Is My Ankle Sprained or Fractured?

Uneven pavement, a faulty step, a slide tackle on the soccer field — your ankles probably aren’t top of mind until you feel that unmistakable twinge of pain signaling injury. Made up of bones, cartilage, tendons and ligaments, your ankle is the fulcrum point that links your leg to your foot, allowing the foot to move up and down and side to side independently of the leg. These are all essential movements in walking, running, climbing stairs and playing sports. But this delicate connector is also vulnerable to damage, with ankle sprains or fractures among the most common orthopedic injuries among all age groups. 

Is it Strained, Sprained or Broken?

An ankle strain is when the muscles or tendons overstretch or tear.  With a sprain, it’s the ligaments that overstretch or tear. Strains and sprains can occur when the ankle twists from a misstep or impact. With more than 23,000 cases a day in the U.S. alone, ankle sprains and strains are one of the most frequently seen injuries by healthcare providers — and that number doesn’t include minor injuries treated at home. Ankle strain and sprain symptoms may include:

• Swelling

• Bruising

• Tenderness to the touch 

• Instability and weakness 

By contrast, an ankle fracture is when one of the bones in the ankle breaks or cracks, occasionally from the same types of unexpected movements as a sprain, but more often due to blunt force. Automobile accidents are the leading cause, and in severe cases of compound fractures, the bone may puncture the skin. The symptoms of a fracture can include those of a sprain/strain, as well as:

• Inability to bear weight 

• Decreased range of motion

• Increased pain

Treating Common Ankle Injuries

In most cases, follow the RICE regime (rest, ice, compression and elevation) and take an anti-inflammatory medication such as ibuprofen. If your ankle is still swollen after 24 to 48 hours, or you have reduced mobility and significant bruising, see an orthopedic specialist who can determine whether there are ligament tears, any damage to the cartilage or broken bones. 

If you have an ankle strain or sprain, your doctor may prescribe a walking boot or cast to immobilize your ankle while it heals. You also may see a physical therapist to help restore flexibility and strength with exercises such as foot flexes and seated stretches.

If the injury turns out to be a fracture, more extensive evaluations and solutions will be needed. Imaging diagnostics may include: 

• X-Rays to show if a bone is broken or displaced and in how many places. Added pressure during an X-ray, called a stress test, can help determine next steps.

• A computed tomography (CT) scan, which creates a cross-section image of the ankle and is especially useful when the fracture extends in the joints.

• A magnetic resonance imaging (MRI) scan, which provides high-resolution images of both bones and soft tissue such as ligaments. 

Once your doctor determines the severity of the injury, they’ll recommend an appropriate treatment that may include a cast or surgery. Ankle fracture treatment requires extended healing with your foot in a nonweight-bearing position to allow the bones to heal. 

Tips To Prevent Ankle Injuries

While you may not be able to prevent an ankle injury from an accident, there are some steps you can take to minimize damage and avoid strains and stress fractures.

• Develop your ankle joints through exercises that encourage ankle strength and flexibility, such as walking or running on lower-impact surfaces.

• Wear well-fitting shoes and avoid unlevel or underlit areas.

• Reduce added strain on bones and ligaments by maintaining a healthy weight.

• Eat a healthy diet that includes vitamin D and calcium — essential building blocks for healthy bones and tissue.