When it comes to foot and ankle injuries, most of us have experienced sprains, strains, or fractures (or all three!). But not everyone can point out all the differences between the three or how each type of injury varies in severity and may present differently than you might imagine it to (like an ankle sprain).
Being able to tell the difference between sprains, strains, and fractures can be incredibly helpful immediately after sustaining an injury and understanding the next steps to receiving a diagnosis and beginning treatment.
Sprains & Strains: Acute Soft-Tissue Injuries
Sprains and strains are soft-tissue injuries and fall under the umbrella term “acute injuries.”
Other acute soft-tissue injuries include:
- Bursitis,
- Contusions (Bruises), and
- Tendinitis.
The most common soft tissues people most commonly injure are:
- Ligaments,
- Muscles, and
- Tendons.
Sudden traumas that cause sprains and strains consist of:
- Falls,
- Twisting, and
- Blows to the Body.
These sudden traumas can happen while participating in athletics, exercising, and everyday activities like stepping off the curb.
Treating Soft-Tissue Injuries at Home
Regardless of the type of soft-tissue injury and its severity, the same initial treatment applies to it all: R.I.C.E.
R.I.C.E. stands for:
- Rest,
- Ice,
- Compression, and
- Elevation.
This four-part treatment is easy to complete at home, effectively mitigates pain, reduces swelling, and promotes healing.
After sustaining an injury, even if it ultimately requires more medical intervention, R.I.C.E. is the first step in keeping yourself comfortable and your body ready to heal.
What Are Sprains?
A sprain is the stretching or tearing of a ligament, a soft tissue that connects one bone to another, forming a joint (e.g., your ankle).
Many ankle sprains happen when the foot rolls inward, putting significant tension on the ligaments on the outer ankle.
After spraining an ankle (or another joint), you may experience the following:
- Ankle Instability/Looseness,
- Bruising,
- Limited Range of Motion,
- Pain,
- Swelling, and
- Tenderness.
Classifying Sprains by Severity
There are three sprain severity classifications:
- Grade 1 (Mild) – minor stretching that causes slight damage to ligament fibers.
- Grade 2 (Moderate) – partial ligament tearing with an abnormal joint looseness during certain movements.
- Grade 3 (Severe) – complete ligament tearing with substantial joint instability.
You may also hear a popping noise(s) or sensation(s) when you sustain the injury.
What Are Strains?
A strain is the stretch of the muscles and tendons independently or simultaneously. The injury may also escalate to a partial tear or a complete tear.
Symptoms of a strain include:
- Cramping,
- Inflammation,
- Muscle Spasm,
- Muscle Weakness,
- Pain, and
- Swelling.
Athletes in contact sports and sports with quick starts are at an increased risk of experiencing muscle and/or tendon strains.
Many strains can be resolved with R.I.C.E. and simple physical therapy exercises for relieving pain and restoring mobility. However, severe tears may require surgical intervention.
What Are Fractures?
Bones are not entirely rigid. They have some give. Fractures (broken bones) occur when an outside force is placed on our bones greater than they can accommodate.
The amount of force that causes a fracture typically determines the severity of the injury.
If a force exceeds a bone’s breaking point by a small margin, the bone may crack rather than break completely through. However, extreme force (e.g., a car crash) may shatter the bone entirely.
Fractures: Symptoms
Common symptoms include:
- Bruising,
- Deformity (An Out-of-Place Limb or Bone Puncturing the Skin)
- Severe Pain,
- Swelling, and
- Tenderness.
To confirm and evaluate the extent of the fracture, your doctor will take X-rays. These X-rays will help determine the necessary treatment plan.
Fractures: Treatments
Treatments for fractures include:
- Plaster or Fiberglass Cast – The most common treatment option that immobilizes the injured bone(s) once the doctor realigns the broken ends so the bone(s) can heal properly.
- Functional Brace or Cast – A suitable treatment for some fractures where the brace or cast allows controlled movement of the joints near the break.
- External Fixation – A surgical procedure involving a doctor placing metal pins/screws above and below the fracture, connected to a metal bar outside the patient’s skin.
- Open Reduction and Internal Fixation – The doctor realigns the bone fragments and inserts screws or attaches metal plates to the exterior of the bone. They may also insert rods through the center of the bone to help hold the bone fragments together.
Ankle Fractures
When you fracture your ankle, two joints are impacted: the ankle joint and the syndesmosis joint.
The three bones that make up the ankle joint are as follows:
- Tibia (Shinbone) – larger bone of the lower leg
- Fibula – smaller bone of the lower leg
- Talus – small bone between the tibia and fibula and the heel bone
Ankle fracture classification is dependent on which area of the ankle bones is broken.
Calcaneus (Heel Bone) Fractures
Fracturing your heel bone is potentially disabling and is commonly a result of severe force (e.g., a car crash, falling from a ladder, etc.). The powerful impact crushes the heel, which may shorten, widen, and deform it.
These fractures often require reconstruction surgery to restore mobility. However, there is a risk of developing long-term complications, such as:
- Arthritis,
- Decreased Mobility,
- Pain, and
- Swelling.
The heel bone sits directly below the three bones making up the ankle and is one of seven (and the largest) bones in the foot called tarsals.
Toe & Forefoot Fractures
Toe and forefoot fractures are prevalent and may occur after a blow to the foot or from repetitive use/overuse. They can be particularly painful, but treatment often only involves sufficient rest and altering activities to allow the bone to heal.
These fractures occur in the forefoot and can affect one or more of the 14 phalanges (toe bones) and five metatarsals (the long bones making up the foot’s arch).
The Foot & Ankle Center
Please make an appointment at The Foot & Ankle Center so we can evaluate possible sprains, strains, and fractures. Foot and ankle injuries can significantly impact your quality of life. That is why we urge everyone to get in with a medical professional as soon as possible so you can get on the road to healing and feeling like yourself.
New patients can request an appointment today at https://www.facstl.com/request-appointment/.
You may also reach us by email at judym@facstl.com and by phone at (314) 487-9300.