Sprained Ankle or Broken Ankle?

Posted by on Monday, April 30th, 2012

The American Academy of Orthopedic Surgeons says that about 25,000 people every day sprain an ankle. Considering my own experience with missteps, twists, rolls and trips, I find this stat completely unsurprising. It is amazingly easy to do nutty things to your ankles.

If you just kind of bend your ankle, experience a little bit of an “Oww” and then go on, maybe with a few careful steps, then fine. It gets sticky, though, when your ankle is swollen and seriously hurts. Then you might find yourself asking one of life’s great questions: “Is this sprained…or broken?!”

Excellent questions! First let’s clarify the actual textbook difference between the two: a sprained ankle is a strain of the ligaments that connect bones; a broken, or fractured, ankle is when the bones themselves are damaged. Keep in mind, though, that if you break your ankle, you may also damage some ligaments along the way.

Now, order in the court ! Let’s do a cross-examination to determine which injury you have.

What happened? If you answer something like, “I took a bad step and twisted my ankle or rolled my ankle,” chances are you have a sprain. If you answer, “I tripped and fell, or dropped a rock on my ankle,” then you probably have a broken ankle.

Did you hear any sounds? If you answer, “I could have sworn I heard a kind of  popping sound,” you have a sprain. If you answer, “I thought I heard a cracking sound,” then you probably have a fracture. If you answer, “I couldn’t hear anything beyond my shrieks of pain,” then that probably is also another sign that you have a fracture.

Is it swollen? If you answer “Yes,” then, um….you have some kind of ankle injury.

Is it swollen, but also lumpy or crooked? If you answer “Yes,” then you probably have a fracture.

Do you have any numbness in the area of the ankle? If you answer yes, then again, that’s saying, “Fracture!”

Can you put any weight on it? If you answer in a very annoyed tone, “Yes, I can, but it hurts!!” then you probably have a sprain. If you try to put weight on it and your answer is “Oww!! Owww!!” followed by a collapse to the ground, then you probably have a fracture.

That last question seems like it should clear everything up, but sometimes a severe sprain can be so painful that it puts you in hesitation mode: “Is this a bad sprain or a break?” Moreover, high ankle sprains also make it difficult to put weight on your foot; the main difference there is that the pain with a broken ankle is more localized and there’s likely to be swelling and perhaps bruising, while high ankle sprains often don’t look bad. They just feel bad.

In the end, if you’re not sure, the best thing to do is see a podiatrist at The Center for Podiatric Care and Sports Medicine (212.996.1900) to get a clear diagnosis, probably by having some x-rays done. I know, no one wants to go to a doctor if they don’t have to, especially if you’re asking yourself the “broken or sprained” question late at night or while you’re on vacation and your only option is a long wait in an emergency room. But if you don’t have a correct diagnosis and you let an injury linger without the right treatment you’re going to create more trouble for yourself than if you just had it checked out in the first place; trying to patch it up yourself with some duct tape and paper clips may seem like a good idea, but trust me, it’s not. Besides, if you’re teetering on the edge of, “Yes, it hurts when I put weight on it, but I still am putting weight on it,” then even if it isn’t broken, you probably have a sprain that is so bad you’ll need some kind of treatment, whether it’s a brace, crutches, or potentially physical therapy down the road. Sprained ankles are an injury that people may shrug off, but they can get complicated. So get that ankle checked out!

If you have a foot or ankle injury, but aren’t sure what to do about it, contact The Center for Podiatric Care and Sports Medicine. Dr. Josef J. GeldwertDr. Katherine Lai, and Dr. Ryan Minara have helped thousands of people get back on their feet.



If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine LaiDr. Nadia Levy, and Dr. Ryan Minara have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.

39 Responses to “Sprained Ankle or Broken Ankle?”

  1. nancy says:

    what if my ankle is swollen and it hurts when i twist it but i can put weight on it perfectly?

    • cindy says:

      Nancy, it’s fine. My younger daughter is a dancer and soccer player and experiences it atleast once a week. This week she tripped and had a hard time with her ankle in dance class. She should be fine within two days.

  2. Philip says:

    What if I can’t put weight on it and it hurts to move it
    At all and it hurts all the eay to the pinky toe from my ankle?

  3. what if my ankle is swollen lumpy i can put a bit weight on it and it's fat? says:

    what if the ankle is swollen lumpy i can put a bit weight on it and it’s fat?

  4. Breanna says:

    i have all the symptoms of a fractured ankle. swollen, cant put ANY pressure on it, i am pretty sure that i heard a pop or crack but i couldn’t tell, and it has some discolorization, but it doesnt look as bad as the picture above. is it still a fracture or a really bad sprain??

  5. EmmilyValado says:

    Well i was walking down a fight of stairs and al of a sudden my ankle pushed to the side and i fell no pain but aot of swelling. I have had this incident happen to me 4 times in my life.
    i can put all my weight on my ankle and it does not hurt. Also i am very heavy in weight.
    Is this a broken ankle or a twisted.

