Twisted ankle, wrist or knee: is it a sprain or a break?
Most twisted ankles, wrists and knees are sprains: stretched or torn ligaments that heal with rest, ice and gentle movement. A short checklist called the Ottawa ankle rules helps decide when an X-ray is needed. If you can't take four steps or the bone itself is tender, get it checked.
A sprain is a stretched or torn ligament, while a strain is an injury to a muscle or tendon, according to MedlinePlus.
Under the Ottawa ankle rules, an X-ray is needed if you can't take four steps or if certain spots on the ankle or foot bones are tender.
A mild sprain usually heals in 7 to 10 days, and more severe sprains can take several weeks.
Gentle, early movement helps most ankle sprains recover better than long bed rest.
On-site X-ray is available only at our main clinic, 29 N Cass Ave, Ste A, in Westmont, IL.
What usually causes a twisted ankle, wrist or knee?
A joint is held together by tough bands called ligaments. When a joint bends farther than it should, those bands stretch or tear. MedlinePlus describes a sprain as a stretched or torn ligament and notes that ankles and wrists are the most common places for one.
Ankle: rolling your foot on a curb, a stair or uneven ground, or landing badly from a jump
Wrist: catching yourself with an outstretched hand when you fall
Knee: twisting while your foot stays planted, common in soccer, basketball and skiing
Winter slips: icy driveways and parking lots cause many falls each Illinois winter
Sprains cause pain, swelling, bruising and trouble moving the joint. Many people feel or hear a pop when it happens. A strain is different: it is an injury to a muscle or tendon, most often in the lower back or hamstring.
Sprain, strain or broken bone? How to tell
These injuries can look alike in the first few hours. This table shows the usual differences.
Common joint injuries compared
Injury
What is hurt
Common signs
Usual care
Sprain
Ligament at a joint
Pain, swelling, bruising, a pop at the time of injury
Rest, ice, compression, support
Strain
Muscle or tendon
Pain, muscle spasm, swelling, trouble using the muscle
Rest, then gentle stretching
Fracture
Bone
Pain right on the bone, can't bear weight, swelling, sometimes numbness
X-ray, then a splint or cast
Ankle sprain grades
Grade 1: the ligament is stretched. Mild swelling and little pain when you stand on it.
Grade 2: a partial tear. Moderate swelling and bruising, and the ankle feels a little loose.
Grade 3: a complete tear. Major swelling and pain, and the ankle feels unstable.
Even clinicians often can't tell a bad sprain from a small fracture just by looking. That is what an X-ray is for.
First aid for a sprain in the first 48 hours
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Start care right away. These steps follow MedlinePlus guidance for sprains.
Rest the jointAvoid putting stress on it for a few days. A sling, brace or crutches can protect it.
Ice itApply ice right away to reduce swelling. Wrap the ice in a cloth and never put it directly on the skin.
Wrap itUse an elastic bandage to limit movement. Wrap firmly but not tightly. Loosen it if your toes or fingers tingle or turn pale.
Raise itKeep the swollen joint above the level of your heart, even while you sleep.
Ease the painIbuprofen or acetaminophen can help. Follow the package directions. Do not give aspirin to children.
Start moving gentlyA review in American Family Physician found that early, gentle weight bearing helps ankle sprains recover better than long rest.
How long to wait
Call a provider if swelling has not started to improve within 2 days, or if pain lasts several weeks. A mild sprain usually heals in 7 to 10 days. Most ankle sprains settle within two to six weeks. Our article on how long a sprained ankle stays swollen explains what normal healing looks like.
Do you need an X-ray? The Ottawa ankle rules in plain words
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Clinicians use the Ottawa ankle and foot rules to decide who needs an X-ray. A review in American Family Physician reports that the rules are nearly 100 percent sensitive for finding fractures in adults and in children as young as five. In plain words, ask these questions:
Is the bony knob on the outside of your ankle tender when pressed along its back edge or tip?
Is the bony knob on the inside of your ankle tender along its back edge or tip?
For foot pain: is the bump halfway along the outer edge of your foot tender? (This is the base of the fifth metatarsal.)
For foot pain: is the bony spot on the top inner side of your midfoot tender? (This is the navicular bone.)
