Foot & Ankle | Dr. Breanna Ferguson – Healthy Living Magazine

Dr. Breanna Ferguson | Podiatrist

I sprained my ankle and the ER says there’s no fracture, but I still have really bad pain. What should I do?

I see this a lot; people who have gone to the ER and are told nothing is broken. They’re given some crutches, ibuprofen, and told to stay off it for a few days and they’ll be fine.

Fast forward a few weeks or even months to years later when they follow up in my office and say, “Doc, I’m having a lot of pain and swelling, but the ER told me nothing was broken.”

I then have to explain to patients that just because there was no fracture does not mean there isn’t a significant injury. What most people do not realize is that an x-ray doesn’t always show everything that can be going on, even in very severe ankle sprains. Ankle sprains occur when the ligaments around the ankle are damaged due to either forcefully twisting or turning the ankle. Sometimes this force can be as minimal as stepping off a curb the wrong way. This type of injury places increased tension on the soft tissues surrounding the ankle.

A severe sprain can affect the ligaments that support the ankle, and sometimes can cause a tear of those ligaments, resulting in long-term instability, chronic pain and recurring sprains. There also can be strains or tears to the tendons on the sides of the ankle. The tendons usually still function but are persistently inflamed and painful. One of the worst situations that can occur after a severe ankle sprain is damage to the ankle joint cartilage. In most cases these conditions are not evident on x-rays and typically require a specialist to do further testing and treatment.

So, if you are having continued pain, swelling, or symptoms of giving way after an ankle sprain, it’s very important to get it evaluated. I tell people if you have an ankle sprain that is bad enough for you to show up in an emergency room or urgent care, then it’s bad enough to at least warrant a follow-up visit at or our office for further imaging and possibly bracing, immobilization, physical therapy, or even surgery.

With early diagnosis and treatment most people can fully recover and get back to their activities pain free, which is especially important for athletes, dancers and exercise enthusiasts.