  6. Ryan says:

    Hi i dont normally injury my self and i actually have never broke a bone but the other day at work i crashed my ankle into a moving cart machine it hurt me enough to stop and take my steel toe boot off and it swelled right up i kno i shud of told my work but i didnt ( idiot i know ) but anyway i continued working like the retard i am and went home to an ow ow as it says up there i can walk on it and all that but if i bend my foot upwards it hurts.. and the only reason im wondering is because from what people have told me theyve said a break hurts more then a sprain..so if theres any feedback for me let me know please

  7. hollie says:

    i think it is a sprain but i dont no. i kicked a really really heavy ball on the top of my foot near my toes and i cant move my ankle up or down without quite a bit of pain. it also hurts when i put pressure on it. it is swelling up too.

  8. carley says:

    K I was I was in gym when the bell rang to go to 4th period so i was going down the stairs of the bleachers and all of a sudden a fell I dont know if I tripped or wat and so when I fell my ankle bent so that the bottom of my foot was facing the other foot i could walk but it hurt and its been hurting for two days should I go to the doctor cause my teacher ms.bell said I was just being a hyprocodriac

  9. Troy Novaro says:

    I am a Pro wrestler and I had a bad landing after a stunt from the top rope, my foot went under me and I felt a pop the I couldn’t move it when I went to stand it popped again and feeling came back I pinned the guy and walked out since then its been swollen severely at first but not so bad now the swelling now has gone to the top of my foot on the second day it is slightly bruised but I can walk on it slightly i don’t feel much pain at all

  10. Valerie says:

    I am travelling in India, slipped on a wet mat, and am pretty sure fractured my ankle (from you descriptions/photos above), but who do you recommend here? Please help. Thank you.

  11. Tara Hall says:

    Eek! My 14 year old daughter twisted her ankle on a landing in dance…her ankle does not hurt at all but the whole side of her foot is hurting and swollen…she can not put any weight on it…she said she did hear a ‘sound’…when asked if it was popping or cracking she looked at me quizzically “Huh?” She’s my dragging herself across the floor because it throbs if she stands up…I think part of that is fun to slide across the wood floor…but geez, it’s a Saturday..ER visits will just xray it not set it…they will make her wait for orthopedist on Monday…so do I just wait for Monday? If she fractured that metatarsal, is it bad to wait 2 days? sigh.

  12. Taylor says:

    I was in Tae Kwon Do running backwards as last Friday was a conditoning day and when I took another step my ankle buckled and kinda rolled my mom says it’s fine and that I probably strained it but it’s slightly swollen and it hurts constantly when I walk on it. Any answer for me?

  13. theman says:

    i just sprained my ankle yesterday. it didnt hurt as much when i first rolled it. it ached badly 5 min after.. then the pain went away. for the rest of the daay till the evening then the pain was pretty bad…. then the next morning ( today) it was the worst pain i ever have had even when i broke my arm… so a sprain has a 10 of 10 of pain

  14. kim brewery says:

    My ankle was very swollen for bout 3 weeks could still walk on it though swelling has nearly gone 12. Weeks later but I sat down crossed legged the other day and heard a kinda crack click. Sound now its started to ache again there its still a bit lumpy to .

  15. Randall robert says:

    I had a torn tendon and I had a cast on but I got it removed. It’s been 4 weeks since I had my cast and I have been going to physical therapy but when I rotate my ankle it feels very stiff only when I just go on the ball of my foot. What should I do? I do everything my therapist tells me to do but it’s not helping. Should I ice it or just tell my doctor.

  16. Mallory says:

    i have all the symptoms of a fracture BUT my ankle is NOT swollen. it just hurts really bad to walk on it. i can move it but my whole foot is numb so it soes hurt that bad. i dont know what to do and i compete in a really big competition in FL in 3 days!!

  17. Violet says:

    I was playing outside last night and me and my friend were jumping on speech others back and tried to flip each other. But as I went to flip over her I got scared and hesitated and fell, my leg went behind my back and I heard and felt t pop 4 times, after that it felt really dumb. I am laying on my couch ugly now and I have not been able to sleep cause every time I move it it cause excruciating pain. Now I just turned 13 yesterday and I sent know if I should go to the doctors. Do I have a fractured ankle or a sprained ankle. And if I don’t go get this checked out will it cause me to have ankle pains in the future. My ankle is really swollen and red but it hasn’t turned colors yet.

  18. Samantha says:

    On the weekend, I got hit in the left ankle with a hammer, on the left side. It didn’ hurt at the time but the next night I had basketball training and I went ‘ Oh crap’ and almost fell on the floor, but I still pushed through basketball training. Since I go to a big school and I couldn’t put any pressure on it, my mum hired me crutches for a week, we have not been to the doc’s yet.

  19. Caitlin says:

    I do not know how I have received my injury, but it hurts to walk or even stand for more then 5 minutes. At some moments, a really sharp pain will enter my foot. I haven’t been to a doctor yet, but I have noticed that my foot is crooked and swelling. I also hear a cracking noise when I move it. But is it a sprain or fracture?

