Ankle Sprain vs. Broken Ankle

You’ve injured your ankle and can’t put your weight on it. It hurts and is tender to the touch, bruised, and swollen. It could be a sprain, or it might be broken.

The symptoms of an ankle sprain are a lot like a fracture, but you’ll need to know which injury you have so you can heal the right way.

What's an Ankle Sprain?

This happens when you damage the ligaments in your ankle.

Ligaments are the tough, stretchy bands that hold your bones in place and help keep the joint stable. They're meant to stretch and move, but only to a point. A sprain means that a ligament is torn or stretched beyond its limits.

What's an Ankle Fracture?

This happens when at least one of three bones in your ankle breaks.

If just one bone is broken, you may not realize how bad the injury is. But if multiple bones break at once, you will lose stability in your ankle and may not be able to walk.

An ankle fracture can also lead to ligament damage.

How Can I Tell the Difference?

To help figure out what the injury might be, ask yourself a few questions:

  • Was there a noise when it happened? A sprain may occur silently, or in severe cases there may be a popping sound. With a fracture, you might hear a crack.
  • Is your ankle misshapen? While swelling is a symptom of both injuries, if your ankle looks clearly “off,” it’s most likely because a bone is broken.
  • Does your ankle feel numb? With a sprain, you feel pain. But if you have numbness or tingling, your ankle is most likely broken.
  • Where is the pain? If your ankle hurts or is tender to the touch directly over your ankle bone, you probably have a fracture. If the pain is in the soft part of your ankle, it’s more likely a sprain.

If you’re still not sure, see your doctor. He can examine your ankle and give you a number of tests to figure out which injury you have.

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Treatment for a Sprain

It’s usually less involved when you are healing from a sprain. Most sprains will clear up on their own.

You may take anti-inflammatory drugs such as ibuprofen (Advil, Motrin) or naproxen (Aleve).

And your doctor may advise you to try the “RICE” method to ease your inflammation:

  • Rest
  • Ice
  • Compression (with an elastic bandage)
  • Elevation (ankle above the heart)

You may need physical therapy for a moderate sprain. You should start range of motion exercises once the pain and swelling subside. Surgery is usually for severe cases when other treatments have failed.

Treatment for a Fracture

If you think your ankle is broken, you should get medical treatment right away. You need to have the ankle immobilized. This could involve crutches or a cast.

Your doctor may try to align the broken bones to help you heal. If the bones are unable to stay in place after your doctor has tried to stabilize the fracture, you might need surgery.

You can also apply ice, elevate your ankle, and take pain relievers. Talk to your doctor.

Recovery Times

These can be vastly different for the two injuries as well.

A sprain may clear up within days, with worse sprains needing several weeks to heal.

Fractures usually take much longer. It could be 6 weeks to several months before you’re back to your regular routine. For most ankle fractures, you can do your rehab with a basic home exercise program of stretching, range of motion, strengthening, and balance exercises.

WebMD Medical Reference Reviewed by Lisa Bernstein, MD on December 28, 2016

Sources

SOURCES:

American Academy of Orthopaedic Surgeons: “Sprained Ankle,” “Ankle sprains: what’s normal, what’s not.”

American Podiatric Medical Association: “Sprains, Strains & Fractures”

Mayo Clinic: “Sprained Ankle.”

American Orthopaedic Foot & Ankle Society: “Ankle Sprain”

Southeast Orthopedic Specialists: “The Difference Between a Broken and Sprained Ankle.”

Emory Healthcare: “Is it a Sprain? Or a Fracture?”

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