Fractured vs. sprained ankle - how to tell the difference?
Be it from an on or off the court experience, many can relate to ‘rolling an ankle’ or other traumatic ankle event. Reported over 2.1 million times a year in Australia alone, these injuries are as notoriously painful as they are debilitating.
One of the initial challenges with an ankle injury is that it is not always obvious whether it is fractured, and whether it has been sprained (damage to the ligaments). This is because intense pain, swelling and bruising are signs common to both, where even moderate sprains can sometimes be accompanied by aggressive bruising.
Unfortunately, ankle injuries happen very often, and many people will attempt to ‘walk it off’ or ignore them. However, neglecting an ankle injury can result in poor healing, including reduced range of motion, weakness, and impaired balance. These factors increase the risk of future injury, and it is important to get the right diagnosis and treatment early on.
What are the symptoms of a fractured ankle?
Localised pain – If you can point with one finger at a bony surface where you are feeling pain (rather than the entire general ankle area), this could suggest a fracture.
The four key areas to check (highlighted in red):
Outer ankle:
6cm above the ankle
The bony point (fifth metatarsal) on the outside of the midfoot
Inner ankle:
6cm above the ankle
The bony point at the top of your inner arch (Navicular bone)
Deformity – If your ankle seems misshapen or your foot doesn’t really look like it lines up with your leg, this could suggest a fracture or dislocation.
Weightbearing - If you are unable to place your bodyweight on your foot immediately after the injury and in the emergency department for four steps.
If you have answered “Yes” to any of the above, we strongly recommend getting an X-ray as soon as possible to confirm or rule out a fracture.
What happens if my ankle is fractured?
If a fracture is confirmed, treatment will vary depending on where and which bones are broken, and the severity of the fracture. Your ankle will either need to be immobilised (in a cast or boot) or you may require surgery. Both will undergo a period of limited weight-bearing and activity restrictions, and the average healing time can range from 6-12 weeks. This is then followed by a period of active rehabilitation and physiotherapy.
What are the symptoms of a sprained ankle?
One of the most common causes of ankle sprains is when the foot is twisted, and the ligaments on the outside of the ankle are overstretched. To determine the severity of your injury, a physiotherapist will assess the following symptoms:
Bruising and swelling
The nature and severity of your pain
Specific areas of soft tissue that reproduced your pain
Signs of numbness, pins & needles, reduced blood circulation
Your ability to place your bodyweight on the injured foot
Treatment for a sprained ankle
With the right guidance and treatment, a sprained ankle normally recovers between 4-12 weeks, depending on the severity. This is generally achieved by an initial phase of rest and encouraging soft tissue healing, followed by treatment (such as manual therapy, taping) and a guided exercise program. Conveniently, this is now known as the "“PEACE & LOVE” principle:
What about strapping?
The purpose of taping is to support the weakened ankle as it heals to prevent re-injury. In our experience, it is also a visual reminder for you and the people around you to be careful.
Physiotherapists are experts in strapping and can teach you how to tape to your specific injury. Be sure to let your physiotherapist know if you are allergic to adhesives. Otherwise, you can always request for a test strip first.
How to strap a sprained ankle
Watch our video of a typical strapping done by a physiotherapist:
How can physiotherapy help?
As experts in movement, physiotherapists are skilled in evaluating and designing a rehabilitation plan for your ankle injury.
Visit a physiotherapist for an assessment, where you will be given a variety of exercises to target range of motion, balance, strength for your ankle recovery. Manual therapy can reduce your pain and stiffness, and the exercises are designed in proportion to your stage of recovery.
Whether you want to get back into running, your football training, or your gym routine, we help you set key targets towards your personal recovery goals.
Let us help you with your ankle recovery - get in touch with our team via the contact form or book an appointment to discuss how we can help.
The information in this article is only intended to serve as a guide and should not be used to make a diagnosis. Sterling Physiotherapy recommends seeing your GP or physiotherapist for an appropriate assessment if you are concerned about an injury to your ankle.