  20. Yoshiko says:

    Last night I was at gymnastics. At the end of the evening we went on the tumble track (trampoline track). The first thing I did was land on my left outer toe a little twisted upper body but a gentle landing with the very forgiving bouncy track. I did hear a pop like when cracking a joint in general. A familiar painful steps after rolling an ankle type in the past. No immediate big swelling but swollen around the outer ankle. Particularly over the inner portion of the outer ankle, and the pain can be pinpointed there with prodding. Hurt driving home pedal stepping with toes on the clutch, but better when pushing down with my heels. Annoying stiffness going up the front lower leg. Worst is when trying to turn my toes inwards resisting force when checking out my range of motion. I’m working two 3 week long expedition lined up bearing and pulling a lot of weight over glaciers, and up a mountain. Also walking downhill toes pointing downwards, and walking horizontally/diagonally with a flexed/rolled ankle etc. Need a lot of strength and flexibility with my ankle. Leaving next Tuesday! Been icing and taking Ibu since last night. Will I be ok?

    • Jenn F. says:

      Certainly this is not what you want to hear, but you’ll be hard-pressed to find a doctor who would say you’ll be find on this expedition. Perhaps you can find a mule to take you up the hill? Ankle instability and placing further stress on your bones can lead to overcompensation in other areas and conditions like posterior tibial tendon dysfunction. Taking it easy is the best thing you can do. You don’t want to end up in excruciating pain on the top of a mountain. Please contact Dr. Geldwert directly to see if there is any type of brace or precautions you can take as you recover: 212-996-1900 or by email: http://www.healingfeet.com/contacts.php. Thanks for reading!

  21. Lizzie says:

    Hi, when I walk my ankle REALLY hurts!!! I can barley walk on it! There is no swelling, or bruising or pain except for when I walk! Don’t know what to do!!! And in my school you have to have a doctors note for every little injury tht is wrapped or whatever!!! HELP

  22. allison m says:

    I was walking downstairs lost balance and fell a few stairs. At first it hurt to put pressure on my ankle/foot (ie driving) but I could tolerate walking. Today it hurts if I try to rotate it, no swelling, no bruising but if I touch the top near my ankle it really hurts.

  23. allison says:

    So I fell down the stairs a couple hours ago. Definitely heard a crack, it was loud. Couldnt walk on it and theres light bruising and serious swelling. Sprain or fracture?

  24. Greysen says:

    a couple of weeks ago i landed hard after a jump in a soccer game. when i landed my ankle did not twist but i heard a popping noise. i can walk fine now but i have a hard time twisting my foot to the outside and the pain i feel travels from the top of my foot to just above my ankle and it is slightly swollen on the outside of my ankle, is this a minor fracture of just a bad strain?

    • Jenn F. says:

      An x-ray is the only guaranteed way to know for sure, but… a “popping” sound is usually characteristic of a break. Persistent swelling and bruising that is still there the next day are also common signs of a fracture. The old adage “If you can walk on it, it’s not broken” is simply not true. We’ve had plenty of people walk into the office with a fracture of some sort. It’s unlikely you’ll require surgery, but immobilization is very important. In most cases, this requires a cast. Minor foot fractures may only need a removable brace or shoe with a stiff sole. Naturally, we recommend stopping in for a visit if you’re in the NYC area. With fractures, prompt, proper treatment is important to prevent the development of arthritis or complications that could keep you sidelined from the sport you love. Thanks for reading!

    • Kristen says:

      Sounds like I have the same injury that you did. Wondering if you got an X-ray? If so, was it fractured? Thanks!

  25. Marissa says:

    Back in 2010, I tripped over a rock. I didn’t think anything of it because I’m a klutz. After dropping my dad off at work, I got home and noticed that my ankle/foot was swollen and bruised. I then worked a 10hr shift, walking around and lifting 30 lb objects. After tripping, and throughout the day, I noticed the pain getting more and more intense. I didn’t have the means to see a doctor, so I ignored it. Now, 3 yrs later, I’m getting sharp pains on that same ankle. Also, there’s always a redness on the ankle, and if I’m walking on it too much, I get sharp pains throughou my ankle. There’s also a spot on the skin that … I’m sorry if it sounds gross … is like constant dead/peeling skin. If anyone can help me with this, that would be great. I know I need to see a doctor, however I don’t have the financial means to see one yet. Thanks!

  26. Jamie says:

    I’ve heard that sprains can hurt far worse than breaks. I’ve sprained my ankle many times. Mostly during softball. About 3 or 4 months ago, I hurt my ankle. My ankle still hurts but it’s not terrible unless I twist it a little. Whenever I move my ankle up or down it pops and starts to aggravate me. What’s up with it?

    • Jenn F. says:

      Ankle ‘popping’ can occur after sprains due to scar tissue, cartilage damage, or possibly from a dislocating tendon. No treatment is needed if the popping causes no pain. If pain is associated, I recommend you see an ankle specialist for evaluation.

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