How to Tell If It’s a Sprain or Fracture

When you twist your ankle or fall awkwardly, it can be hard to tell if you’ve experienced a sprain or something more serious, like a fracture. The symptoms often overlap, but knowing the difference is important for getting the right treatment and healing properly.

At Barrington Orthopedic Specialistss, our expert team of foot and ankle surgeons, including Dr. Lynette Mahoney, Dr. Raymond O’Hara, and Dr. Narendra Patel, specializes in diagnosing and treating a full range of foot and ankle injuries. Whether you’re dealing with a mild sprain or a more complex fracture, we offer personalized, advanced care to help you heal with confidence. To get started, you can schedule your appointment online or call our office.

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Let’s take a closer look at how to tell the difference between a sprain and a fracture—and what steps to take for proper recovery.

What Is a Sprain?

A sprain is an injury to the ligaments, the tough bands of connective tissue that hold bones together and stabilize joints. Sprains occur when a joint is forced beyond its normal range of motion, often by a sudden twist, turn, or impact.

This overstretches or tears the ligament, leading to pain, inflammation, and reduced joint function. Sprains commonly affect the ankle, but can occur in any joint.

Symptoms of a Sprain

Pain around the affected joint, especially when moving or bearing weight
Swelling and bruising, often developing within hours of the injury
Limited range of motion or stiffness in the joint
Popping or tearing sensation at the time of injury
Difficulty walking or using the joint, depending on severity

Sprains are typically graded based on severity:

Grade I (Mild): Ligaments are stretched but not torn; minor swelling and discomfort
Grade II (Moderate): Partial ligament tear; noticeable swelling, bruising, and joint instability
Grade III (Severe): Complete ligament tear or rupture; significant swelling, pain, and loss of joint stability

How to Treat a Sprain

Initial care for most sprains involves the R.I.C.E. method:

Rest: Avoid putting weight or stress on the joint to prevent further injury.
Ice: Apply an ice pack for 15–20 minutes every 2–3 hours until swelling and pain improve.
Compression: Use an elastic bandage or compression wrap to help control swelling and provide light support.
Elevation: Keep the injured limb raised above heart level to reduce swelling.

Depending on the severity, additional treatment may include:

Immobilization with a brace, splint, or walking boot to protect the joint and allow healing.
Anti-inflammatory medications (NSAIDs) to relieve pain and swelling.
Physical therapy: Targeted exercises to restore range of motion, strength, balance, and flexibility, and reduce the risk of future sprains.
Crutches or a cane may be recommended for lower extremity sprains to assist with mobility during the early recovery phase.

If pain persists, worsens, or the joint feels unstable, it's important to be evaluated by a specialist to rule out fractures or more serious ligament injuries.

What Is a Fracture?

A fracture refers to a break or crack in a bone, often resulting from direct trauma, such as a fall, collision, or sudden twisting motion. Fractures can vary in severity, from tiny hairline cracks to complete breaks that shift the bone out of alignment. They may occur anywhere in the body, but are especially common in the foot, ankle, wrist, and long bones of the limbs.

There are several types of fractures:

Stable fracture: The broken ends of the bone remain aligned and in place.
Displaced fracture: The bone fragments are misaligned and may require surgical intervention.
Comminuted fracture: The bone is broken into three or more pieces.
Stress fracture: A small, hairline crack caused by overuse or repetitive force.
Open (compound) fracture: The broken bone pierces through the skin, increasing the risk of infection.

Symptoms of a Fracture

Sudden, sharp pain at the time of injury that may worsen with movement
Immediate swelling, bruising, and tenderness at the site
Visible deformity or limb that appears bent, twisted, or out of place
Inability to bear weight or use the affected limb normally
Grinding or popping sensation with movement
In some cases, numbness or tingling if nerves are involved

If you're unsure whether you’ve sustained a sprain vs. break in your foot or ankle, it’s best to consult a specialist right away for imaging and diagnosis.

How Fractures Are Treated

Treatment is tailored to the type, location, and severity of the fracture, as well as the patient’s age, activity level, and overall health. Common options include:

Immobilization: A cast, splint, or walking boot is used to stabilize the bone and allow it to heal naturally over several weeks.
Pain management: Anti-inflammatory medications and other pain relievers help reduce discomfort and inflammation.
Surgery: Severe, unstable, or displaced fractures may require surgery. This may involve:
- Closed reduction (manipulating bones back into place without cutting the skin)
- Open reduction and internal fixation (ORIF) using metal screws, plates, or pins to stabilize the bone
Physical therapy: Once the bone begins to heal, rehab exercises help restore strength, flexibility, and range of motion. This is especially important after long periods of immobilization.

If untreated, fractures can heal incorrectly (malunion), delay healing (nonunion), or lead to chronic pain and joint dysfunction.

Key Differences Between Sprains and Fractures

Because sprains and fractures can share similar symptoms—like swelling, bruising, and pain—it’s not always easy to tell them apart without imaging. However, there are some key signs that can help guide your next steps:

Type of Pain

A fracture typically causes sharp, sudden pain at the exact moment of injury. The pain may worsen with any attempt to move or bear weight. A sprain, on the other hand, usually leads to dull, aching, or throbbing pain that develops gradually and intensifies with activity or movement.

Swelling and Bruising

Both injuries cause swelling, but fractures tend to swell faster and more dramatically. Significant bruising may also appear quickly around a broken bone, while sprain-related swelling often builds over time.

