surgery. Dr. Kevin Lam, DPM, FACFAS, the practice’s founder and clinical director, is board-certified in foot surgery and reconstructive rearfoot/ankle surgery. The practice has served Southwest Florida since 2005 across nine locations from Marco Island to Sarasota, including Naples, Estero, Fort Myers, Cape Coral and Port Charlotte.
For an ankle injury, that means everything happens under one roof: in-office digital X-rays, same-day appointments for acute injuries, walking boots and bracing, structured rehabilitation, custom orthotics and — when a severe injury demands it — advanced surgical reconstruction. If you twisted an ankle this weekend and it is not improving, you do not need to guess whether it is serious.
Frequently asked questions
How long does a high-ankle sprain take to heal?
Mild (Grade I) sprains often improve in two to four weeks. Grade II injuries commonly take four to eight weeks. Severe Grade III sprains with widening between the leg bones can require surgery and roughly three months of recovery. Returning before the ligament has healed is the main reason these injuries linger.
What is the difference between a high-ankle sprain and a regular ankle sprain?
A regular sprain injures the ligaments on the outside of the ankle. A high-ankle sprain injures the syndesmosis — the ligaments binding the tibia and fibula together above the joint — and typically takes longer to heal because every push-off step loads it.
Do high-ankle sprains always need surgery?
No. The large majority heal with a boot or brace, protected weight bearing and rehabilitation. Surgery is reserved for severe sprains in which stress X-rays show the leg bones separating, or for chronic instability that does not respond to therapy.
Schedule an appointment at FFLC
If ankle pain is not settling — whether from a sports injury, a fall or a twist on the court — the board-certified podiatrists at Family Foot & Leg Center can examine, image and grade the injury the same week you call. Schedule an appointment at FFLC online, or call 239-430-3668 — same-day appointments are available across our nine Southwest Florida locations, and our phones are answered around the clock.
