Ankle injuries are very common, especially among athletes and active individuals. The two most frequent types of ankle injuries are sprains and fractures.
While both involve damage to the ankle, there are key differences between a sprained ankle and a broken ankle in terms of severity, symptoms, causes, diagnosis, and treatment.
This article will compare sprained versus broken ankles in depth.
Sprained Ankle vs Broken Ankle: What’s the Difference?
A sprained ankle is an injury to the ligaments that connect and support the ankle bones. It occurs when the ankle rolls, twists, or turns beyond its normal range of motion, overstretching or tearing the ligaments.
A broken ankle is a fracture or break in one or more bones that make up the ankle joint. It usually results from trauma, impact, or sudden forceful twisting of the ankle.
While both ankle sprains and fractures cause pain and swelling, a broken ankle typically presents with more severe symptoms and an inability to bear weight due to bone damage. Knowing how to distinguish between a sprain and a fracture is key for proper first aid and recovery.
Symptoms of a Sprained Ankle vs Broken Ankle
A sprained ankle usually causes:
- Pain or tenderness over the injured ligament
- Swelling around the ankle joint
- Bruising from ruptured blood vessels
- Difficulty bearing full weight on the injured foot
- Loss of range of motion and stiffness in the ankle
Meanwhile, the most common signs and symptoms of a broken ankle include:
- Severe pain when trying to bear weight or walk
- Significant swelling, often within hours of injury
- Bruising and discoloration around the ankle
- Obvious deformity or joint instability
- Bone protruding through the skin (open fracture)
- Numbness or tingling below the ankle
The inability to place any weight on the injured foot without intense pain is a hallmark sign of a broken ankle. The joint may also appear deformed or out of place with a fracture.
Causes and Risk Factors Of Both Issues
Here are some major causes and risk factors involved with ankle sprains.
- Rolling the foot inward while landing from a jump
- Stepping off an uneven surface like a curb or stepping onto an irregular surface and twisting the ankle
- Stumbling, tripping, or falling and landing with an inverted ankle
- Sudden changes of direction or pivots while running that tweak the ankle joint beyond its normal range
Risk Factors That Can Predispose An Individual To Ankle Sprains Include:
- A previous ankle sprain which can weaken the ligaments and joint stability
- Weak muscles surrounding the ankle that cannot adequately support the joint
- Participating in sports with frequent jumping, cutting, or pivoting motions
- Improper or poorly fitted footwear that does not provide enough traction and ankle support
- Obesity which places more strain on the ankle ligaments
Broken ankles have some different common causes:
- Falling from a significant height and landing directly on the ankle
- Twisting the ankle with extreme force as may occur during contact sports
- Direct blow or trauma to the ankle such as from an object or another player
- Severe high-impact accidents like car crashes
Those most at risk for broken ankles include:
- Older adults with osteoporosis or osteopenia resulting in weaker bones more prone to breaking
- Athletes playing high-intensity sports like football, soccer, basketball, and snowboarding
- Individuals with medical conditions affecting bone health and density
- Those taking medications long-term like steroids that can weaken bone and increase fragility
While sprained ankles often result from an inward rolling ankle motion, broken ankles more commonly stem from sudden trauma and extreme force through the ankle joint.
Diagnosing a Sprain vs Fracture
Doctors can usually diagnose a sprained ankle from a physical examination. They will check for point tenderness over the injured ligaments.
Also, they will assess for instability when gently moving the ankle in different directions. In addition, they will test the ability to bear weight both while standing and during walking.
They will also check for limitations in range of motion in the ankle joint. Moreover, they will look for swelling, bruising, or deformity.
They may order X-rays or additional imaging tests like an MRI. This is to confirm the sprain severity and rule out an occult ankle fracture not visible on initial exam.
To diagnose an ankle fracture, doctors will order X-ray imaging. They will also frequently get CT or MRI scans.
This allows them to fully visualize the broken bone(s). It also helps guide treatment planning. Doctors will check for bone displacement or dislocation at the break site.
They will also assess for multiple broken fragments or comminution. In addition, they will look for widening of the ankle joint space.
This indicates instability. Moreover, they will check for associated injury to tendons, ligaments, or soft tissues surrounding the fractured bone.
Doctors can sometimes diagnose an obvious ankle fracture on exam alone. They will look for significant swelling, inability to bear weight, and visible joint deformity.
However, imaging tests are always required to determine the exact location and classification of the fracture.
Treating Sprained vs Broken Ankles
Treatment for a sprained ankle focuses on the RICE protocol in the first 2-3 days. This involves rest, ice, compression, and elevation.