Deformity or Abnormal Positioning

A visible lump, bend, or misalignment near the joint is a strong indicator of a fracture. Sprains may cause swelling and tenderness but rarely lead to an obvious deformity.

Mobility and Weight Bearing

A fracture often makes it nearly impossible to bear weight or move the injured area without intense pain. With a sprain, movement is painful but generally still possible—though limited and uncomfortable.

Sound or Sensation at Injury

People with a fracture may hear or feel a snap at the moment of injury. A sprain might involve a pop or tearing sensation when the ligament is overstretched.

When in doubt, it’s always safest to have the injury examined by a foot and ankle specialist. X-rays or other diagnostic imaging can confirm whether the injury is a fracture or a sprain and help guide proper treatment.

When to Seek Medical Attention

While some mild sprains can be managed at home, it's important to recognize when professional care is needed. Early evaluation can prevent long-term complications and support a smoother recovery.

You should seek immediate attention from a foot and ankle specialist if you experience:

Severe or worsening pain that limits your ability to walk or stand
Inability to bear weight on the injured foot or ankle, even with support
Visible deformity or unnatural joint position that may indicate a fracture
Persistent numbness, tingling, or changes in skin color, which may signal nerve or circulation issues
Rapidly increasing swelling or bruising, especially if accompanied by throbbing pain or instability

If you're unsure whether your injury is a sprain or fracture, don’t wait. Prompt diagnosis with imaging and orthopedic evaluation ensures you receive the right treatment from the start.

Prevention Tips to Avoid Future Injuries

Reducing your risk of sprains and fractures starts with consistent, mindful habits—especially if you’ve experienced an injury in the past. Here’s how to help protect your joints and stay active safely:

Wear the right footwear: Choose supportive, activity-specific shoes that offer proper grip, ankle support, and cushioning. Replace worn-out shoes regularly.
Strengthen muscles around joints: Focus on ankle, foot, and leg exercises to improve stability and support. Strong muscles help absorb stress that might otherwise impact bones or ligaments.
Maintain flexibility: Gentle stretching before and after exercise keeps joints limber and reduces the chance of overextension or strain.
Warm up and cool down: Begin each activity with a light warm-up (such as walking or gentle range-of-motion exercises) and end with a cooldown to prevent stiffness.
Pay attention to your environment: Avoid uneven or slippery surfaces when possible. Use extra caution when walking on ice, sand, or rocky terrain.
Use proper gear: If you’re playing sports or working in physically demanding environments, always wear the appropriate protective equipment.
Balance training: Incorporate balance-focused movements, like single-leg stands or stability exercises, to prevent ankle rolls and stumbles.
Listen to your body: Fatigue increases the risk of injury. Rest when needed and don’t push through sharp or persistent pain.
Maintain overall health: A balanced diet, proper hydration, and regular physical activity contribute to bone strength and joint integrity.

Even small changes to your daily routine can make a big difference in preventing future injuries—especially if you've had a sprain or fracture before.

Why Choose Barrington Orthopedic Specialists for Foot and Ankle Care

When it comes to treating sprains, fractures, or chronic foot and ankle conditions, you need expert care that’s both comprehensive and compassionate. At Barrington Orthopedic Specialists, our board-certified foot and ankle surgeons, including Dr.Patel, Dr. Mahoney, and Dr. O’Hara, deliver personalised, evidence-based care designed to restore strength, mobility, and confidence.

Here’s what sets our team apart:

Specialised Expertise: Our podiatric surgeons are highly trained in both conservative and surgical treatments for a wide range of conditions, including Achilles tendon injuries, ankle fractures, deformities, and complex joint issues.
Conservative First, Surgery When Needed: We prioritise non-surgical care like bracing, custom orthotics, and physical therapy. When surgery is necessary, we use minimally invasive techniques to promote quicker healing and better outcomes.
State-of-the-Art Surgical Options: For patients who require surgery, our specialists offer advanced procedures such as ankle arthroscopy, bunion correction, Lisfranc fracture repair, ankle replacement surgery and many other procedures.
On-Site Rehabilitation Services: We provide physical therapy right here in our facility, allowing for seamless communication between your surgeon and your rehab team. This close collaboration ensures your recovery is monitored and adjusted in real time.
Immediate Orthopedic Care Access: With our on-site imaging and urgent care clinic, you can skip the ER and be seen quickly by orthopedic experts. We’re equipped to evaluate and treat injuries promptly—getting you back on your feet faster.
A Continuum of Care Under One Roof: From diagnosis to surgery and through recovery, our team is with you at every step. We work closely with you to build a treatment plan that aligns with your health goals and lifestyle.

Whether you’re dealing with a sudden injury or managing a long-standing foot or ankle issue, you can count on Barrington Orthopedic Specialists to deliver the highest standard of care, tailored just for you.

Trust the Experts at Barrington Orthopedic Specialists

Understanding the difference between a sprain and a fracture is crucial, but the best way to ensure proper care is to consult experienced orthopedic foot and ankle specialists. At Barrington Orthopedic Specialists, our dedicated team, including Dr. Mahoney, Dr. O’Hara, and Dr. Patel, is here to guide you every step of the way.

If you're dealing with an ankle or foot injury, don’t hesitate. Schedule your appointment online or call us today and take your first step toward recovery.