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Ankle Bone or Joint Injury

Sprained Ankle vs Broken Ankle

Minute Read


Posted 4 months ago


Last updated: 03/12/2022


by James McCormack

How to tell the difference between a Sprained Ankle and a Broken Ankle?

A common question on social media is how to tell the difference between a sprained ankle and a broken ankle. It can be difficult to decipher even for a medical professional based on symptoms alone, as there is a lot of cross-over in the symptoms of each condition. This article will detail what a sprained ankle and a broken ankle are and try to help you understand the critical clinical differences we try to identify when a patient attends one of our clinics.

Anatomy is essential for differentiating between the two, so first of all, 3 bones make up the ankle: the Talus, Fibula and Tibia. There are lateral ligaments on the outside of the ankle, strong ligaments at the front and deltoid ligaments on the inner aspect of the ankle.

Sprained Ankle vs Broken Ankle: Symptoms

A sprained ankle is a tear or sprain to one or more ligaments of the ankle. Symptoms of a sprained ankle include a sudden onset of pain with a twisting or turning motion. The location of the pain is over the injured area, and it is common for there to be swelling almost immediately around the affected ligament.

A broken ankle bone has an immediate onset of pain and swelling that can be associated with an audible click or popping noise. It is usually too painful to bear weight or walk on a broken ankle, and in the acute stages, patients often report a numb sensation that is not present with a sprain.

Sprained Ankle vs Broken Ankle: Causes

A sprained ankle occurs most commonly in the lateral ligaments of the ankle; a sudden twist causes a sprain of these ligaments, turn or slip, whereas a broken ankle is often the result of direct trauma to the ankle joint from a tackle or a fall.

Stress fractures of the ankle can occur innocuously, while a sprained ankle typically has a definitive mechanism of injury.

Sprained Ankle vs Broken Ankle: Diagnosis

A Physical therapist can evaluate an injured ankle for a fracture based on a patient’s symptoms; pain on hopping and pain on palpation of the affected bone. Still, a broken ankle requires an x-ray to confirm the diagnosis.

A physical evaluation, including special clinical tests such as an anterior drawer or talar tilt tests, is sufficient to diagnose a sprained ankle. Some cases may require a scan to identify the severity of a sprained ankle; an MRI is the gold standard form of imaging.

Sprained Ankle vs Broken Ankle Treatment

A sprained ankle can be managed with a comprehensive rehabilitation protocol consisting of strengthening, stretching and balance exercises that should become increasingly difficult over a 4-8 week period, while a severe sprain may require 12 weeks of rehabilitation.

A stable broken ankle requires 4-6 weeks in a walker boot to allow the bone to unite before commencing a similar rehabilitation protocol to that of a sprained ankle; however, there usually is more muscle atrophy associated with a broken ankle from the time spent in the boot.

Sprained Ankle vs Broken Ankle: Conclusion

It is difficult to differentiate between a sprained ankle and a broken ankle. Therefore, we always recommend seeing a medical professional for a diagnosis if you have ankle pain before beginning self-guided treatment.

Physiotherapy with James McCormack

This is not medical advice and we recommend a consultation with a medical professional such as James McCormack before trying any of these exercises. James offers Online Physiotherapy Appointments for £45.

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