Ankle sprains and ankle fractures are common ankle injuries. However, both injuries often cause similar symptoms, which can initially confuse patients. Mistaking an ankle fracture for a sprain, or vice versa, can lead to incorrect healing and lasting pain, which can result in further problems in your ankle joint. In this blog, we will provide a comprehensive comparison of ankle sprains and ankle fractures, outlining the differences in symptoms, diagnosis, treatment options, and recovery timelines.
What Is a Sprained Ankle?
A sprained ankle, otherwise referred to as an ankle sprain, is a common ankle injury that occurs when a person twists, turns, or rolls their ankle in an awkward position. This unexpected movement of the ankle causes a stretch or a tear in the ligaments that hold the ankle bones together. These ligaments stabilize the joints and prevent excessive movement. However, when the ligaments are forced beyond their normal range of motion, a sprain occurs.
What Is a Fractured Ankle?
An ankle fracture, or a broken ankle, is a common ankle injury and one of the most common bone fractures. A fractured ankle occurs when you break one or more bones in your ankle joint. An ankle joint consists of the tibia (shinbone), the fibula (calf bone), and the bone that connects them, the talus. A fractured ankle can involve one or more broken joints at the same time.
Causes of Ankle Fractures and Sprains
Ankle fractures and sprains can occur for various reasons:
- Accidents, including car accidents
- Falling or tripping, or landing directly on your feet after jumping down from a height
- Missteps while playing sports or stumbling can result in an awkward twist, turn, or roll in the ankle
These are some of the common causes of ankle sprains:
- Falling and twisting your ankle
- Landing on your foot after jumping or pivoting
- Walking or exercising on an uneven surface
- Sports
- Another person stepping or landing on your foot during a physical activity
Symptoms of Ankle Fractures and Sprains
Ankle fractures and sprains have similar symptoms, but there are some differences that will help you get an accurate diagnosis. A person may feel one or more of these symptoms at the time of injury.
Common Symptoms of a Broken Ankle
Open ankle fractures are obvious because the bone protrudes through the skin. Common symptoms in other types of ankle fractures include the following:
- Intense and throbbing pain that begins instantly after the injury
- Swelling
- Bruising
- Bleeding under the skin
- Tenderness
- Joint deformity
- Trouble walking, lifting, or bearing weight
Common Symptoms of a Sprained Ankle
If you have an ankle sprain, you may experience a popping sensation or hear a similar sound at the time of injury. Some common symptoms of a sprained ankle include the following:
- Pain in the foot
- Difficulty bearing weight or walking
- Tenderness in the ankle
- Swelling
- Bruising
- Limited range of motion
- Instability in the ankle
Diagnosis of Ankle Fractures and Sprains
There are reliable ways to diagnose ankle fractures and sprains, as well as differentiate between the two.
Physical Examination
The first step in diagnosing an ankle fracture or a sprain is a physical examination. A doctor visually inspects the injured foot and asks you questions about the injury. The ankle is checked for swelling, tenderness, bruising, and bleeding. Your doctor will provide an accurate diagnosis based on a thorough physical evaluation.
Imaging Tests
You may need to undergo a few imaging tests so that your doctor can carefully assess the extent of the injury and determine the most suitable treatment methods, as well as your recovery timeline. X-rays are the most common test used for ankle injuries, but your doctor may also recommend an MRI or a CT scan, depending on the severity of the pain you are experiencing and the extent of the fracture or the sprain.
Stress Tests
Stress tests are also part of a physical examination, which involve intentionally trying to move the ankle to evaluate the severity of the fracture, the sprain, or the ligament damage. A doctor may also have you perform weight-bearing activities to pinpoint the most painful areas in your foot. They also assess your range of motion and ability to walk. Some common stress tests are the anterior drawer test, the talar tilt test, and the external rotation test.
Treatment Options for Ankle Fractures and Sprains
Both ankle fractures and sprains can be treated reliably with comprehensive treatment methods, including medication, physical therapy, and surgery.
Common Treatments for an Ankle Fracture
Treatment for an ankle fracture depends on which bone is broken and the severity of the fracture. Some common treatments include the following.
- Medications: Your doctor may suggest over-the-counter (OTC) medications to manage and relieve pain and inflammation, such as ibuprofen (Advil).
- Physical therapy: You may need to undergo physical therapy, which involves exercises that help restore range of motion and strength.
- Surgery: In some cases, an orthopedic surgeon may put pins, plates, and screws in your foot to keep a bone in place as it heals. These materials are removed once the bone is healed or if they start causing pain.
