How to Tell the Difference: Sprain vs. Break

If you’ve ever twisted your ankle, landed on your wrist or taken a hard fall, you may have wondered: Is it a sprain or a break? Understanding the difference between a sprain, a fracture and a strain can help you decide the best next step for treatment.

“There is a lot of overlap in symptoms, especially sprains and fractures,” Charlie Miller, MD, a sports medicine physician at OSF HealthCare, said.

“Both can present with bruising, swelling or inability to bear weight, which is why proper diagnosis is important.”

Here are some helpful tips for telling what kind of injury it might be.

Sprain vs. fracture vs. strain

• Sprain: A sprain means you’ve stretched or torn the ligaments – the tough bands of tissue connecting bones at a joint. Common sites include the ankle, knee, wrist and thumb.
• Strain: A strain affects muscles or tendons (which attach muscles to bones) and involves stretching or tearing.
• Fracture (break): A fracture is another word for a broken bone. This can range from a thin crack (stress fracture) to a complete break.

Is a sprain worse than a broken bone?

A mild sprain may heal quickly, but a severe sprain that completely tears a ligament can take as long as, or longer than, a fracture to recover. In some cases, severe sprains require surgery.

How to tell if it’s a sprain, strain or break

The only way to know for sure is through a medical evaluation, often with an X-ray or other imaging. Still, some signs may help you guess:

• Sprain: Symptoms include pain, swelling, bruising and limited movement in the joint. It may feel unstable or wobbly.
• Strain: Symptoms include pain, muscle weakness, cramping or spasms, often after overuse.
• Fracture: Symptoms include severe pain, obvious deformity like a hard bump or knot, inability to bear weight or use the limb, inability to bend or move finger or toe, and sometimes a “snap” sound at the time of injury.

Look for signs to tell if your arm, hand, knee, ankle or foot is sprained:

• What it feels like: Tenderness, swelling and pain that worsens when you move the joint
• What it looks like: Swelling and bruising, sometimes redness around the injured area

Common areas for sprains, strains and fractures

These injuries can happen anywhere in the body, but the most frequent locations include:

• Sprained ankle
• Sprained knee
• Sprained wrist
• Sprained hand or thumb
• Sprained foot
• Strained hamstring or back
• Broken arm, wrist, hand, finger, ankle, foot or toe

How to treat a sprain

For mild sprains and strains in the arm, hand, knee, ankle or foot, the RICE method can help:

• Rest the injured area
• Ice to reduce swelling (20 minutes at a time)
• Compression with a bandage or wrap
• Elevation above heart level

Over-the-counter pain relievers may also help. More severe injuries may need bracing, physical therapy or surgery.

How long does a sprain take to heal?

• Mild sprains: One to two weeks
• Moderate sprains: Three to six weeks
• Severe sprains: Several months, sometimes longer if surgery is required

Healing time for fractures varies but generally takes six to eight weeks or more, depending on the bone and severity.

When and where to seek care

If you’re unsure whether you have a sprain, strain or break – or if you experience severe pain, visible deformity, inability to move or bear weight or numbness – get medical attention promptly.

Options include:

• Emergency department for severe injuries, visible deformity or heavy bleeding
• Urgent care for moderate injuries that need same-day evaluation

“Prompt diagnosis and proper treatment can often help the injury resolve more quickly, in addition to helping reduce risk of complications,” Dr. Miller said.

Knowing the difference between a sprain versus a strain or fracture can guide your first steps, but a medical professional will confirm the diagnosis. When in doubt, get checked, especially if symptoms don’t improve within a few days or your pain is severe.