The Center for Podiatric Care and Sports Medicine

Pop, Snap, Tear: Everything You Ever Wanted To Know About Ankle Injuries

Posted by on Thursday, December 5th, 2013


Did you know… 25,000 people sprain their ankles each day? In fact, more than a million emergency room visits are for ankle sprains, fractures, strains and tears. Ankle injuries aren’t just for athletes and weekend warriors. Anyone can fall prey to uneven sidewalks or an icy parking lot. Ankle sprains tend to happen mostly to men between the ages of 15 and 24 years or women older than 30.

ankle injury
Coming down at an awkward rotation can tear, break or sprain the ankle. Image Source:

Types of Ankle Injuries: Sprains, Strains & Fractures — Oh My!

Okay, so your ankle is red, swollen, bruised and painful. Your first thought is probably, “Did I break it?” The answer all depends on which ankle component you injured during your little tumble. The ankle is made up of the tibia and fibula leg bones, as well as the talus foot bone. These bones are held together by connective tissue called ligaments, which keep the bones in place. Tendons attach the muscles to the bone for added mobility.

– Injured bone? It’s a fracture. There are several different breaks — the medial malleolus (inner tibia), posterior malleolus (back tibia) or lateral malleolus (end of the fibula).

– Injured ligament? It’s a sprain. Overstretched ligaments can cause microscopic tears, complete tears or ruptures.

– Injured muscle or tendon? It’s a strain. The peroneal tendons can develop inflammation from overuse or trauma. Tendons can also rupture or slip out of place as a result of repeated overstretching.

foot and ankle injuries
Image Source:

How Do I Know If My Ankle Is Broken, Sprained, Or Strained?

Unfortunately, the symptoms of all ankle injuries are pretty much the same. Occasionally, breaks are pretty obvious because the ankle contorts to an unnatural position, but we find these cases are rare. With sprains, you may feel like your ankle is extremely stiff. With a fracture, the ankle may feel tender to the touch. Severe sprains can hurt and swell as much as a break. You may or may not be able to walk on a broken ankle. The only way to know what has happened for sure is to visit a sports medicine doctor for a physical exam and possibly an x-ray as well.

Follow The R.I.C.E. Method For Acute Treatment Of Ankle Injuries

First aid for injured ankles involves the ever popular R.I.C.E. method:

  • Rest: Get off your feet! Now is no time to finish the race. Walking around to “see how you feel” will not help any type of suspected injury, so simply don’t do it! Call on a friend to help you limp to a chair.
  • Ice: In lieu of ice, there’s nothing like a freezer-cold bag of peas. Freezing your ankle will help slow or reduce the swelling. Swelling produces chemical mediators called cytokines that can cause lots of pain. Ice can also affect protein production and growth rate for tissues, say researchers. For proper icing, apply a compress within 48 hours of an injury. Apply the ice for 20 minutes and take it off for at least 20 minutes before reapplying.
  • Compression: A wrap with an elastic bandage can keep the ankle immobile and supported to prevent further injury until you can make it to the doctor. If your toes turn blue or lose feeling, loosen the wrap!
  • Elevate: Elevating the ankle to heart level reduces pain and swelling.

An untreated ankle injury can lead to long-term issues like arthritis, weakness and repeat injury, so be sure to see a professional, rather than waiting it out! In the meantime, be sure to take an acetaminophen or ibuprofen to take the edge off the pain.

How To Treat Ankle Injuries

Ankle fractures may be treated by immobilizing the ankle with a brace, splint or cast. Severe breaks may need to be re-broken into position and casted or surgically affixed together. The average break takes at least six weeks to heal. The surrounding ligaments and tendons do not return to full mobility for three months to two years, so physical therapy is often needed.

Mild sprains are  treated with the RICE method for several days after which regular activity may resume. Moderate sprains may require a special boot or splint to immobilize the ankle for a week or two. Exercises can improve flexibility and strength. Severe sprains involving complete tear or rupture require immobilization of the  joint, a longer period of physical therapy and possible surgical intervention.


If you have any foot problems or pain, contact The Center for Podiatric Care and Sports MedicineDr. Josef J. GeldwertDr. Katherine Lai, Dr. Ryan Minara and Dr. Mariola Rivera have helped thousands of people get back on their feet. Unfortunately, we cannot give diagnoses or treatment advice online. Please make an appointment to see us if you live in the NY metropolitan area or seek out a podiatrist in your area.