Rest means avoiding any activities that put weight on the injured ankle to allow the ligaments time to start healing. Putting weight on a sprained ankle too soon can lead to increased swelling and pain.
Ice should be applied intermittently for 15-20 minutes at a time to reduce swelling and pain around the injured ligaments and joints. Cold therapy constricts blood vessels, limiting bleeding and inflammation.
Compression using an elastic wrap or ankle brace can help restrict swelling and provide support. Ankle braces should fit snugly without restricting circulation.
Keeping the ankle elevated above heart level promotes drainage of fluid buildup and swelling. Elevation is most effective when combined with icing and compression.
Later treatment for sprained ankles may include over-the-counter pain medication, immobilization, physical therapy, braces, and sometimes surgery for complete ligament tears.
For broken ankles, treatment is focused on stabilizing the fracture for proper healing. This typically involves:
- Splinting followed by a hard cast or walking boot for 6-8 weeks to immobilize the ankle and prevent displacement of bone fragments
- Surgery for certain displaced or unstable joint fractures to realign the bones
- Strict non-weight bearing until follow-up imaging indicates the bone is mending
- Physical therapy after the fracture has started to heal to regain strength and mobility
During the recovery process, it is important that you wear high-quality ankle braces. Wearing ankle braces can provide much-needed support to your ankle whether it is sprained or recovering from a fracture.
Returning Back To Your Daily Workout Regimen
Individuals recovering from mild to moderate ankle sprains can often resume light exercise within 1-2 weeks. However, pivoting, cutting, and high-impact sports should be avoided for at least 4 weeks post-injury to allow the ligaments to fully heal.
Most patients need to refrain from any intense workout for a minimum of 8-12 weeks after sustaining a broken ankle. Light cardiovascular activity can potentially be introduced after 6-8 weeks if approved by the orthopedic surgeon.
Sports and exercises that produce jarring impacts or ankle twisting won’t typically be permitted until at least 12-16 weeks post-fracture to ensure the bone has completely healed.
It is essential to follow all activity restrictions outlined by the treating physician. Returning to an intense workout too quickly after either injury can cause repeat damage or complicate recovery.
Working with a physical therapist to develop a gradual return to sports program can help prevent re-injury.
Preventing Future Ankle Sprains and Fractures
Many sprains and fractures are preventable through proper strength training, ankle bracing, and activity-appropriate footwear.
- Wearing shoes designed for the sport with adequate lateral support and traction
- Taping or bracing ankles during activities requiring pivoting, jumping, or cutting
- Improving balance and ankle proprioception with wobble board exercises
- Strengthening lower leg and core muscles to enhance ankle joint stability
- Stretching and warming up ankle ligaments pre-exercise
- Rehabilitating fully after prior sprains before returning to sports
Those at risk for osteoporotic fractures can additionally benefit from having bone mineral density testing done, especially around age 50.
Consuming adequate calcium and vitamin D supports bone health and can help prevent fractures. Incorporating weight-bearing and muscle-strengthening exercise routines also helps maintain bone density.
If osteoporosis is diagnosed, taking bone-targeting medication may be recommended to strengthen bones and reduce fracture risk.
Making living areas safer by removing tripping hazards, adding grab bars, and improving lighting can also help prevent fractures in those with weaker bones. Taking a multifaceted approach is key to reducing fracture risk in populations prone to osteoporosis.
While no prevention measures are perfect, following suitable precautions tailored to the individual can help reduce ankle injury rates.
Frequently Asked Questions
How do I know if my ankle is broken or sprained?
A broken ankle usually causes immediate severe pain, swelling, inability to bear weight, and visible deformation. A sprain causes milder pain, swelling, and bruising but no obvious deformity.
Is a sprained ankle more painful than a break?
No, a broken ankle is generally much more painful than a sprained ankle. The broken bone causes severe pain when any weight is put on it.
Can you still walk on a broken ankle?
No, you should not walk on a broken ankle because it risks damaging the joint further. A broken ankle requires immobilization for proper healing.
Can you walk on a sprained ankle?
Yes, you can usually walk on a mildly sprained ankle, though with a limp. More severe sprains may require a boot or crutches to avoid putting weight on the injured ligaments.
What Heals Faster? Sprained Ankle or Broken Ankle
A sprained ankle generally heals faster than a broken ankle. This is because ligament tears require less regeneration time compared to broken bones that must rebuild lost bone tissue.
With appropriate treatment, most patients make a full recovery after an ankle sprain and achieve normal ankle function.
However, a small percentage of severe sprains lead to chronic pain and instability, requiring surgery or bracing.
You have to be quick and careful in getting both of these issues treated as soon as you can.