What is the Difference Between a Sprain and a Fracture?

In the classic Looney Tunes cartoons, there was a returning bit where a black female cat would accidently end up with a white stripe running along the middle of her back. A hopelessly romantic skunk, Pepe Le Pew, would fruitlessly pursue the feline, much to her annoyance. Despite her irritation, Pepe would continue his efforts in vain, to comic effect. Well, this illustrates that there are certainly times when it’s essential to accurately distinguish between two similar, yet rather different, things – just like knowing the difference between an ankle sprain and fracture!

It's easy to mistake ankle sprains and fractures from each other because they can result from similar events and have several common symptoms.

Both injuries can occur when an ankle is faced with excessive stress at an unnatural angle. An example of this is a misplaced step. It is rather common to land awkwardly on the outside edge of the foot, which will then either overstretch ligaments or cause a break in the bottom end of the fibula. Either way, you will likely experience pain and swelling in the affected ankle, but these are two different injuries.

When ankle ligaments are stretched beyond their intended range, it’s an ankle sprain. The joints in the ankle are complex and made up of numerous connective tissues that can become sprained due to abnormal motion (rolling, twisting). If you are able to place weight upon the affected foot, it is likely this is the injury you have suffered.

With a broken ankle, one of the bones—although, most often the bottom end of the fibula—has become fractured. Sometimes these breaks happen due to a single, traumatic event (like an accident). At other times, overuse leads to a stress fracture – a tiny crack formed by the cumulative force of repetitive action. This injury is often more painful than a sprain, and you will experience difficulty putting weight on the affected ankle (and especially with walking).