Sprains, Strains, Breaks and Fractures: How to Tell Them Apart

Learn about treating these common injuries

Whether you’re an athlete or you just took a tumble, all of us push ourselves a little too far at times. So how do you know if that sharp pain in your ankle is a strain, a sprain or a fracture?

Any severe pain might mean a visit to your doctor or even the emergency room. But when you know the differences, it’s possible to figure out if you have a sprain versus a strain — and when you need urgent fracture treatment.

“If you have a broken bone or a serious sprain or strain, visit one of Geisinger’s orthopaedic urgent care clinics for a consultation,” suggests Michael Jung, MD, orthopaedic trauma surgeon at Geisinger. “You can even get advice online if you aren’t sure what to do.”

What’s the difference between a sprain, a strain and a fracture?

Sprains, strains and fractures can have similar symptoms, but there are subtle signs that can indicate if you can care for an injury at home or need to seek urgent care.

Sprain

What’s injured: The ligaments, the tough bands of fibrous tissue that connect the bones in your joints, are stretched or torn.
Symptoms

Pain
Limited mobility
Swelling
Bruising

You may also notice: You heard or felt a pop when you were injured. You may have rolled an ankle, fallen on a wrist or otherwise twisted or wrenched an injured area.

Strain

What’s injured: A muscle or a tendon (the tissue that attaches muscle to bone) is stressed.
Symptoms:

Bruising and swelling
Muscle spasms
Cramping
Weakness
Immobility

You may also notice: You felt the pain when you overstretched or overused a muscle.

Break or fracture

What’s injured: Your bone is cracked. Whether it’s just a hairline crack or your bone is in pieces from trauma, healthcare providers may call it either a break or fracture.
Symptoms:

Can’t move the joint
Can’t bear to put weight on the limb
Feel numbness in the injured area
Have swelling or bruising directly over a bone
Pain from a sprain-type injury that won’t go away after 2 weeks

You may also notice: Sometimes there’s a visible deformity when a bone is broken, but often you can’t tell just by looking at it. In severe cases, though, the bone can pierce the skin. This is called a compound fracture.

Sprain vs. strain treatment

Although they affect different tissues, strains and sprains both benefit from treatment using the RICE method:

R – Rest the injury for 48 hours

I – Apply ice for 20 minutes at a time, 4 to 8 times a day

C – Compress the injury to reduce swelling

E – Elevate the injured limb about 8 inches above the heart

After your injury has a chance to heal, your healthcare provider may refer you to physical therapy to encourage healing and strengthen and stabilize the area.

Types of fractures

“Bones can break in many ways, which require different kinds of treatments,” says Dr. Jung. The most common types of fractures include:

Segmental: 1 bone broken in 2 places
Comminuted: 1 bone broken in 3 or more places
Compression: bone crushed and flattened
Spiral: a spiral-shaped fracture around the bone
Transverse: fracture forms a straight line across the bone
Greenstick: not serious enough to cause the bone to separate

Break or fracture treatment

Worried you may have a fractured bone? It’s time to seek professional medical care.

“Getting medical treatment quickly is vital for broken bones,” says Dr. Jung. “Continuing to use a broken bone can cause the break to worsen. The pieces may move farther from one another, or the sharp edge of a broken bone can pierce tissue.”

Before the bone can properly heal, it should be set in place. Your healthcare provider will set it before immobilizing the bone.

“At first, new bone is soft and knits together at the edges of the break, so you don’t want it to move,” says Dr. Jung. “Even minor untreated fractures can lead to chronic pain down the line, as your ligaments are forced to accommodate bones that may not be straight.”

The average fracture takes about 6 to 8 weeks to heal. After confirming the break with an X-ray, your doctor may treat you with:

Immobilization

Your doctor will want you to keep the injured area still while it heals and wear devices to allow you to heal quickly with little risk of getting injured again. You might need to use a:

Cast
Sling
Splint
Wrap
Brace
Medical boot

Traction

When the bones aren’t lined up properly, doctors will realign bones through gentle pulling. You may receive numbing or medications or even be placed under anesthesia.

External fixation

In severe cases, doctors will use a surgical procedure where metal pins or screws are placed to stabilize the bone.

Physical therapy

After the fracture has a chance to heal, your healthcare provider may refer you to physical therapy (PT). Practicing PT encourages strength and healing, helps you regain full use of the area and stabilizes your movement to prevent repeat injury. This is critical if you haven’t been able to move for a while.

When to see a doctor for a sprain, strain or fracture

It’s not always easy to tell if you or your child have a sprain, strain, fracture or break. Swelling and bruising directly over a bone or being unable to put weight on the limb means you should visit your nearest urgent care or orthopaedic urgent care clinic. If the injury is serious or life-threatening — such as a compound fracture, severe swelling or visible deformity — call 911 or head to the nearest emergency room.