Ankle Sprain vs. Fracture Treatment

The American College of Sports Medicine reports that 25,000 ankle sprains happen daily, accounting for nearly half of all sports-related injuries. Ankle fractures are less common, occurring 187 times among every 100,000 people. However, both sprains and fractures can be problematic and may keep you off your feet for an extended period unless the right treatment plan is prescribed. 

Here are a few things you should know about ankle sprains vs. fractures that will ensure you recover in as little time as possible.

Ankle/Lower Leg Anatomy

Understanding basic ankle and lower leg anatomy will help you understand how ankle injuries occur and the difference between a sprain and fracture. 

Three bones come together to form the ankle joint, which is responsible for moving the foot up and down:

  • The tibia is the shin bone, the larger bone in the lower leg. The tibia connects to the knee joint and the ankle joint. The knobby protrusion on the inside of your ankle is part of the tibia.
  • The fibula is a smaller bone that runs perpendicular to the tibia. The bony protrusion on the outside of your ankle is part of the fibula.
  • The talus is a bone in your foot located just above the heel bone.

Just below your ankle joint is the subtalar joint, which allows your foot to move from one side to the other. Numerous ligaments and tendons surround the ankle and subtalar joint, providing stability and allowing the bones to adhere to one another.


Illustrated anatomy of a foot and ankle   


Difference between Sprain and Fracture

Each foot comprises 26 bones, 30 joints, and over 100 muscles, tendons, and ligaments that support, balance, and enable mobility. Because feet are one of the most complex parts of the body, they are susceptible to injury, especially for individuals participating in high-impact sports. Ankle sprains and fractures are common foot injuries, but how are they different?

The difference between a sprain and a fracture is pretty simple. An ankle sprain occurs whenever there is damage to a ligament surrounding the ankle joint. A fracture involves a crack, or break, in one of the three bones that make up the ankle joint. 

When trying to remember the difference between an ankle sprain vs. a fracture, remember that a sprain is soft tissue damage, while a fracture is a break in your bone. 

Although ankle fractures are much more severe, they are often difficult to distinguish from sprains and may produce many of the same symptoms. In fact, sometimes sprains are actually more painful than fractures. 

To determine whether an injury is a sprain vs. a fracture, your doctor will usually take an x-ray. X-rays are also used to determine the degree and type of injury. 

Common Types of Ankle Sprains

These are some of the most common types of ankle sprains: 

  • Inversion or lateral ankle sprain: this most common type occurs when the foot becomes overly inverted, causing the outer ligaments to stretch beyond their normal capabilities.
  • Eversion or medial ankle sprain: occurs whenever the foot rolls toward the inside, stretching the medial or deltoid ligament.
  • High ankle sprain: occurs when there is a sudden twisting of the ligaments near where the tibia and fibula meet.

Degrees of Ankle Sprains

Ankle sprains are classified into three different degrees:

  • 1st-degree: the least severe form, it happens whenever the ligaments are merely stretched rather than torn. Mild pain, swelling, and stiffness are common.
  • 2nd-degree: the most common type, it involves a partial tear to one or more ligaments. With a second-degree sprain, moderate pain, bruising, and loss of motion may be noticed.
  • 3rd-degree: the most serious, resulting in a complete tear of a ligament. A third-degree sprain may result in severe pain and make walking very difficult.


Illustrated anatomy of a normal ankle vs. sprained ankles


Types of Fractures

More serious ankle injuries can result in a hairline crack or fracture, which may be classified as one of the following:

  • Lateral malleolus fracture: involves a fracture to the fibula bone only. It is the most common type of fracture.
  • Medial malleolus fracture: characterized by a fracture only in the tibia bone.
  • Bimalleolar ankle fracture: a severe injury in which there is a fracture in both the fibula and tibia bones.


Anatomy of an ankle fracture


Common Causes for Ankle Sprains & Fractures

Any movement that results in instability of the foot or ankle may cause a sprain or fracture. The odds are greater when performing a strenuous activity that requires very fast, side-to-side motions, such as in basketball or tennis. 

Other causes include

  • Slip and fall accidents on wet or icy surfaces
  • A loss of balance such as when falling down stairs or stepping off a curb the wrong way
  • Performing running or other high-impact activities while on hard surfaces
  • Improper footwear, particularly high-heeled shoes among women

Benefits of Physical Therapy

Many people shrug off ankle sprains as no big deal; however, recent research from the University of North Carolina suggests that such an injury has long-lasting effects. A study performed on college students with chronic ankle instability (which often results from a sprained ankle) showed that these individuals moved significantly less than others. 

Another report published in the Journal of Orthopedic & Sports Physical Therapy¸ revealed that 70% of those who sprain their ankles will continue to have problems with them and that 80% will suffer a subsequent sprain. While most sprains can heal on their own, physical therapy is important to rebuild strength in your ankle and prevent future injuries. 


Person in sneakers standing on balance board


Even though there are differences between a sprain and a fracture, they both require care. You should seek out physical therapy to treat an ankle injury. Property treatment can improve balance, endurance, and flexibility to promote good healing. Restoring proper ankle function is key to improving strength and preventing future injury.

No matter if it’s a sprain vs. fracture, your physical therapist may prescribe exercises to increase your range of motion, in addition to showing you ways to modify certain movements to avoid putting too much stress on the ankles. 

If you are bothered by an ankle sprain or fracture, please contact us today to schedule a consultation. We can be reached at or our main office at 570-208-2787. A Doctor of PT is ready and willing to answer all your questions!

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