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How Do I Know If My Ankle Is Sprained or Broken?

How Do I Know If My Ankle Is Sprained or Broken?

You injured your ankle. Now you’re hobbling around with a tender and swollen lower limb, and you’re trying to figure out next steps — hopefully less painful steps.

The two most common ways to injure your ankle are spraining the joint or breaking ankle bones — and the two are very different, even though they share many of the same symptoms.

While coming to see us is really the only way to definitively determine what’s going on inside your ankle, the team here at William Schell, MD, with board-certified orthopedic surgeon Dr. Schell at the helm, can provide you with a few rules of thumb.

So, if you’re wondering whether you’re dealing with a sprained ankle or a broken ankle, here are some points to consider.

Sprained ankles — a matter of soft tissues

Each year in the United States, around two million people sprain an ankle. Since these are just the ones who seek help, there could be many more sprains that go unreported. Whatever the final tally, the point is that ankle sprains are incredibly common and affect everyone from athletes running around on a field to someone stepping off a curb awkwardly.

When you sprain an ankle, you damage the ligaments that connect the bones in your ankle joint. In 90% of cases, ankle sprains occur because of your foot turning inward, which stretches and tears your anterior talofibular and calcaneofibular ligaments on the outside of your ankle.

There are also different degrees of sprained ankles, and the more the ligaments are damaged, the worse the symptoms, which include:

We want to point out that a bad ankle sprain can be a more severe injury than a mild stress fracture, so don’t assume that a sprain is better news than a fracture.

Ankle fractures — hard tissue damage

Your ankles are where three bones come together, and a broken ankle can involve any of the three, including the:

  1. Tibia — shinbone
  2. Fibula — a thin bone that runs toward the outer leg from the knee to the ankle 
  3. Talus — a bone that’s located between your heel bone the tibia and fibula

Broken ankles are far less common than sprained ankles, but they still account for 15% of ankle injuries.

The symptoms of an ankle fracture are much the same as a sprained ankle — pain, tenderness, bruising, and swelling. 

Differentiating between ankle sprains and broken ankles

Absent an X-ray machine, there are some ways to make an educated guess about what’s going on in your ankle. For example, if you see an obvious deformity in your ankle, it points toward a dislocated bone and a fracture.

How you injure your ankle can also guide us — when you twist or rotate your ankle, an ankle sprain is often the result. When it comes to a broken ankle, there’s usually more trauma involved — you land badly from jumping or you were in an accident in which your ankle was struck.

The duration of your symptoms can also be indicators — when you break your ankle, the pain is immediate and gradually gets better as the bone heals. With a badly sprained ankle, the pain can get worse if you don’t seek treatment.

Making matters more confusing is the fact that you can have both a sprained ankle and an ankle fracture at the same time.

We feel that your ankles are important and that, if you’re feeling pain and having trouble walking, you should come see us. A quick X-ray can shed some much-needed light about what's going on inside your ankle, allowing us to get you back to moving without pain.

For expert diagnosis and care of your ankle injury, please contact our New York City office, which is located on Columbus Circle on the Upper West Side.

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