Is it a Sprain or a Fracture? How to Tell the Difference
Feb 06, 2026
People confuse sprains and fractures all the time, and it’s not hard to see why. Both injuries hurt, cause your foot or ankle to swell, and can leave you limping around, wondering what happened. However, they’re completely different injuries that need distinct treatments.
With improper fracture or sprain care, you could end up with poor healing, chronic pain, or long-term complications. The only way to know which injury you’re dealing with is to come in and have an X-ray and a thorough examination.
At South Texas Foot Surgeons, PA, in San Antonio and Kerrville, Texas, our expert team specializes in evaluating foot and ankle injuries. We have the experience and skill to quickly determine whether you’re dealing with a sprain, a fracture — or both.
A sprain is a ligament injury. Ligaments are strong bands of tissue that connect bones to one another and help keep joints stable. In the foot or ankle, a sprain usually happens when the joint twists or rolls beyond its normal range of motion. This can stretch or tear the ligaments that support the joint.
Sprains can range from mild to severe. A mild sprain may involve overstretched ligaments, while a severe sprain can include partial or complete ligament tears. Even though sprains don’t involve broken bones, they can still be very painful and limiting.
A fracture is a bone injury, or break. A foot or ankle fracture can happen from a direct impact, a fall, or repeated stress over time. Bone breaks can be a tiny crack (stress or hairline fracture) that’s barely visible on an X-ray, or a complete fracture where the bone is broken apart or even shattered into pieces.
The joints and ligaments may also be damaged when a fracture occurs. Because fractures involve slower-healing bone tissue, they need specialized treatment to heal properly.
Ligament sprains and bone fractures often look and feel similar at first. Both can cause pain, swelling, bruising, and difficulty putting weight on the foot. However, if applying light pressure over a bone causes significant pain, the injury is likely a fracture. If the pain you feel is in the soft tissue around a joint, it’s probably a sprain.
With a sprain, swelling may appear quickly, and the area may feel unstable or weak. Some people notice pain mainly when moving the affected foot in certain directions. That said, these signs are not exclusive to sprains. Some fractures can cause very similar symptoms, which is why expert diagnosis is critical.
Fractures often cause sharp or deep pain, especially when placing weight on the foot. Swelling and bruising can be significant, and the area may be tender to the touch. You may notice pain even at rest or at night. Still, you’ll need an X-ray to know for sure.
Mild to moderate sprains often heal with the RICE method: rest, ice, compression, and elevation. You might also need a brace or boot to stabilize the joint. After healing, physical therapy (PT) helps rebuild strength and prevent future injuries.
Fracture treatment depends on the type, location, and severity of the break. Simple fractures where the bone is still aligned might just need a cast or boot to immobilize the foot or ankle as it heals.
More complex fractures might need the bone manually realigned before casting. Severe fractures sometimes require surgery with pins, plates, or screws to hold the bones in place.
Depending on severity, most sprains get better within a few days to a few weeks. Fractures often take several weeks or even months to heal fully.
You can’t reliably tell the difference between a sprain and a fracture on your own. The symptoms are too similar, and getting it wrong can cause long-term complications.
If you’ve injured your foot or ankle and you’re dealing with pain and swelling that make it difficult to walk, we can help. Contact your nearest South Texas Foot Surgeons, PA, office in San Antonio or Kerrville, Texas, to schedule a same-day injury evaluation today.