Is It a Sprain or a Fracture? When to See a Podiatrist for Your Ankle Injury

Most people who injure their ankles can’t tell right away whether they’re dealing with a sprain or a fracture. You twist your ankle stepping off a curb or land wrong during a pickup game, and the pain and swelling develop within minutes. The injury feels serious, but separating a bad sprain from an actual break isn’t as simple as most people think.

At Cascade Foot & Ankle Center in Provo and Nephi, Utah, board-certified podiatric surgeon and wound care specialist Jared Clegg, DPM, FACFAS, and our team help patients assess the severity of their ankle injuries and develop personalized treatment plans that promote complete healing.

Here’s how to tell the difference between a sprain and a fracture, and when you should seek professional care.

Understanding your ankle’s complex anatomy

Your ankle joint connects three bones: the tibia, fibula, and talus. Strong bands of tissue called ligaments hold these bones together and control movement. Sprains damage the ligaments, while fractures involve breaks in the bones themselves.

How you injured your ankle often gives clues about what happened inside the joint. Twisting motions typically affect ligaments, causing sprains. Direct impacts or severe rolling injuries can break bones. 

However, the same accident can cause both types of damage simultaneously, which is why you always need a professional evaluation for an ankle injury.

Key differences between sprains and fractures

While sprains and fractures can look similar at first, a few key signs help tell them apart:

Pain patterns and location

If you experience pain in the softer parts of your ankle, particularly on the outer or inner sides where ligaments attach, you’re more likely to have a sprain. Fractures hurt directly over the ankle bone itself. Press gently on your ankle bone. If that specific spot is exceptionally tender, it could be a fracture.

Sounds at the time of injury

Fractures often make a distinct cracking noise at the moment of injury. After a fracture, you might also hear or feel grinding or crunching sounds or sensations when you try to move your ankle.

Swelling and visible deformity

Both injuries cause swelling and bruising, but the appearance can differ. Sprains typically swell within hours, creating a puffy appearance around the affected area. Fractures can cause immediate, severe swelling. The bigger difference is in the shape of your ankle. If the alignment looks crooked, warped, or irregular, you’re probably looking at a fracture rather than a sprain.

Numbness or tingling

Sprains are painful but typically do not cause numbness. Fractures can cause tingling or numbness in the affected area. If you experience numbness, seek medical attention immediately, as this may indicate potential blood flow problems that require urgent care.

Weight-bearing ability

Can you walk on it? Many people with mild to moderate sprains can limp around, even though it hurts. Most fractures make walking extremely painful or impossible. If you can’t take a few steps without severe pain, a fracture is more likely.

Diagnostic tools that identify hidden injuries

Dr. Clegg uses several methods to determine the exact nature of your ankle injury and develop an appropriate treatment plan. 

Common diagnostic tools include:

• Physical examination with specific movements and pressure tests
• X-rays to show bone breaks and displacements
• MRI scans to detect ligament tears, cartilage damage, and bone bruising
• CT scans for complex fractures involving multiple bone fragments
• Ultrasound to evaluate soft tissue injuries and fluid accumulation

For injuries that remain unclear after initial testing, we may recommend additional imaging at follow-up appointments to catch problems that weren’t visible immediately after your accident. Some fractures and ligament tears only become apparent once the initial swelling decreases.

Expert ankle injury care in Provo or Nephi, Utah

Ankle injuries heal best when treated promptly with proper diagnosis and care in the early stages. Call Cascade Foot & Ankle Center or schedule an appointment online to have Dr. Clegg evaluate your injury and prevent long-term complications.