Foot and Ankle Specialists consider an ankle sprain “syndesmotic” if the injury damages the ligaments of the distal tibiofibular syndesmosis; otherwise known as a “high ankle sprain.” Lateral ankle sprains occur more commonly than Syndesmotic Sprains, though high ankle sprains cause more pain above the ankle joint. Syndesmotic injuries can sometimes evade diagnosis, and physicians may consider the possibility of a Syndesmotic injury in athletes presenting pain around the upper ankle and lower leg.