The patient called my office after collapsing during a hike while carrying a heavy pack. He’d hobbled back to his truck after the fall with the support of his hiking poles, and now his ankle was swollen and painful. He thought it was sprained. Should he schedule an appointment?
Yes. One of the most common misconceptions about ankle injuries is that sprains and strains are less severe than a break. All three conditions can prove serious and require medical attention.
While athletes are most susceptible to these injuries, anyone can stumble or fall. So, what is the difference between sprains, strains and breaks?
An ankle sprain is an injury to one or more ligaments, usually on the outside of the ankle. Ligaments are bands of tissue that support the body’s joints and provide stability. Ankle sprains are most common in jumping sports like basketball or volleyball, but any activity even walking, can cause a sprain. Common symptoms include pain or soreness, swelling, bruising, difficulty walking, or stiffness in the joint.
A strain twists, pulls or tears a muscle or tendon. Tendons connect muscles to bones. Contact sports like football, or sports that require quick starts such as running races, put athletes at risk for strains. Symptoms may include pain, muscle spasm or weakness, swelling and cramping.
A break, or fracture, is a partial or complete break in a bone. Breaks generally occur when the ankle rolls inward or outward, such as stepping off a curb the wrong way. You may experience throbbing pain, swelling and bruising. It can be difficult to put weight on the ankle, and the bone may look deformed. If the bone protrudes through the skin, emergency care is required.
It’s important to seek medical attention for any ankle sprain, strain, or break. Until the ankle can be evaluated by a foot and ankle surgeon, follow the P.R.I.C.E. protocol—to prevent further injury, rest the ankle, apply an ice pack, compress the ankle with an elastic bandage, and elevate the foot.
And the patient with the “sprained” ankle? An office X-ray revealed a serious fracture. I met him the next day in surgery and repaired his broken ankle with a plate and six screws.
Dr. Ralph Wentz is a board-certified foot and ankle surgeon in Salida and a fellow of the American College of Foot and Ankle Surgeons.