A high ankle sprain occurs when the ligaments above and around the ankle (see image below) get damaged or over-stretched. High ankle sprains are more serious than other ankle sprains because these specific ligaments hold the two lower bones of the shin together.
Sometimes, these can happen when the deltoid ligaments, the ligaments on the inside of your ankle, have been torn. You might feel pain in the deltoid area, in the ligaments of the high ankle, or even in the fibula. High ankle sprains are also called syndesmotic ankle sprains after the bone and ligaments involved.
A high ankle sprain is an injury that involves a different set of ligaments than in the common ankle sprain. These ligaments are located above the ankle joint and between the tibia and fibula. They form what is known as the syndesmosis (pronounced “SIN-des-MO-sis”).