Sprained Ankle vs. Broken Ankle: 6 Ways to Tell the Difference

Ankle Injuries, Sports Medicine


Ankle injuries are quite common. But, how do you tell if it’s a sprain or fracture?

Ankle injuries are a common orthopedic issue, with around 1 million people going to the ER for ankle injuries each year. The majority of those traumas were either due to a sprained ankle or a broken ankle. But, what is the difference between these two painful conditions?

Given the complex structure of the ankle, with its seven bones and three major ligaments, it’s easy to see how an ankle is injured either during a sporting event or from a bad fall. Although a sprained ankle and a broken ankle exhibit similar symptoms, these two conditions are quite different. Knowing those differences can help you get the treatment you need to heal faster.

6 questions to determine if your ankle is sprained or fractured

You’ve just hurt your ankle. The pain is intense and you can’t walk. There may also be some noticeable swelling or discoloration. So, what do you do? First, ask yourself these questions to better help you understand whether you’ve sprained your ankle or fractured it.

1. Where is the pain?

Pain centered along the ankle bone — the hard part of the ankle — indicates an ankle fracture. If the pain radiates from the softer areas of the ankle, like the ligaments, that can indicate the ligament has been sprained or possibly torn.

2. How intense is the pain?

A sharp, intense pain at the moment of the injury is the typical sign of an ankle fracture. While there may be pain when the injury occurs, an ankle sprain begins with less intense pain that builds over time.

3. Did your ankle make a sound?

Yes, you can hear an ankle injury. A broken ankle emits a cracking sound as the bone breaks. Meanwhile, a popping or snapping sound accompanies a sprained ankle.

4. Does your ankle appear swollen or discolored?

Both injuries can cause swelling and bruising. But as with pain, the swelling and bruising register more immediately after a broken ankle, yet may be more gradual with an ankle sprain. Another distinguishing feature of a fracture is a noticeable deformity in the ankle. The joint loses its natural shape after a break. If a ligament is damaged, the ankle typically retains it structure.

5. Is your ankle tingling?

A broken ankle typically results in a tingling sensation. A sprain does not.

6. Can you walk?

Both injuries make it difficult and painful to walk. However, a broken ankle doesn’t allow you to bear any weight on your foot. You can walk with a sprained ankle, but it won’t be easy.

How to heal your ankle sprain or fracture

Now that you know the differing characteristics of an ankle sprain and fracture, you can get the right treatment. You may need an X-ray or MRI to determine which one you’ve suffered, Then it’s on to physical therapy.

How to treat a sprain

The first line of treatment for a sprain is the RICE method, or Rest, Ice, Compression (with a tape), and Elevation. Over-the-counter nonsteroidal anti-inflammatory medications can reduce the discomfort. Mild sprains may heal on their own. If the pain doesn’t subside in a few days or a week, see your doctor. You may need additional therapy, such as a boot or brace to immobilize the ankle, and potentially physical therapy to increase the range of motion.

How to treat a fracture

Go to the doctor right away! A broken ankle requires immediate medical attention. You’ll need a cast to stabilize the bone so it can heal correctly. If the bone is severely misaligned, you may need surgery to put the bone back into its proper position.

Get back on your feet!

At All Sports Physical Physical Therapy, we treat all types of orthopedic injuries, including those to the ankle. Whether you’ve sprained or broken your ankle, you can be assured we have a treatment plan to get you back on your feet. Contact us for a consultation.

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