How to Tell an Ankle Sprain from an Ankle Break

Feb 9, 2017

There’s a good chance you’ve experienced this before: you have bruising and swelling and you’re asking yourself “Why does my ankle hurt so badly?”

Sound familiar? Well, of course it does – ankle injuries are some of the most common injuries humans can sustain. If you take a moment to think about how often you move your feet, this probably makes sense. Even if you aren’t an athlete and never set foot on a basketball court, ankle sprains and breaks can happen.

Now, because they definitely share some symptoms, you should know how to tell an ankle sprain from an ankle break. The good news is that your go-to foot doc is here to discuss these injuries more in-depth and help you understand which is the one causing your pain and difficulty.

Ankle Sprain or Fracture?

Beyond the fact they have similar symptoms, sprains and fractures can both develop from the same kind of physical trauma. If you rotate your foot excessively, you could damage the soft or hard tissues in the valuable ankle joint.

From a purely technical perspective, the difference between an ankle sprain and ankle fracture is the tissue affected. In the case of a fracture, it is obviously a bone that has been cracked. With a sprain, a connective tissue known as a ligament (which binds bones together, as opposed to tendons that connect bone to muscles) has been extended beyond its intended range. This overextension can cause either partial or complete tearing.

Since both conditions have swelling, bruising, and pain—and can be caused in the same kinds of traumatic incidents—you should know that the level of pain and weight-bearing abilities several hours after the injury is key in determining which you have.

You will typically have greater pain and difficulty in bearing weight on the affected foot (to the point you simply cannot even do it) with a fracture than you will with a sprain. Further, you may even develop “fracture blisters” within the first 12 hours following a break. As you might imagine, these are blisters that develop in the area of a broken bone. They tend to form more often in areas of the body that have less amounts of fat cushioning under the skin. (If you reach down and feel your ankle joint, you probably aren’t going to find a lot of fat down there.)

Two important reasons for being able to distinguish an ankle fracture from an ankle sprain are that 1) you can take measures to cut the amount of time for soft tissue injuries to heal and 2) walking on a fracture will make it worse. In either case, you absolutely must take measures to prevent further injury.

Woman Runner with a Hurt Ankle

Treatment for Your Ankle Injury

Controlling swelling is essential for an ankle sprain, especially as part of early treatment. Once the ankle becomes puffy, it can take months and months for complete healing to take place. If you can minimize the swelling early, you are looking at closer to 2-3 weeks of recovery. For this reason, we have developed dynamic compression splints, which can get you back to activity in the least amount of time.

If your injury occurs on a weekend or after office hours, it is common to go to an emergency room for treatment. ER doctors and medical staff do not view the injury as being life-threatening (and rightfully so, since it isn’t). They are more concerned with getting you treated and out in case a “true” emergency comes in. (Well, unless you are treated by one of my residents!) This leads to a high probability of either misdiagnosis or under-diagnosis. For example, they might note that your ankle has been sprained and miss a fifth-metatarsal fracture—sometimes (inaccurately) called a Jones fracture—that happens when the overextended ligament tugs on the outer edge of a fragile foot bone and pulls some of it off.

It’s important to note that if you are a smoker, the odds of complications of healing a fifth metatarsal fracture go up 10 fold. This bone is fragile because of diminished blood supply, and tobacco use makes things worse because it causes blood vessels to constrict. As such, surgery may not heal this. (So if you are looking for another reason to quit smoking or using tobacco products, there you go.)

Another potential secondary injury you may have with an ankle sprain is sinus tarsitis. Just like with those fifth metatarsal fractures, this is another condition often missed by ER staff. Of course, we know to look for it and will provide the appropriate care you need.

Speaking of “appropriate care you need,” come see us here at our Indianapolis, IN podiatrist office if you are in need of professional medical attention for any foot or ankle issue. Even something that may seem as minor as an ankle sprain can become a bigger problem when left untreated, is treated improperly, or not treated soon enough. Don’t try to “walk it off.” We will provide the treatment you need.

Call us at (317) 545-0505 to request your appointment or contact us online today!