Pain and swelling after an ankle injury don’t always tell you much about the extent of the damage. A severe sprain can hurt worse than some fractures, and a small crack in the bone might feel no different than stretched ligaments.
The two injuries feel surprisingly similar in the first few hours, and many people incorrectly assume they can tell the difference on their own.
At Aloha Foot and Ankle Associates in Mission Viejo, California, we can help you figure out exactly what happened to your ankle and get the right treatment from the start.
A sprain damages the ligaments that connect your bones and keep your joints stable. These tough bands of tissue can stretch too far or tear completely when your ankle twists beyond its normal range of motion.
A fracture means a break in the affected bone. Your ankle has several bones that can break, including the tibia, fibula, and talus. Fractures range from hairline cracks to complete breaks where the bone separates into pieces.
Both injuries happen the same way — sudden impact, awkward landing, or twisting motion — which is why the cause doesn’t help you tell them apart.
Sprains and fractures cause immediate pain, swelling, and bruising. Your ankle will hurt when you move it or try to put weight on it. You might hear a pop or crack when the injury happens, though this sound occurs with both severe sprains and fractures.
The location of your pain doesn’t always clarify things, either. The most common ankle sprains hurt on the outside of your ankle, right where certain fractures also cause pain. Even the intensity of pain overlaps — grade 3 sprains with complete ligament tears can hurt just as much as broken bones.
Some symptoms point more strongly toward a fracture, such as:
Only an X-ray can actually determine whether you have a sprain or a fracture, so a proper diagnosis from a doctor, like our team of podiatrists, is essential to finding the appropriate treatment.
Treating a fracture like a sprain means walking on a broken bone, which can shift fragments out of alignment and damage surrounding tissue. Some fractures need immobilization or surgery to heal correctly, and waiting too long makes recovery harder.
The opposite problem causes issues, too. Assuming every painful ankle is broken and staying completely off your feet can actually slow healing from a moderate sprain, since gentle, early movement helps ligaments recover faster.
X-rays reveal fractures and show us whether the bones are aligned correctly or if fragments have moved out of place. When the X-ray looks normal but your symptoms suggest deeper damage, we might recommend an MRI to check for cartilage or tendon injuries that don’t appear on standard imaging.
We combine imaging with a thorough physical exam. Testing your range of motion, checking joint stability, and identifying areas of specific tenderness all help us pinpoint exactly what’s injured.
How we treat your ankle depends on whether the injury is in the ligaments or the bone. Treatments we may recommend include:
Sprains heal with rest, sometimes immobilization, and a gradual return to activity. Physical therapy helps restore strength and prevent chronic instability. Most sprains don’t need surgery unless multiple ligaments have torn or the ankle keeps giving out from repeated injuries.
Fractures need immobilization to let the bone heal in the correct position. Minor fractures might heal in a walking boot, while displaced fractures often require surgery to realign and stabilize the bone with plates or screws.
Our team at Aloha Foot and Ankle Associates can figure out exactly what’s wrong with your ankle and create a treatment plan that gets you back to normal activities safely.
Call our Mission Viejo office at 949-364-2525, or use our online booking tool to schedule your appointment.