- Other procedures: If you have a displaced fracture, your doctor may perform surgery on your foot to realign the bones in a process called reduction. In many cases, it may be necessary to employ immobilization to prevent a broken bone from moving, such as by using a boot or a cast.
Common Treatments for a Sprained Ankle
Treatment for a sprained ankle depends on the severity of the injury. The goal of all treatment options is to reduce the swelling and the pain. Some standard treatment options include the following.
- Self-care: The self-care approach includes the RICE method, which involves rest, ice, compression, and elevation.
- Medications: In most cases, your doctor will recommend OTC pain relievers, such as ibuprofen, naproxen sodium, or acetaminophen.
- Devices: Your doctor may recommend a device to help you walk and perform basic tasks with a sprain, such as an elastic bandage, sports tape, an ankle support brace, a cast, or a walking boot.
- Physical therapy: As your ankle progresses and the pain improves, physical therapy may be introduced to help restore your ankle’s range of motion.
Recovery Timelines for Ankle Fractures and Sprains
The recovery timeline for ankle fractures and sprains varies depending on the severity of the injury and the treatment method. For a faster recovery, it’s essential to adhere to the recommended treatment schedule. Below is a brief overview of the recovery timelines for ankle sprains and ankle fractures.
Ankle Sprains
There are generally three classifications of ankle sprains: mild, moderate, and severe. Mild sprains, which involve minor stretches or microscopic tearing of ligaments, may heal within three weeks. Moderate sprains, which occur when a ligament is significantly torn, usually heal in three to four weeks. Severe sprains, which involve a complete ligament tear and cause severe pain and swelling, take around three to six months to heal.
Ankle Fractures
Ankle fractures can take a significant amount of time to heal, but the exact recovery timeline depends on the nature of the injury and the treatment methods. If you didn’t undergo surgery, your ankle might heal in 12 to 16 weeks. However, if you have undergone surgery to repair more than one bone in your ankle, it may take two years before your ankle is completely back to normal. It’s essential to adhere to the medication regimen, rest, and follow the recommended treatment protocol to ensure a speedy recovery. Oftentimes, ankle fractures lead to post-traumatic ankle arthritis in the future.
Get Treatment for Ankle Sprains and Fractures With Dr. Gary Driver
Ankle fractures and sprains are common ankle injuries. However, mistaking an ankle fracture for a sprain, or vice versa, can lead to serious consequences. Therefore, if you experience any type of ankle injury, it’s critical to get immediate medical attention, a diagnosis, and a comprehensive treatment plan. Dr. Gary Driver is a triple-board-certified, fellowship-trained foot and ankle surgeon who can accurately diagnose your ankle fracture or sprain and help you follow a personalized treatment plan for a lasting recovery.
FAQs
Can I walk on a sprained ankle?
Whether or not you can walk with a sprained ankle depends on the severity of the sprain. It’s generally not recommended to walk with a sprained ankle without a boot or a brace for support because that can lead to increased swelling and pain, as well as delay ligament healing, which will halt your recovery progress.
Can a sprained ankle turn into a fracture if not treated properly?
No, a sprained ankle cannot turn into a fracture because sprains affect ligaments, while fractures affect bones. However, not letting your ankle sprain or fracture heal can eventually lead to more severe, and possibly permanent, issues in the ankle joint.
What happens if I ignore a sprained or broken ankle?
Ignoring an ankle sprain or a fracture can lead to permanent damage to your ligaments or bones, which can cause chronic ankle instability. You will develop weakness, and it will be harder for you to walk, bear weight, or perform physical activities. Not receiving proper treatment for a sprained or broken ankle can also lead to further problems in your ankle joint, such as arthritis.
Can a mild ankle sprain heal on its own?
Yes. However, proper treatment is still crucial to strengthen the ligament and prevent sprains in the future.
When can I return to sports or physical activity after an ankle injury?
That depends on the extent of your injury and the severity of pain. Your doctor will be able to provide you with a personalized treatment plan and an estimated timeline for recovery. It’s essential to follow the doctor’s recommendations and obtain their confirmation before resuming sports or physical activity.
What’s the best way to reduce swelling in an injured ankle?
The RICE method is generally considered the best way to reduce swelling in an injured ankle, but you should always follow your doctor’s recommendations.
Citations
- American Academy of Orthopaedic Surgeons (AAOS). (2022). Ankle fractures (broken ankle). OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/ankle-fractures-broken-ankle/.
- American Academy of Orthopaedic Surgeons (AAOS). (2023). Sprained ankle. OrthoInfo. https://orthoinfo.aaos.org/en/diseases--conditions/sprained-ankle/.
