You or your child had an accident and now the ankle is bruised and swollen, and hurts when you touch it. You’re wondering if the ankle is broken or sprained and what you should do about it.

It’s important to know which type of injury you have because treatment can be different for broken bones and sprains. But it’s a good idea to see an ankle specialist for either injury since sprained ankles often need as much care and attention as broken ankles.

Below, we cover the differences between sprained and broken ankles, possible treatments and what you can do to make sure your injury doesn’t turn into a long-term concern.

What’s the difference between ankle sprains and ankle fractures?

Simply put, sprains and fractures affect different parts of your ankle.

A fracture is when you break a bone

You have three bones in your ankle. A fracture is when you break one or more of these bones. Some fractures are minor, like a break that doesn’t go all the way through the bone (a stress fracture), or a bone that’s broken in two, but the pieces stay where they’re supposed to be (a nondisplaced fracture). Other fractures are more serious, for example when a bone breaks in multiple places (a displaced fracture) or a broken bone pokes through your skin (an open fracture).

Ankle fractures are usually caused when an ankle joint is put under extreme pressure – perhaps during a motor vehicle accident, falling or if something heavy drops on your foot. But ankle stress fractures can also be overuse injuries caused by sports such as long-distance running.

A sprain is when you damage your ligaments

Ligaments are the fibrous tissue that connect your bones and provide stability when you move. If you have a sprain, it means that one or more of the ankle's ligaments is stretched or torn. If you stretch your ligament, your sprain will be mild, and you may not have a lot of symptoms. If you partially or completely tear your ligament, the injury will likely be more painful and take longer to heal.

Sprains happen when your ankle and a ligament are forced out of their normal positions – perhaps when falling, jumping or walking on an uneven surface. A broken ankle bone can also lead to ligament damage, which means you can have a fracture and a sprain at the same time.

Signs and symptoms of a sprained ankle vs. broken ankle

Ankle injuries have common symptoms such as pain, swelling and bruising. But there are also differences in symptoms for sprains and fractures because they affect different parts of your body.

So, what does a broken ankle look like? What does an ankle sprain feel like? The following can be symptoms of sprained and broken ankles, but having your ankle examined by a doctor is the only way to know, for sure, which injury you have.

Get treated for your ankle injury right now

Ankle fractures and serious ankle sprains need treatment to get better – and can quickly get worse without it. We offer same-day appointments and orthopedic urgent care for ankle injuries so you can be treated as soon as possible. But if you have an open fracture and a bone is poking through your skin, head to an emergency room.

Healing time: Sprained ankles vs. broken ankles

Ankle injuries can take a long time to heal, depending on the type of fracture or sprain.

How long it takes for a broken ankle to heal

With a broken ankle, it can be weeks or even years before it’s fully healed. Healing time will depend on the location and number of broken bones – a stress fracture might heal in 6-8 weeks, for example. But if you have a serious fracture that needs surgery, it might be two years before your ankle fully heals.

What happens if an ankle fracture goes untreated

Broken ankle bones should always be treated by an ankle specialist as soon as possible. Without timely treatment, an ankle fracture can get bigger or damage the soft tissues (like ligaments) around the broken bone. And if you have an open wound, it can get infected.

If you don’t treat an ankle fracture, your ankle may not heal properly. This can increase your chance of developing bone problems – like arthritis or a permanent foot deformity – that cause chronic pain and make it difficult to walk.

How long it takes for a sprained ankle to heal

Here’s something that’s surprising: healing times for sprained ankles can be as long (or even longer) than with broken ankles. While some sprains go away quickly, others can turn into long-term problems. The difference in healing time comes down to how damaged your ligament is. If your ligament is just stretched, your ankle may heal within a couple of days without treatment. But if your ligament has been partly or completely torn, it can take up to six months to heal, and you’ll definitely need medical treatment.

What happens if you don’t treat an ankle sprain

If you have a minor sprain, your symptoms will usually go away after a few days of self-care. But if symptoms last longer than that, there’s a good chance that your ligament has been torn. If you don’t get treatment for a torn ligament, your ankle may not heal properly, possibly creating ankle weakness and other ongoing problems.

Chronic ankle instability is a condition where it feels like the outside of your ankle continually “gives way” when you’re walking, running or standing. This makes it hard to move around and easy to injure your ankle over and over again. Other symptoms of chronic ankle instability include swelling and discomfort that don’t go away.

How sprained ankles and broken ankles are treated

Treatment of ankle injuries differs depending on the seriousness of the injury. The following are things to keep in mind, but it’s always best to talk to an ankle specialist to make sure you’re getting the right treatment for your injury.

Ankle sprain recovery: Some injuries can be treated at home, but some need medical care

If you think you have a sprain, it’s generally okay to wait a day or two before seeing a doctor. Mild sprains usually get better with home care, but more serious sprains need medical treatment. So if your ankle doesn’t look better after a couple days or starts to look worse, make an appointment with an ankle specialist.

RICE therapy helps with pain and swelling of new injuries

The RICE method – rest, ice, compression and elevation – is a recommended way to reduce the pain and swelling of new injuries.

When you first injure your ankle, one of the best things to do is to sit back and put your foot up. Try to keep your ankle elevated for the first 24-72 hours, including overnight. During the first 24 hours, apply ice to your injury for 10-20 minutes at a time, three or more times a day. It’s also recommended that you wear a compression bandage around your foot as you heal.

Over-the-counter medications can provide added relief

Pain relievers like ibuprofen (Advil) and naproxen sodium (Aleve) can help reduce the pain and swelling that come with ankle sprains. But check with your doctor to make sure they are safe for you.

Small movements can start the healing process

While it’s important to relax your ankle after an injury, it’s also important that you start moving it around as soon as possible. Moving your ankle will help to increase blood flow to the area and promote healing.

