Difference Between Sprained Ankle vs Broken Ankle

Sportsman with sprained or broken ankle.

Twisting and injuring your ankle is a painful event. In a moment, your ankle can be injured with a wrong step. The ankle is a complex joint with muscles, ligaments and multiple bones that can be damaged. When you have an ankle injury, you could have a sprained or broken ankle, but they can have similar symptoms. Here is the difference between a sprained ankle vs broken ankle, including the anatomical variances, symptoms and treatments.

What Is a Sprained Ankle?

The ankle contains multiple ligaments that connect the different bones. Ligaments allow the bones to move independently, but still stay connected and in the right configuration. When the ankle is twisted beyond the normal range of motion, the ligaments can be stretched or torn. When this occurs, it is a sprained ankle.

A sprained ankle is a painful injury and can limit mobility until the ligaments heal. Ankle strains are similar but involve damage to the muscles and tendons in the ankle instead of ligaments. Since the ankle ligaments are responsible for ankle joint stability, it can be difficult or painful to balance or put weight on a sprained ankle. Symptoms of a sprained ankle include:

  • Pain, usually more on the outside of the ankle
  • Swelling and fluid retention
  • Limited movement
  • Redness and possible bruising

Sprained ankles can be mild to severe. In most cases, you can still put weight on the ankle, but it may be painful. Sprained vs broken ankles can heal on their own – most begin to feel better with rest, ice and elevation in a few days. Severe sprains may require longer recovery over a few weeks and in extreme cases, may require surgery to repair torn ligaments.

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What Is a Broken Ankle?

The symptoms of a sprained ankle vs broken ankle are very similar. Both can cause swelling, bruising, pain and limited function. While a sprain ankle involves damaged ligaments and soft tissues, a broken ankle involves fractures of the bones. This is a more serious injury and will require medical treatment to ensure it heals properly. Broken ankle symptoms can vary depending on which bones are fractured and the type of fracture. However, there are a few signs that an ankle is broken versus sprained:

  • No weight can be put on the ankle
  • There is a visible deformity to the ankle
  • Deep purple skin and bruising
  • Severe pain
  • Pain or tenderness when pressing on the outside of shin

Broken ankles do not feel better over time – they tend to become more painful. While a sprained ankle may be very painful at first, within a few days most sprains improve, and weight can be gingerly put on the foot. If you cannot put any weight on your ankle in 2-3 days, you likely have a broken ankle, not a sprain.

Treatment for broken ankles depends on the fracture. The fibula, tibia and talus all can be fractured and be diagnosed as a broken ankle. The tibia is the main shin bone on the inside of the lower leg and the fibula is the smaller shin bone on the outside. The talus is the bone that connects the foot to the shin to make the ankle joint. If the fractures are severe, surgery may be needed to align or connect the broken bones. However, many broken ankles can be reduced and set without surgery and then allowed to heal within a cast or boot.

Can an Ankle be Sprained and Broken?

If you have a severe injury, it can be difficult to tell a sprained ankle vs broken ankle because it is both. When there is impact to the ankle, it can fracture bones and tear ligaments at the same time. Car/motorcycle accidents, sports injuries, falls and other events that twist or impact the ankle can damage multiple components, including breaking bones, straining tendons and tearing ligaments.
A running woman stopped by ankle injury.

How Do I Know If I Have a Sprained vs Broken Ankle?

The best way to find out if your injured ankle is sprained or broken is to head to an urgent care facility or your doctor’s office. X-rays or an MRI may be ordered to check for tissue or bone damage. If you have severe pain and cannot put weight on your ankle, it is best to have it looked at right away to ensure it is not damaged further. If there are bone fractures, you want the bones aligned as quick as possible to ensure it heals correctly to prevent mobility issues in the future.

It is hard to tell the difference between a severe sprained ankle vs broken ankle without a medical diagnosis from a doctor. The best advice is to have any severe ankle injury examined to ensure you receive the best treatment for fast recovery.