Ankle Sprains vs. Strains: How to Tell the Difference and When to Seek Treatment
- Team VSON
- Nov 15
- 3 min read
Ankle injuries are some of the most common orthopedic problems, especially in active mountain communities like Eagle and Summit County. Whether you twist your ankle on the trail, during a game, or just stepping off a curb, it can be difficult to know what’s actually injured.
So, what is an ankle sprain vs strain, and how can you tell which one you have? Below, Dr. John Paul Elton, board-certified orthopedic surgeon and foot and ankle specialist at Vail-Summit Orthopaedics & Neurosurgery (VSON), explains how to identify your injury and when to seek expert care.
What is an ankle sprain vs strain?
The terms “sprain” and “strain” are often used interchangeably, but they involve different tissues. Understanding what is an ankle sprain vs strain helps determine both treatment and recovery time.
Ankle Sprain: A sprain occurs when the ligaments, the strong bands of tissue that connect bone to bone, are stretched or torn.
Ankle Strain: A strain affects muscles or tendons, which connect muscles to bones. Strains typically involve overstretching or small tears in the muscle fibers.
“Sprains involve the stabilizers of your joint, while strains involve the movers,” explains Dr. Elton. “Knowing what is an ankle sprain vs strain helps us guide patients toward the right rehab plan and get them back on their feet safely.”
How ankle sprain occurs
Understanding how ankle sprain occurs can help prevent future injuries. Most sprains happen when the ankle rolls inward or outward beyond its normal range of motion, often during sports, hiking, or even walking on uneven terrain.
Common causes include:
Sudden twisting or turning motion
Landing awkwardly from a jump
Wearing unstable footwear
Previous ankle injuries leading to weakness
“In Colorado, I see a lot of patients who roll their ankle trail running or hiking,” says Dr. Elton. “Once you understand how ankle sprain occurs, you can strengthen the muscles around your ankle to better protect the joint.”
What ankle sprain is the worst?
Not all sprains are created equal. The severity depends on how much the ligament is stretched or torn. If you’re wondering what ankle sprain is the worst, here’s a quick breakdown:
Grade 1 (Mild): Minor stretching or microtears. Some tenderness and swelling.
Grade 2 (Moderate): Partial tear with noticeable swelling, bruising, and limited motion.
Grade 3 (Severe): Complete ligament tear causing instability, significant swelling, and difficulty bearing weight.
So, what ankle sprain is the worst? Dr. Elton explains, “A Grade 3 sprain is the most severe, it can feel and function like a fracture, and it’s not something to walk off. These often need bracing or even surgical intervention to heal properly.”
When should you see a foot doctor?
If your ankle pain lingers for more than a few days, or you experience severe swelling, bruising, or difficulty walking, it’s time for an evaluation.
Dr. Elton recommends seeing a specialist when:
You can’t bear weight immediately after injury
There’s significant bruising or deformity
The ankle feels unstable or “gives out” easily
Pain persists after initial home care
“Early treatment can make a big difference in long-term ankle stability,” says Dr. Elton. “We use advanced imaging and physical exams to determine the extent of injury and create a personalized plan for recovery.”
How to prevent ankle sprains and strains
Preventing how ankle sprain occurs starts with balance, strength, and flexibility training. Simple steps like warming up before activity, wearing supportive shoes, and using balance boards or resistance bands can improve joint control.
“Once someone understands what is an ankle sprain vs strain, they can take proactive steps to avoid reinjury,” says Dr. Elton. “We often recommend physical therapy to retrain stability and improve confidence on uneven ground.”
About Vail-Summit Orthopaedics & Neurosurgery
Vail-Summit Orthopaedics & Neurosurgery (VSON) has been serving the mountain communities of Vail, Frisco, and Edwards, Colorado, for over 40 years. Our team of fellowship-trained specialists provides world-class care for athletes and active individuals across the region. From injury prevention to surgical excellence, VSON is dedicated to helping patients return to the sports and lifestyles they love, stronger than before. Contact our team today!