Sprained Ankle Vs. a Broken Ankle. What’s the difference?

What Are the Main Differences Between Broken and Sprained Ankles?

A doctor is most experienced at telling the difference between a sprain or a fracture. When examining your ankle injury, the doctor will gently touch the ankle to decide where the pain is most intense.

• If touching the skin over a ligament causes pain, the ligament is may be torn. (called a sprain)
• If touching the skin over a bone causes pain, the bone may be fractured.

Sprains

Ankle sprains are stretches or tears in the ligaments that hold the ankle in place.

Signs of a sprain may include:

• pain, tenderness, bruising and swelling, particularly around the outside of the ankle joint.
• pain or weakness when putting weight on the injured ankle and difficulty using it normally.
• less often, muscle spasms or cramping, where your muscles painfully tighten on their own.

Broken Ankle (Fracture)

Ankle fractures can affect the bump of bone on the outside of the ankle, which is the end of the lower leg bone(fibula). Or they can affect the bump on the inside of the ankle, which is the end of the larger leg bone (shinbone, or tibia), or the back of the shinbone, or both.

If a doctor has examined your injured ankle, they may take x-rays when:

• you have pain around the ankle bumps
• you’re unable to put weight on the injured ankle without help, immediately after the injury AND later in the emergency department or doctor’s office
• you’re unable to walk 4 steps with or without limping
• you have bone tenderness just above or just below the ankle bumps.

Other possible signs of an ankle fracture may include:

• symptoms that last more than a few days - it can take up to 24 hours for the full bruising to show.
• the ankle joint looks like it’s at an odd angle or out of line after an injury (this may also be a sign of joint dislocation)

If your ankle is very swollen or you have spasms, your doctor may give you a splint, which is a device to stop your joint from moving for a few days. This is to allow the swelling to go down enough to examine the joint again.

Getting medical advice for an injured ankle

If you've injured your ankle and you think it may be badly sprained or broken it’s important to seek medical help immediately. Call 111 or go to your nearest A&E if you experience any of the following after an ankle injury:

• Severe pain, bruising or swelling, or if these symptoms are getting worse
• It hurts to put weight on it, it’s stiff or difficult to move
• You have a high temperature or feel hot and shivery
• Your ankle is at an odd angle, or a bone is sticking out
• You have a bad cut or wound
• Your toes are blue, white or feel numb
• You’ve treated it at home and it’s not getting better

How to Treat Sprained Ankles

Treating sprains and strains at home

For the first couple of days, follow the 4 steps known as RICE therapy to help bring down swelling and support the injury:

• Rest – stop any exercise or activities and try not to put any weight on the injury.
• Ice – apply an ice pack (or a bag of frozen vegetables wrapped in a tea towel) to the injury for up to 20 minutes every 2 to 3 hours.
• Compression – wrap a bandage around the injury to support it.
• Elevate – keep it raised on a pillow as much as possible.

Don’t:

To help prevent swelling, for the first couple of days try to avoid:

• heat (such as hot baths and heat packs)
• alcohol
• massages

Do:

When you can move the injured area without pain stopping you, try to keep moving it so the joint or muscle does not become stiff.

Pain relief for sprains and strains

Pain relief is available from pharmacies for minor conditions, in the form of tablets, plasters or gels that can be applied to the skin.

Pain relievers include:

• Paracetamol to ease the pain, taken by mouth as capsules or tablets
• Ibuprofen to bring down swelling, rubbed on the skin as gel, or applied as patches.
• Nurofen products contain Ibuprofen, which can provide superior pain relief to paracetamol in acute pain.
• Nurofen Joint & Muscular Pain Relief 200mg Medicated Plasters containing ibuprofen, can relieve the pain of ankle sprains for up to 24 hours per plaster, when applied to the skin. They can be used for up to 5 days and the flexible plaster conforms to the ankle joint, to allow for normal movement.
• Nurofen Joint & Back Pain Relief Max Strength 10% Gel containing ibuprofen provides soothing relief where it is applied and penetrates the skin rapidly to help relieve inflammation in tissue and joints such as the ankle.
• If needed, Nurofen Express Liquid Capsules 200mg provide effective relief faster than standard ibuprofen^** and up to 8 hours relief^††.
  ^**refers to absorbtion
  ^††with a 400mg dose

If you’re unsure of which treatment is best for you, speak to a pharmacist or your GP.

Physiotherapy for sprains and strains

If you have a sprain or strain that's taking longer than usual to get better, a GP may be able to refer you to a physiotherapist.

Treating an Injured Ankle

While you're waiting to see a doctor

There are some things you can do:

• raise your ankle if possible
• gently hold an ice pack (or a bag of frozen peas) wrapped in a towel on your ankle for 15 to 20 minutes every 2 to 3hours
• stop any bleeding – put pressure on the wound using a clean cloth or dressing
• wrap your ankle loosely in a bandage to help support it (if your ankle is not at an odd angle)
• remove any jewellery on your ankle or toes
• use painkillers such as paracetamol or ibuprofen gel (or ibuprofen tablets). Remember not to use more than one ibuprofen containing product at a time.
• don’t eat or drink anything in case you need surgery
• don’t move or put weight on your ankle if possible

When you see a doctor

You'll usually have an X-ray to check if your ankle is broken (fractured) and to see how bad the break is. Some minor fractures may not need treatment, but a doctor will decide what is best for you. More serious breaks may require a special boot or plaster to help support or hold your ankle in place while it heals. Sometimes the bones may need to be moved back into place or surgery to fix the broken bones.

Once you’ve been treated, your doctor will usually ask you to come back for follow-up appointments to check that your ankle is healing properly.

Some Causes of Ankle Injuries

• The ankle is a complicated joint, capable of a wide range of movement in several directions and angles that allows us to move and balance on level and uneven ground. The ankle is placed under a lot of force because it supports our full body weight, particularly while we’re running and jumping.

You may be more likely to injure your ankle, if:

• you often participate in sport, particularly basketball, football, volleyball, and climbing
• you don’t exercise regularly - less strength, flexibility, and co-ordination can weaken muscles and joints, making them less flexible
• your exercise technique is poor, which may cause excessive pressure on joints or muscles
• you don’t warm up enough before and cool down after exercising, which may lead to muscle fatigue and less support for joints.
• you wear the incorrect footwear, increasing the risk of sprains
• you move in a way where the foot is forced up or down or rolls in or out, increasing the risk of an ankle fracture

Ways to Avoid Ankle Injuries

Although you can’t always prevent sprains and strains you can decrease the likelihood by wearing walking boots that protect the ankle (rather than shoes) when hiking over hills or uneven ground, or for manual labour. If you often participate in sport, you’ll also want to follow the tips below, to help avoid ankle injury.

Tips to Reduce Ankle Pain Whilst Running or Doing Exercise

You may find that these strategies help lessen the likelihood of ankle injury when doing exercise or sport:

Warm up

Before exercising, try doing an aerobic activity at an easy pace to gently increase your heart rate and get your body and muscles ready for more intense activity.

Cool down

After exercising, gradually decrease your exercise intensity level until your breathing and heart rate have returned to normal. Then do gentle stretches whilst your muscles are still warm

Use the correct equipment.

• Wear appropriate shoes and replace shoes as they wear out
• Wear comfortable, loose-fitting clothes that allow free movement

Follow a balanced fitness programme

Try to follow an exercise routine that incorporates the 4 functional fitness pillars: cardiovascular exercise, strength training, balance and flexibility. Add new activities and exercises gradually and with caution. Avoid exercising or playing sport when you’re tired or you’re in pain. Be sure to take regular days off from exercise.