Ankle Sprain vs. Fracture - Brace Direct

Ankle Sprain vs. Fracture

Your ankle supports your body weight and helps you move around. An injured ankle can leave you bound to the bed. 

The ankle functions by the collective working of various soft and hard tissues. It is a complex joint comprising multiple ligaments and tendons vulnerable to injury.

Trauma or injury to the ankle can lead to torn soft tissues or broken bones.

If you are suffering from shooting pain in your ankle, you might be unsure whether it is a sprain or a broken ankle. Both conditions can cause similar symptoms, including pain upon walking, tenderness, bruising, and swelling, rendering it somewhat hard to distinguish between them.

Accordingly, this article will discuss how to distinguish ankle sprain vs. fracture. Read on to learn more.

What Is an Ankle Sprain?

man holding his ankle in pain

An ankle sprain is one of the most common musculoskeletal complications. As per reports, an acute ankle sprain is the most common type of ankle injury. 

Players participating in team sports such as soccer, basketball, and rugby, etc., are most prone to developing ankle sprains. 

Injury can damage the ligaments or fibrous tissue that form the ankle joint, known as an ankle sprain. Repeated stress creates microtears in the ligament that can increase in intensity if not treated timely. 

The extent of ankle sprains is classified on the level of ligament tear. Stretching of the ligament is grade one. Minor ligament tears fall in the grade two category, while complete tearing of one or more ligaments is categorized as grade three.

Causes of Ankle Sprains

An acute ankle sprain is usually the outcome of a sports injury. However, the most common causes of ankle sprains include the following:

  • Abnormal twisting or rolling of the foot¬†
  • Persistent walking/ exercising on uneven surfaces¬†
  • Falls or landing awkwardly on the foot

What Is an Ankle Fracture? 

The different bones of the ankle region can break under excessive pressure, leading to an ankle fracture. The severity of ankle fractures can range from simple hairline fractures to complex fractures involving multiple bones requiring surgery. In the event of injury, you can fracture either of the three bones, i.e., the tibia, fibula, and talus. 

Causes of Ankle Fracture 

man holding his ankle in pain after playing soccer

Ankle fractures typically occur due to direct impact trauma. That include: 

  • Sports injuries injuries¬†
  • Road traffic accidents¬†
  • High-impact falls¬†

The risk groups for ankle fracture also include diseases that affect the bones. People with arthritis (osteoarthritis and rheumatoid arthritis) are more prone to fractures. Multiple myeloma is a cancerous disease that causes bone lesions and fractures. Opposed to ankle sprains, ankle fractures are more common in older individuals. 

How To Differentiate? Ankle Sprain vs. Ankle Fracture

Differentiating an ankle sprain vs. ankle fracture is a little complex. Symptoms like pain, bruising, swelling, and redness are common in both conditions. 

However, some noticeable differences and signs can help tell the two apart. 

How Do I Know if I Sprained My Ankle?

Noticing the sound at the time of injury can explain the underlying damage. A ‚Äúpop‚ÄĚ sound is common during ligament tears immediately after the impact, suggesting a sprained ankle.¬†

Pain due to a sprained ankle occurs in the soft tissue of the ankle instead of the bone. The intensity of the pain associated with a sprained ankle is generally mild-to-moderate. An ankle sprain will be sore and limit the range of your motion; however, you will be able to bear weight on the ankle despite the pain. 

In most cases, a ligament tear does not affect the ankle alignment. Grade 3 ankle sprains can change the foot appearance but without altering the alignment,

Swelling and bruising in an ankle sprain does not develop immediately but gradually. It is also localized and occurs to a lesser extent. 

How Do I Know if I Broke My Ankle?

man checking woman's ankle after injuring her ankle

It generally requires a lot of force to break a bone, like a direct blow. You might hear a cracking or crunching sound at the time of injury. 

While you will feel pain in both cases, the severity and sharpness of fracture pain are much higher than a sprain. Ankle fracture sprain is mild at the time of injury but intensifies with time. You will feel this pain upon touching your ankle bone. 

A differentiating feature between an ankle sprain and a fracture is the presence of nerve symptoms. There is a high incidence of superficial peroneal nerve injury following ankle fracture. Involvement of the nerve leads to different symptoms, including:

  • Numbness¬†
  • Paraesthesia¬†
  • Burning¬†
  • Tingling¬†

If you feel your foot is heavy or numb, there is a significant chance of an underlying ankle fracture. 

The swelling and bruising associated with an ankle fracture are quick to develop. You will notice an immediate accumulation of fluid. The area around the fracture site quickly becomes red, swollen, and warm. The broken bone is tender and painful to touch. The rapid appearance of symptoms indicates a fracture. 