Could you not take four steps right after the injury, and still can't now?
If any answer is yes, get an X-ray. If every answer is no, a fracture is very unlikely, and an X-ray usually isn't needed. A clinician still confirms this with a hands-on exam.
Urgent Care Center of Westmont, also known as Immediate Care Center of Westmont, treats sprains and suspected fractures for children and adults, 7 days a week. Our team is led by board-certified physicians.
History and exam. Your clinician asks how the injury happened, then checks swelling, tenderness, blood flow and feeling below the injury.
X-ray when needed. If a fracture is possible, we take X-rays on-site at our main clinic at 29 N Cass Ave. Our clinic inside Jewel-Osco does not have X-ray, so go to Cass Ave for a possible break.
Support. Depending on the injury, we may place a splint, wrap or sling.
A plan. You get pain-control and home-care advice, plus guidance on when to return to sports or work.
Follow-up. Some injuries need a bone specialist. When that is the case, we explain why and help you plan an orthopedic visit.
Little kids often can't say where it hurts. Refusing to walk, limping for more than a day, or not using an arm are all reasons to come in. The Ottawa ankle rules have been studied in children as young as five, but the clinician will decide about X-rays for younger kids. Do not give aspirin to children.
Teens and athletes
The American Academy of Orthopaedic Surgeons says returning to sports before the ankle has healed and been rehabbed can lead to repeat sprains. Plan on balance and strength work before cutting and jumping again.
Older adults
A fall on an outstretched hand can break the wrist, and a broken wrist can look a lot like a sprain. If a fall leaves a wrist or ankle swollen and tender on the bone, get it checked rather than waiting.
Recovery and how to prevent the next sprain
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Recovery happens in stages. First, pain and swelling calm down. Next comes range-of-motion and balance work. Last is a slow return to full activity, with straight-line running before quick turns. Minor sprains may take about two weeks to rehab, while severe ones can take 6 to 12 weeks.
Warm up and stretch before exercise and sports.
Do balance and strengthening exercises, especially after a past sprain.
Wear shoes that fit well and support your activity. Skip high heels on uneven ground.
Watch your footing on trails, curbs and icy sidewalks.
Use a brace or tape early in your return to sports if your clinician suggests it.
Pain that lasts longer than 4 to 6 weeks may mean a chronic sprain and deserves a recheck. If your injury also involves your back, see our guide to back and muscle pain, or browse all symptom guides.
You often can't tell without an X-ray. Pain right on the ankle bones, tenderness on the outer edge of the foot, or being unable to take four steps all point toward an X-ray under the Ottawa ankle rules. If none of those apply, a sprain is much more likely. A clinician can confirm with a quick exam.
Should I go to urgent care for a sprained ankle?
Yes, if you can't walk four steps, the bone is tender, swelling isn't improving after two days, or the ankle feels unstable. Urgent care can examine the ankle, take an X-ray and place a splint or wrap. In Westmont, IL, X-ray is available only at our main clinic at 29 N Cass Ave.
Can you walk on a sprained ankle?
Often, yes. Many people with a mild or moderate sprain can walk with some pain. A review in American Family Physician found that early, gentle weight bearing helps ankle sprains heal better than long rest. If you can't take four steps at all, get an X-ray to rule out a fracture first.
How long does a sprained ankle take to heal?
A mild sprain usually heals in 7 to 10 days, according to MedlinePlus. Most ankle sprains settle within two to six weeks, while severe sprains can need 6 to 12 weeks of rehab. Pain that lasts more than 4 to 6 weeks may mean a chronic sprain and should be rechecked.
Which Westmont, IL clinic has an X-ray machine?
Only our main clinic, Urgent Care Center of Westmont at 29 N Cass Ave, Ste A, Westmont, IL 60559, has on-site X-ray. Our clinic inside Jewel-Osco on Ogden Ave does not. If you think you might have a broken bone, go straight to the Cass Ave clinic or book your visit online there.
Should I wrap a sprained wrist or knee?
A snug elastic wrap can limit swelling and movement in the first days. Wrap it firmly but not tightly, and loosen it if the fingers or toes tingle, go numb or turn pale. A brace or splint may give better support. A clinician can show you the right type for your injury.
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