Is It Just a Sprain or Something Worse? How to Tell the Difference

You roll your ankle, it swells up, and every step makes you wince. It’s easy to think, “It’s just a sprain—I’ll walk it off.” But what if it’s more than that?

Ankle injuries are super common, whether it’s from sports, a misstep off the curb, or even slipping on a wet floor. While many are sprains, some turn out to be more serious—like a fracture, torn ligament, or tendon damage. So how can you tell the difference?

Let’s walk through it (not literally—at least, not if you’re in pain).

First, what is a sprain?

An ankle sprain happens when the ligaments—those stretchy bands that hold your ankle joint together—get overstretched or torn. This usually happens when your foot twists awkwardly, often to the side.

Sprains can be mild, moderate, or severe depending on how much damage there is.

Common signs of a sprain:

• A popping or snapping feeling at the moment of injury

• Swelling around the ankle

• Bruising or discolouration

• Pain when putting weight on it

• Some stiffness, but usually some movement is still possible

Most sprains feel sore and swollen, but you can usually move your ankle (even if it hurts). You may be limping, but still able to walk a little.

So… what counts as “something worse”?

If it’s not just a sprain, you might be dealing with something like:

• A fracture (broken bone)

• A complete ligament tear

• Tendon damage or a dislocation

These injuries are more serious and often need a different kind of treatment, sometimes even surgery or a longer rehab process.

Red flags to watch for:

If any of the following sound familiar, it’s best to get checked out:

🚩 1. You heard a loud crack or pop

A sprain might make a soft pop, but a loud crack could mean a break or major tear.

🚩 2. You can’t put any weight on it at all

If even resting your foot on the ground feels impossible, that’s a warning sign.

🚩 3. It’s badly misshapen

If your ankle looks out of place, or your foot is pointing at an odd angle, head to urgent care. This could be a dislocation or fracture.

🚩 4. Numbness or tingling

This might mean nerve involvement—something that doesn’t happen with a typical sprain.

🚩 5. The swelling and bruising came on really fast

Severe swelling within minutes can suggest a more serious injury.

When to see a physio or doctor

If you’re not sure what you’re dealing with, it’s always smart to have it looked at. A physiotherapist can assess your movement, strength, and pain patterns to help figure out what’s going on.

Sometimes, they’ll recommend getting an X-ray or scan just to rule out a fracture.

How physio helps—either way

Whether it’s a mild sprain or something more involved, physio plays a key role in your recovery. We help:

• Reduce pain and swelling

• Restore strength and balance

• Improve your ankle's movement and flexibility

• Prevent future injuries (especially if you’ve sprained it before)

We’ll also guide you on when it's safe to return to work, sport, or daily activities—so you don’t rush back too soon and make things worse.

Final thoughts

Not all ankle injuries are created equal. What feels like a simple sprain could be something more serious—and the longer it goes untreated, the harder it can be to heal.

So if your ankle’s still swollen, painful, or not quite right after a few days, don’t just “tough it out.” Book in with your physio. Getting the right diagnosis and a recovery plan early on can save you months of frustration later.