If you’ve recently hurt your ankle, you may be concerned that you have a sprained or broken ankle. Distinguishing between them can be difficult and an accurate diagnosis often requires an X-ray or other imagining test.

In this article we’ll look at the differences between a sprain and a broken ankle, and how these injuries are treated.

A sprained ankle is an injury to the ligaments of your ankle. Ligaments are dense pieces of connective tissue that hold your ankle bones together and help stabilize your joint.

Sprains usually occur when you suddenly twist your foot and overstretch your ligaments. Most often, the ligaments in the outer part of the foot get sprained. It’s less common to sprain your inner ligaments.

Some potential causes of a sprained ankle include:

  • walking or running on an uneven surface
  • landing on the side of your foot when running, jumping, or pivoting
  • twisting your ankle while falling
  • rolling your ankle while walking or running
  • having somebody land on your foot while playing sports

Most sprained ankles are minor injuries, but they can range in severity depending on the amount of damage to your ligaments. The severity of an ankle sprain can vary as follows:

  • Grade 1 sprain. One or more ligament is overstretched but not torn. You’ll likely be able to move your foot normally after a few days, and it will likely heal within 2 weeks.
  • Grade 2 sprain. A ligament is partially torn and your doctor may be able to feel instability when they move your ankle. It may take 6 to 8 weeks to heal.
  • Grade 3 sprain. The ligament is completely torn. It may take 3 to 6 months or longer to regain full strength and mobility.

Many people mix up the terms sprain and strain. However, the two injuries affect different structures in your body.

  • A sprain is an injury to a ligament connecting two bones together.
  • A strain is an injury to a muscle or a tendon that connects your muscle to the bone. A strain is also known as a pulled muscle or torn muscle.

A broken ankle — also called an ankle fracture — is when one or more of the bones around your ankle joint breaks.

There are three bones that make up your ankle joint. They include your:

  • tibia or shinbone
  • fibula, the smaller long bone in your lower leg
  • talus, the bone above your heel bone and below your fibula and tibia

Broken ankles are a relatively common injury that make up about 15 percent of ankle injuries seen in emergency departments. The severity can vary from a hairline fracture to a displaced fracture that requires surgery.

There are many potential causes of a broken ankle, but usually the injury results from a twisting injury. A broken ankle can also be caused by direct impact to the ankle, such as a car accident or a sports-related impact.

If you have a clean break that doesn’t require surgery, you can usually fully heal within 6 to 8 weeks. If you need surgery, it may take anywhere from 12 weeks to 2 years to regain full function of your ankle.

The symptoms of a broken and sprained ankle are similar, and the injuries can be difficult to tell apart, especially in cases of serious injuries that involve a lot of swelling. It’s also possible to have both a sprain and a fracture.

Sprained ankle symptoms

Broken ankle symptoms

  • immediate sharp pain (often more painful than a sprain)
  • bruising
  • swelling
  • tenderness
  • a visible deformity (especially if your ankle is also dislocated)
  • trouble bearing weight on your foot

Asking yourself the following questions may help you narrow down what type of injury you have.

However, you should still have a medical professional examine your ankle even if you think you know what type of injury you have.

It’s important to get medical attention if you think you may have broken your ankle, or if you have severe pain, swelling, or bruising after injuring your ankle.

Your doctor or healthcare professional will carefully examine your ankle, foot, and lower part of your leg. They’ll also check for tenderness and move your foot to get an idea of how well you can move your ankle joint.

If your injury is more severe, your doctor may recommend one or more of the following imaging tests to help them accurately diagnose your injury:

Even though the symptoms of a sprained and broken ankle are similar, the treatments are quite different.

Treatment for a sprained ankle

Treatment for a sprained ankle aims to:

  • reduce pain and swelling
  • restore your full range of motion
  • return your ankle to full strength

For the first few days, you can follow the RICE method to reduce swelling:

  • Rest. Stay off your feet as much as possible.
  • Ice. Ice your foot for 15 to 20 minutes every 2 to 3 hours.
  • Compression. Wear an elastic bandage that provides compression around the injured area.
  • Elevation. Elevate your foot above the level of your heart when you’re resting.

You can also take over-the-counter pain relievers like ibuprofen to help manage pain.

Once the swelling passes, your doctor may recommend that you visit a physical therapist. A physical therapist can put together a customized plan of stretches and exercises to help restore the function of your ankle.

Surgery is rarely needed to treat ankle sprains.

Treatment for a broken ankle

With a broken ankle, your treatment plan will vary based on the location and severity of your fracture. Generally, it may include:

  • Immobilization. You’ll likely need to wear a protective boot or cast to give your bone time to heal.
  • Closed reduction. Your doctor may need to insert pins through your skin to realign the two ends of your bones if you have a displaced fracture.
  • Surgery. More severe breaks may need surgery to ensure your ankle bones stay aligned during the healing process.
  • Physical therapy. Once your bone is healed, a physical therapist can give you a customized stretching and exercise plan.
  • Pain relievers. Your doctor may recommend over-the-counter pain relievers such as Tylenol to help manage pain.

The best way to speed up your recovery from any injury is to listen to the advice of your healthcare professional and to follow their instructions.

Sprained and broken ankles have similar symptoms. If you think you’re dealing with either, it’s important to visit a medical professional for a proper diagnosis.

A broken ankle is a more severe injury than a sprained ankle. With a clean break that doesn’t need surgery, recovery can take around 6 to 8 weeks. If you need surgery, recovery will take longer.

With a minor ankle sprain, it may take around 2 weeks to heal. However, if a ligament is partially or completely torn, it can take longer to fully recover.