Your ankle is responsible for bearing the weight of your body. The inability to put weight on the affected ankle is a crucial feature of ankle fractures. If you suffer from a fracture, you will not be able to put weight on your foot and walk. 

Some individuals cannot press on their affected foot immediately after the fracture, while others experience the inability after several hours or even days. 

Unprotected weight-bearing can lead to further damage to the structures. Thus, if you feel difficulty bearing weight, we recommend you avoid trying it repeatedly. Consult a doctor for immediate medical attention.

Complications of Ankle Sprain and Fracture

Untreated ankle injuries can lead to different consequences. Chronic ankle instability is a condition in which the ankle gives away. According to a study, almost 20% of all ankle sprains convert into ankle instability.

It is a secondary disability that results from improper and incomplete healing of an ankle sprain. Individuals with ankle instability experience repeated twisting and turning of the ankle. You may also notice wobbliness or instability in the foot when traveling on uneven surfaces or even while walking. 

Unchecked ankle fractures can cause permanent deformity of the foot, preventing you from walking forever.  

Ankle fractures can also lead to other complications. Osteomyelitis, i.e., a bone infection, can occur when the exposed bone gets infected by bacteria. Open fractures have a high chance of getting infected. 

Compartment syndrome is a rare fracture complication characterized by swelling and pain. According to a study, tibial fractures are frequently associated with compartment syndrome. 

Diagnosing Ankle Sprain and Fracture 

doctor examining and ankle fracture

Your physician will diagnose your condition by physically examining the affected ankle and its range of motion. They will check for any deformity and likely order an X-ray for a proper diagnosis if they suspect a fracture.

For further clarity, advanced imaging like CT scans, MRI scans, and ultrasounds may also be advised to determine the extent of the damage.

Treatment of Ankle Sprains and Fractures

While ankle sprains and fractures present identical symptoms, their treatment differs.

Management of Ankle Sprains 

elevated leg with an ice pack on the ankle injury

Managing ankle sprains is relatively easier. Self-care can effectively heal acute ankle sprains. The best way to treat an ankle sprain is to follow the RICE approach, i.e., rest, ice, compression, and elevation. 

Taking sufficient rest and limiting pressure on the affected foot allows the damaged ligament to heal. Applying an ice pack on the injured ankle for 15 minutes several times can reduce swelling and warmth. Compression of the ankle (with an elastic bandage) helps avoid further increase in swelling. Elevating your foot above your heart while sleeping promotes drainage of fluid accumulation.

Painkiller medicines also provide symptomatic relief. Non-steroidal drugs such as ibuprofen and naproxen sodium effectively alleviate swelling and pain. 

Physical therapy is an effective, non-invasive treatment modality to manage ankle sprains. Manual therapy has proven to have positive outcomes in treating inversion ankle sprains. Physiotherapists help improve blood supply and speed up the healing process. 

Ankle support devices do a fantastic job of promoting healing and preventing further damage. You can use ankle support braces or an elastic bandage to take the pressure off the foot. Casts and walking boots are also effective for ankle sprains. 

Management of Ankle Fractures 

Ankle fractures warrant immediate medical attention and can not heal correctly with home remedies. Over-the-counter painkillers such as acetaminophen can lower the pain intensity in most cases but not heal the condition. 

In mild or moderate cases, you might have to wear a cast on the foot or use a crutch to immobilize the ankle joint and avoid putting weight on it. This immobilization allows proper healing of the bones.

Your doctor might realign the ends of the fractured bone. Based on the feasibility, fractured bone can be reduced manually (by hand), i.e., closed reduction, or via a surgical approach, i.e., open reduction. 

In more extreme cases, surgical intervention might be the only option. The orthopedic surgeon uses pins, screws, or plates to hold the bone in place. 

Physical therapy can help realign the ankle and foot while boosting the healing process and improving the range of motion. 

How Can I Prevent Ankle Injuries?

man and woman stretching outside before exercising

You can prevent ankle injuries by strengthening the tissues of the foot. An exercise program is a great way to recover from and prevent injuries. Building strong bones with proper nutrition can also help prevent injuries.

Warming up before exercise or sports by light stretching and flexing is also crucial. 

If you experience ankle pain during an activity, it is essential to stop and rest till the pain subsides to prevent the symptoms from further aggravating.

Individuals prone to ankle injuries should use appropriate muscle braces to prevent unusual twisting of the ankle.


If you are experiencing ankle pain following strenuous exercise or other physical activity, it is helpful to know the difference between an ankle sprain vs. fracture. Using the information provided above will help you determine the best course of action. Additionally, following a proper warm-up routine can help prevent injury in the future. 

If you believe you have suffered an ankle injury, seek prompt medical advice.