Your ankle hurts. It might be swollen and tender, and maybe you can’t put weight on it. You might have heard a crack or a pop. Maybe you remember a specific injury to the ankle, or maybe it’s gotten more painful over a period of weeks or months. Either way, you’re pretty sure you’ve broken your ankle. Or is it sprained? Is there even a difference?
Yes, there’s a difference between a sprain and a break. Although they have many of the same symptoms, a sprain and a break—its medical term is fracture—are two different injuries that are treated in different ways and have different recovery times.
Symptoms of Ankle Injuries
- Inability to put weight on the injured foot
Sprain Versus Fracture: What’s the Difference?
A sprain is damage to a ligament, a tough, fibrous piece of collagen that connects bones to each other. Sprains are categorized by their degree of seriousness. Grade I sprains, where the ligament becomes stretched, are mild. Grade II sprains are moderate, and these involve partial tears to the ligament. Grade III sprains are the most severe and happen when the ligament is fully torn, or ruptured.
The vast majority of ankle sprains are injuries to the lateral ligament complex on the outside of the foot. These are a set of three ligaments found on the outside of the ankle and connect the heel bone (calcaneus) and ankle bone (talus) to the fibula, one of the bones of the lower leg.
A fracture, on the other hand, is a broken bone. The ankle joint is a meeting of the tibia (shinbone), fibula (the other lower leg bone) and talus (ankle bone). Another joint, called the syndesmosis joint, connects the tibia and fibula. A broken ankle is a fracture of one or more of these bones.
Ankle sprains and ankle fractures have similar causes. Both can be caused by an acute injury such as a car accident or sports mishap, or by wear-and-tear and overuse. Twisting the ankle and rolling the ankle are two common cause of ankle sprains and fractures.
- Direct trauma, such as in a car accident
- Falls or trips
- Walking or exercising on an uneven surface
Treatment for an ankle injury will depend on whether it’s a sprain or a fracture, and the severity of the injury. Imaging studies can help doctors determine whether you’ve sprained or fractured your ankle. A doctor will most likely order an X-ray first. X-rays can show cracks in the bone, but they do not show soft tissue like ligaments. If the X-ray does not indicate a fracture, the doctor may order other tests to confirm that the injury is a sprain.
Most ankle sprains can be treated without surgery. Recovery can be as quick as two weeks for a mild sprain and as long as 6 to 12 weeks for a Grade III sprain.
Ankle sprains—no matter the grade—are treated in three phases. Phase one is resting the injury. That means RICE: rest, ice, compression and elevation. Anti-inflammatory medications can help reduce pain and swelling during this phase. The next phase is focused on restoring range of motion, flexibility and strength to the ankle. Physical therapy is helpful for this. In the last phase, sports and activities are gradually reintroduced.
Fractures may require surgery if the ankle is not stable, meaning the broken bone is out of place. If the ankle is stable, the fracture can often be treated with immobilization by a cast six weeks or longer in order to allow the bone to heal.
To treat a broken ankle surgically, surgeons will first have to realign the broken ends of the bone with each other, a process known as reduction. Then, the broken pieces are held together with plates, screws, rods or wires.
If you’ve sustained an ankle injury and suspect you may have a sprained or broken ankle, call one of Summit Medical Group’s urgent care centers or schedule an appointment with one of our foot and ankle specialists right away.
Going through one of Summit Medical Group’s comprehensive and integrative programs—such as our Fracture Care program, Sprains and Strains Program or our Sports Center of Excellence—will ensure your recovery will go as quickly and as smoothly as possible.