--- title: Ankle Injury - Do I Need An X-Ray? description: Have you injured your ankle of foot? Is it sore, swollen and discoloured? How do you know if its a soft tissue injury or if there may be a bone break (fracture) involved? Find out how to know if you need an x-ray after a foot or ankle injury! image: https://blog.jennyphysiopilates.com/hubfs/Ankle%20Injury%20-xray.png --- [![](https://blog.jennyphysiopilates.com/hs-fs/hubfs/Transparent%20background%20logo%201000%20pixels_cropped.png?width=1000&height=352&name=Transparent%20background%20logo%201000%20pixels_cropped.png)](http://www.jennyphysiopilates.com/) # JennyPhysioPilates ## [Ankle Injury - Do I Need An X-Ray?](https://blog.jennyphysiopilates.com/ankle-injury-do-i-need-an-x-ray) ** Sep 16, 2020 4:05:16 PM / by [Jenny Drennan](https://blog.jennyphysiopilates.com/author/jenny-drennan) Have you rolled over on your ankle or injured your foot? It’s more than likely sore, swollen and a combination of glorious colours! How do you know if it’s just a sprain (soft tissue injury) or if there may be a fracture (bone break) involved?   As clinicians there are a set of guidelines which we use as a *screening test* to help guide our decision making in whether or not to refer for an x-ray after an ankle/foot injury. These are called the Ottawa Ankle Rules.   Going by these these rules:   An** ankle x-ray** is required if there is **pain around the ankle area AND**:   - You are unable to put weight through the leg for 4 steps after the injury occurs (walking with a limp is okay).   **OR**   - You are tender on either of the sticky-out bony bumps located either side of the ankle (particularly towards the rear of these bone bumps) or any bony tenderness above or below these bumps. ---   A **foot x-ray** is required if there is **pain around the middle of the foot AND**:   - You have tenderness over the sticky-out bony bump on the outside of your foot (located about halfway between the outside of your heel and your little toe).   **OR**   - You are unable to put weight through the leg for 4 steps after the injury occurs (a limp is okay)..   **OR**   - You have tenderness over the bony bump on the inside of your foot (a few centimetres in front of the bony bump on the inside of your ankle). ---   It is important to note that these guidelines are for clinicians to combine with their own assessment and clinical reasoning skills. They should not replace an assessment by a medical professional nor medical advice. These guidelines purely act as screening test to help us rule out the possibility of an ankle/foot fracture.   [![Sign up for 2 week free trial!](https://no-cache.hubspot.com/cta/default/407935/0561586b-2649-46b2-a425-1e625109fceb.png)](https://cta-redirect.hubspot.com/cta/redirect/407935/0561586b-2649-46b2-a425-1e625109fceb)   Information based on: [http://www.theottawarules.ca/ankle_rules](http://www.theottawarules.ca/ankle_rules)     Topics: [Injuries](https://blog.jennyphysiopilates.com/topic/injuries) ![Jenny Drennan](https://blog.jennyphysiopilates.com/hubfs/lijenny.jfif) #### Written by [Jenny Drennan](https://blog.jennyphysiopilates.com/author/jenny-drennan) Jenny has over 10 years of experience as a Physiotherapist with a particular interest in pain management for chronic conditions. She has a passion for helping people manage their conditions, regain mobility and confidence in movement. - Recent - Popular - Categories ### Lists by Topic - [Conditions (8)](https://blog.jennyphysiopilates.com/tag/conditions) - [Exercises (8)](https://blog.jennyphysiopilates.com/tag/exercises) - [Low Back Pain (7)](https://blog.jennyphysiopilates.com/tag/low-back-pain) - [Keeping fit & healthy (6)](https://blog.jennyphysiopilates.com/tag/keeping-fit-healthy) - [Injuries (4)](https://blog.jennyphysiopilates.com/tag/injuries) - [Neck Pain (4)](https://blog.jennyphysiopilates.com/tag/neck-pain) - [Pain Management (4)](https://blog.jennyphysiopilates.com/tag/pain-management) - [Physio Led Pilates (3)](https://blog.jennyphysiopilates.com/tag/physio-led-pilates) ### Posts by Topic - [Conditions (8)](https://blog.jennyphysiopilates.com/tag/conditions) - [Exercises (8)](https://blog.jennyphysiopilates.com/tag/exercises) - [Low Back Pain (7)](https://blog.jennyphysiopilates.com/tag/low-back-pain) - [Keeping fit & healthy (6)](https://blog.jennyphysiopilates.com/tag/keeping-fit-healthy) - [Injuries (4)](https://blog.jennyphysiopilates.com/tag/injuries) - [Neck Pain (4)](https://blog.jennyphysiopilates.com/tag/neck-pain) - [Pain Management (4)](https://blog.jennyphysiopilates.com/tag/pain-management) - [Physio Led Pilates (3)](https://blog.jennyphysiopilates.com/tag/physio-led-pilates) [See all](https://blog.jennyphysiopilates.com/ankle-injury-do-i-need-an-x-ray#) ### Recent Posts # Contact Us ** [jenny@jennyphysiopilates.com](mailto:jenny@jennyphysiopilates.com) ** Blackrock Co Dublin, Ireland Copyright 2026 | Designed with ** by [HubSpot](https://www.hubspot.com) [**](https://blog.jennyphysiopilates.com/ankle-injury-do-i-need-an-x-ray#)