Blog Post

You stumbled and you’re experiencing a lot of ankle pain. A bad ankle sprain can sometimes feel as bad as a broken ankle — but how do you know the difference when an injury happens? 

At Northeast Orthopaedics & Sports Medicine, with convenient locations in Schertz, New Braunfels, Live Oak, and San Antonio, Texas, our fellowship-trained orthopedic specialists can help you quickly figure out what you’re dealing with and design a proactive healing plan that gets you back to your life fast.

Here, our sports medicine team explains how ankle sprains and fractures happen and the key differences between them.

What happens during an ankle injury?

The ankle is one of the most complex joints in the human body. It’s made up of several bones, ligaments, cartilage, and tendons that smoothly interact to help you walk, run, jump, and balance. 

With each step you take, your ankle joint sustains tremendous stress — up to 13 times your total body weight when running. All of this stress isn’t a problem when your ankle functions normally, but when you roll your foot or land badly from a step or jump, it can severely strain any of the tissues in the ankle. 

This can involve sprains, fractures, or both. In fact, around 40% of ankle fractures also involve an ankle sprain.

That’s why sprains and fractures frequently occur in similar circumstances and can feel alike at first.

Understanding ankle sprains

An ankle sprain occurs when the ligaments that support the joint stretch excessively or tear. Sprains often happen during sports, when walking on uneven surfaces, or during sudden directional pivots.

Sprains may range from slight ligament stretching to severe tears.

Understanding ankle fractures

An ankle fracture means that one or more of the bones in the joint has cracked or broken. Some fractures are small and look like tiny cracks in the bone. Others may involve a larger break or even a complete break where the bone separates into two or more pieces. 

Fractures can happen in the same ways that sprains occur, although with fractures the impact at the time of injury may be harder.

Telling the difference between an ankle sprain and fracture

Although symptoms can overlap with these ankle injuries, the following symptoms may help you determine whether you’re dealing with a sprain or a fracture.

Pain and location

Most ankle sprains affect the ligaments in the outer ankle — the lateral ligament complex — so the pain tends to center on the outside of your ankle as a whole.  With fractures, the pain is often more focused in a specific area. A severe sprain can hurt as much as a fracture in some cases.

Swelling and bruising

Both sprains and fractures can cause swelling and bruising. Fractures can change the appearance of the joint itself, causing a badly misshapen look. 

Ability to bear weight

Many people with a sprain can still put some weight on the ankle, even though it’s painful to do so. With a fracture, standing or walking can be impossible.

Sounds or sensations 

At the moment of injury, a sprain may cause a popping sensation or sound. A fracture feels or sounds more like a snap. 

If any of these symptoms are familiar, don’t continue using your ankle because you could worsen the injury. Prompt treatment can jump-start healing and help prevent long-term problems like instability or post-traumatic arthritis.

Have you suffered an ankle injury? Call the Northeast Orthopaedics & Sports Medicine office in your area or book your appointment online now.