When approved by a doctor or physical therapist, one exercise that you can do when sitting down (even while elevating your foot) is drawing an invisible alphabet with your big toe. In order for your toe to write letters in the air, your ankle needs to make gentle movements. After doing these exercises, it can be a good idea to elevate your foot and ice your ankle – this can help prevent new pain or swelling.

A little discomfort is okay when you start doing these exercises, but if it hurts a lot, stop doing the exercises and discuss options with your doctor or physical therapist.

Physical therapy can help your ankle heal properly

Physical therapy can improve ankle stability after a sprain and make repeat injuries less likely. Physical therapy for sprains starts about two weeks after you’re injured. If you need surgery, therapy will start once you’ve recovered from surgery.

When you work with a physical therapist, you’ll get a personalized treatment plan designed to help build up the strength and flexibility of your ankle. Physical therapy can be especially helpful if you were off your feet for a long time or needed surgery. How long you’ll need physical therapy for a sprained ankle will depend on how quickly you heal, but it’s usually about a month. Your physical therapist may recommend exercises such as:

• Balance exercises: Your doctor may recommend balance exercises once you’re able to stand without pain. The goal of these exercises is to increase the time you can stand on just your injured foot while decreasing how much you use your arms for balance. While standing on your injured foot, hold your arms out to your sides (standing in a doorway can help you balance if you feel unsteady) and stay in that position for as long as you can. Once you can stay in this position for 60 seconds, try balancing on your injured foot with your arms across your chest instead of out to the sides.
• Stretching exercises: Your doctor may recommend exercises that stretch your Achilles tendon, calf muscles and other parts of your body that support your ankle. Here’s a great exercise to stretch your calf: Sit on the floor with your legs outstretched in front of you. Put a towel around your foot, and then use it to pull the top of your foot toward your body until you feel the stretch in your calf. Hold this for 20 seconds, then relax. Repeat this exercise five times and do several sets during the day.
• Strengthening exercises: Exercises to strengthen your ankle may be recommended once you can stand without pain or swelling. A common exercise is an ankle eversion: Sit on a chair with your injured ankle next to a wall. With your foot flat against the floor, push your ankle outward to the wall. Hold for about five seconds, then relax. It’s usually recommended to do about 10 sets a few times a day.

Ligament reconstructive surgery may help serious or nonhealing sprains

Most ankle sprains don’t require surgery. Your physical therapist may recommend minimally invasive surgery to repair your ligament if it’s completely torn or if your injury is causing instability that can’t be fixed with other treatments. Ligament surgery is more common for people who have repeat ankle sprains.

See a doctor as soon as possible for ankle fractures

If you think you have a broken ankle, make a same-day appointment with an ankle specialist or head to an orthopedic urgent care location. Your foot will likely need medical attention – and the sooner you get care, the sooner you can start healing. Plus, ankle fractures can quickly get worse.

Casts and splints may be enough for simple ankle fractures

When bones move, it can get in the way of healing. Splints and casts can hold your ankle in place so that the fractured bone can heal. Whether you need a splint or cast depends on the location and seriousness of your fracture. If you have a small stress fracture, a removable splint may be an option. Short leg casts are often recommended for minor fractures where your bones haven’t moved out of place. If your bone has broken in multiple places or if you have a bone poking through your skin, an ankle specialist may recommend surgery before putting on a cast.

You’ll need to wear the splint for about 4-8 weeks. During this time, you should try to keep weight off your fractured ankle as much as possible.

Ankle surgery is used for open fractures and poor healing

Ankle surgery is generally recommended if you’ve suffered a severe break or there’s significant damage to the surrounding tissues. For example, if a bone is visible through the skin, is broken in multiple places or is misaligned. Ankle surgery may also be recommended if your ankle isn’t healing properly after other treatments.

Medications can help control the pain and minimize infections

Pain relievers like ibuprofen (Advil) and naproxen sodium (Aleve) can help with any pain from ankle fractures. But taking these medicines can cause side effects like an upset stomach if you take them for a long time, so talk to your doctor about what makes sense for you. If you have an open fracture, your doctor will likely prescribe antibiotics to make sure you don’t get an infection.

Physical therapy helps strengthen your ankle and improve mobility

After an ankle fracture, physical therapy is an important part of the healing process. After being off your ankle for so long, you’ll need to relearn how to safely move your body while building up the strength and flexibility of the ankle joint. When you work with a physical therapist, you’ll get a personalized treatment plan based on your injury and goals for recovery.

The exercises you do when recovering from a fractured ankle are similar to those you’d do when recovering from a sprain. However, recovery usually takes about 6-8 weeks.

Once you’re out of the cast, a physical therapist will likely recommend you start doing range-of-motion exercises like writing the alphabet with your big toe. When you first start these exercises, it may be uncomfortable, but you should stop if you’re feeling significant or lasting pain.

Once you’re able to do range-of-motion exercises with ease, your physical therapist will start you on stretching, flexibility and balance exercises. They will also work with you to develop the strength and stability you need for everyday activities like walking and hobbies like sports.

Get moving after an ankle sprain or ankle fracture

Ankle sprains and fractures heal best when they get the right care quickly – and you take time to rest and build up ankle strength before jumping back into daily life.

For fractures and serious sprains, make a same-day appointment with an ankle specialist or head to orthopedic urgent care. But if you have a broken bone that’s visible through your skin, go to the emergency room.

If you think you have a sprain, it’s fine to try self-care for a couple of days. But if your ankle doesn’t get better or feels worse, make an appointment with an ankle specialist – they’ll be able to determine if you have a sprain or a fracture, as well as the best way to get you back on your feet again.