Signs That An Ankle Injury May Actually Be A Fracture

How do you tell if the pain or discomfort you feel is an ankle sprain or is actually a fracture?  

An ankle sprain is caused by the stretching or tearing of one of more of the ligaments. Most ankle sprains result from injuries to the syndesmotic ligaments that connect the lower end of the shin bones to the ankle bone.

Fractures, however, can range from the tiniest of cracks to a bone break that could pierce your skin. Fractures can occur because of weak bones or lack of muscle tone, although this is not always the case. You could suffer a heel fracture without any apparent cause, fall or blow.

Below are the five ways you can tell if you have a sprain or maybe a fracture.

Can you place weight on your foot?

With a sprain, most people are still able to walk and place weight on their foot. With a fracture, the pain is usually significantly increased and may make it difficult to do this. However, there are exceptions.

Is the pain persisting?

Both ankle sprains and fractures will most likely cause pain, and you will need treatment to manage that pain. With a sprain, it is helpful to rest the area, apply ice as this will reduce the pain and swelling, apply compression to help decrease swelling and elevate the ankle. This is known as the RICE method. After around a week of such treatment, pain from a sprain should start to reduce. If it persists beyond this point, then there is a higher likelihood of something more severe than just a sprain causing the pain.

Does the pain spread to the bones?

Ankle injuries are very common. The ankle is where the tibia, fibula and talus (ankle bone) are joined. Joint injuries are most likely to cause pain along the outside edge of these bones as this is where the ligaments are attached. However, a fracture will often create a broader and deeper pain than a sprain and can also cause nearby tendons and muscles to feel painful.

Pressing along the ankle bone will not necessarily cause pain if it is a sprain but probably will if it is a fracture. Check also the fifth metatarsal bone, which is the long bone on the outside of the foot that connects to the small toe. Fractures here are commonplace.

Does the bone protrude?

When you sprain or fracture a bone, swelling occurs around the area and with a broken bone; this is immediately caused by a haematoma that is bleeding from the fracture fragments. In a case of a fracture, there may be some deformity or even bone breaking through the skin. 

Is there bruising and does it extend up the leg?

Bruising is a sign of either a sprain or a fracture. Ligaments are located at the tips of the bones in the ankle, so bruising will tend to show up in those areas. Bones are very vascular and have a lot of blood flow, resulting in more bruising.

The bruising is caused by the blood vessels and capillaries rupturing and will appear as blue/black marks. The swelling that often accompanies the bruising is caused by the fluid accumulated in the injured area.

When the fracture occurs along one of the leg bones, the bruising may spread from ankle to leg bone, travelling some way up the leg.  

So, as you can see, although sprains and fractures are two very different injuries, the symptoms can be very similar. Unless you can actually see broken bone protruding, it may not be very obvious which injury you have, and an examination and x-ray will be required to determine whether it is a fracture or something less serious.  

Whatever the injury, a podiatrist can help with the recovery process and give you the advice and assistance you need. So including a podiatrist in your recovery plan is a wise move. 

*This blog contains general information about medical conditions and is not advice. You must not rely upon the information in this blog as medical advice. Medical advice should always be sought from an appropriately qualified podiatrist such as ourselves.