Is My Ankle Broken or Sprained? And What Do I Do About It?

Jan 9, 2019

Athletes, often to their own detriment, are normally quite accustomed to “playing through the pain.”

This is especially true at the pro level. In fact, according to one study, almost 4 out of 10 players at the 2010 World Cup took painkillers before every game.

But it’s also common at every level, since athletes tend to be wired pretty similarly—whether they’re playing for eternal glory on a global stage, or just playing for bragging rights at the local park. Hey, if you can still run, you can “run it off,” right?

Unfortunately, no. And this mentality often causes athletes to, among other things:

  • Underestimate the seriousness or severity of any ankle injury, particularly sprained ankles
  • Fail to recognize that their “sprained ankle” may in fact be a broken

But trust us on this one: there’s really no such thing as a “minor” ankle injury, in the sense that you can just sort of ignore it and everything will turn out fine. Even grade I sprains can get a whole lot worse in a hurry if you don’t treat them properly.

And if there’s even a chance that something may be broken, you are definitely going to want to find out as soon as possible.

Unfortunately, far too many times, we see athletes hobble in with “bad sprains,” then have to tell them after the X-ray that their problem is far worse than they originally thought. (Not only that, but also far worse than it would have been if he or she had come in earlier.)


Defining Some Terms

Before we go too much further, let’s define some terms so we know we’re all on the same page.

A broken ankle seemingly has a pretty obvious definition—one or more bones in the ankle have to be broken.

That said, it is worth noting that there’s a lot of variation here, because ankles are complex things. There are actually three bones that are directly involved in the ankle joint:

  • Ankle bone (talus)
  • Shin bone (tibia)
  • Calf bone (fibula)

A break in any of these bones, or even more than one of them at a time, could be considered a “broken ankle.” And the severity of the injury can range from a simple break in a single bone (which may even be possible to walk on, albeit painfully), to multiple unstable fractures in multiple bones (which will definitely stop you from walking, if not radically deform your ankle).

Now, let’s talk ankle sprains.

A sprain is, simply put, an injury to a ligament—usually overstretching or tearing. Ligaments, in case you weren’t aware, are tough-yet-flexible tissues your body uses to connect bones to each other and keep joints stable. There are, in fact, no fewer than eight major ligaments in your ankle joint alone.

If you’re a smart cookie, you may have noticed something about these definitions: they aren’t mutually exclusive. In other words, your ankle could be both sprained and broken at the same time. In fact, this is often the case.

And that’s another big reason why so many broken ankles go initially unrecognized by injured athletes (and sometimes even undiagnosed by careless physicians). The symptoms of the sprain may be “hiding” the break underneath, which may only reveal itself on an X-ray.

Symptoms of an Ankle Injury (and How to Tell the Difference)

The ankle is, almost certainly, the single most commonly injured body part in athletic training and competition—at least if we’re talking about serious injuries that would cause you to miss playing time.

(Considering how much power and explosiveness athletes need to transfer through the ankle joint when running or jumping, how much pivoting and direction shifting they need to do, and vulnerable the joint is to, say, a mistimed slide tackle … well, it’s not really surprising.)

Some of the most common symptoms you might experience, whether the injury is a sprain or fracture or both, may include:

  • Pain that gets worse when bearing weight
  • Swelling
  • Bruising
  • Tenderness when you touch the ankle
  • Restricted movement or motion in the joint
  • Instability or wobbliness
  • A districting “popping” noise or sensation at the moment of injury

So, with all this going on, how exactly would you tell the difference between a sprain or a fracture—especially a mild-to-moderate (relatively speaking) break?

Ankle Sprain

It’s not always 100% possible without an X-ray unfortunately. Still, since breaks are more severe injuries generally, the following signs are all pretty strong evidence that a break is likely:

  • You heard a “crack” rather than just a pop at the moment of injury
  • Bruising and swelling are severe
  • Location of tenderness—as you might expect breaks tend to be the most painful to the touch directly on bone, whereas sprains tend to be most tender in the softer parts surrounding the ankle.
  • Numb or tingling sensations—not all broken ankles will cause these symptoms (some are just really painful), but if you do experience them a break is probably to blame.
  • Deformity in the ankle—while both injuries cause swelling and a severe sprain can cause the joint to fall out of alignment if the tears are really severe, if your ankle looks “not quite in the right place” it is highly likely that you’ve broken it.

One thing to keep in mind, though, is that if you suffer any kind of painful ankle injury that you think could be at least a sprain, you should stop bearing weight immediately and get a professional evaluation.

The axiom “better safe than sorry” definitely applies here.

Best case scenario, it’s just a mild sprain and you can treat it yourself in a couple of days. And if the injury turns out to be worse than you expected, we can get you on the fast track to full recovery as early as possible.

Worst case scenario? You underestimate the injury and continue to train and play, and it gets worse and worse. By the time you come see us, you could have a severe sprain or break that requires a much longer healing time.

And because your injury was not treated properly in the early stages and was not able to heal completely, you may be at significantly higher risk for:

  • Chronic ankle pain and instability
  • Future sprains (which can progressively make the ligaments weaker and weaker and continue to increase the likelihood of re-injury)
  • Early onset of post-traumatic arthritis

Colorado’s No. 1 Choice for Sports-Related Ankle Injury Care

Dr. Yakel is trusted by amateurs and pros alike, including the players of the Colorado Rapids, to provide exceptional care for ankle sprains and fractures.

That’s because we’re focused on getting you back in the game as quickly as possible, with advanced treatment options to accelerate healing and personalized treatment plans that fit your sport, training schedule, and personal goals.

We can even provide you with a full biomechanical gait analysis and set you up with orthotics or even cleat recommendations that will not only reduce your future injury risk, but actually help you improve your performance on the field.

So don’t underestimate your ankle injury. Get the facts, and the best treatment options modern medicine can offer, by contacting the experts at the Colorado Center for Podiatric Sports Medicine today. Just dial (720) 600-3380, or complete our online contact form to get started.

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