Breaking an ankle discussion

So, in a future game the main character will break an ankle very early on. The rest of the story will have them walking with no cast or help to get them out of a cast.

To any of you who have broken/severely twisted an ankle before: how painful is it? Were you able to walk on it or drag it behind you? How long did you have it broken for (without a cast or crutches on)?

And do you have anything to add (sentences/paragraphs relating to it, or games which include a person with a broken ankle)?


Twisted ankle here. Suuuper painful in the moment, painful when pressure or weight is on it for weeks afterwards (level will depend on the pain tolerance, but it’s often not pretty).
You’re not supposed to use that foot until the ankle is strong enough to support you again without pain. Even dragging your feet behind will hurt.

I’ve usually had a splint on, with clutches. Could last anywhere between a week and a month (depending on how bad the twist was). Sometimes I could walk with just the splint, but that usually was by the end, when the ankle was mostly healed.

Oh, and your ankle will always be a bit weaker afterwards, and more likely to twist again. You may also get flairs of pain at random too (more likely to happen if you put a lot of weight/pressure on it).


I’ve also twisted an ankle a number of times. There’s an initial rush of adrenaline when you injure yourself that will sustain you for a short burst of activity in the immediate aftermath, but that usually only lasts a few minutes. For example, while playing softball, I once twisted my ankle halfway between third base and home, and I was still able to run the rest of the way, but the longish walk from the field to the parking lot afterward was much worse. Most people will, before too long, reach a point where they can’t bear to keep walking on the injured ankle, especially since by walking on it they are continually aggravating the injury, causing the pain to increase. Even if they did keep going, severe pain makes it really hard to think about anything else, so the character would have a hard time, say, solving adventure game puzzles. And that’s all with a twisted ankle rather than a broken one, which I imagine would be worse. Of course, it’s fiction, so you can do what you want, but you would definitely sacrifice some realism.

If you wanted to be a little more realistic, if you downgraded from breaking the ankle to twisting it, it would help if the character was able to find some things in their environment that they could repurpose to (1) wrap the ankle and (2) lean on like a cane. Unless they’re trapped in some kind of featureless plane, there should be stuff that could plausibly be around. I don’t know if that would be enough for a broken ankle, though; I suspect probably not.


I’ve broken my ankle and would be happy to help, but couldn’t entirely follow the sentence above.

Excruciating. You might try a step or two (maybe one room move in your game), but you’d soon realise that you mustn’t put any weight on it. Without crutches or people’s shoulders to hold onto you’d be crawling like a three-legged crab.


So basically, the player wakes up with people banging on the bedroom door. Soon you learn they are trying to kill you. And the only way to escape this is by jumping out of the building into the overgrown garden. Of course, the fall (if you didn’t click on the spoiler, a fall) leads to a damaged ankle. Very quickly after this incident, you are teleported through time but not space to a magnificent world with all sorts of things in it.

In essence, what I meant in this is this: There are no doctors.

The chase scene doesn’t last very long, and immediately after (when everything changes) you find a big stick which is of use 1/2 way through the story. You could use that as a crutch though.

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Some ankle breaks would heal by themselves without surgery. Maybe even without a plaster cast or medical walking boot, I don’t know. So if your character can get something to use as crutches he could hobble around all right.

When you take your boot off it’s not going back on again! Your foot’s bound to be injured and swollen.

It’s only really painful when you put weight on it.


This is great! Thanks, guys. I’ll be sure to add in the ability to LEAN ON STICK in the game so you can walk around.

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That’d be too much guess the verb for me. I’d rather have the character use crutch automatically when available, or just crawl when it’s not available.


A broken ankle could be anything from a hairline fracture to a compound fracture. There are multiple bones around the ankle, so a broken ankle depends on exactly which bone or bones are broken. The symptoms and the severity of the pain and the player’s mobility will vary accordingly.

You could also consider dislocation and/or soft tissue injury such as sprains and strains. If it’s a hairline fracture, you could hobble around on it. If it’s a compound fracture where the bone is completely dislodged and poking through the skin, then forget it, you ain’t moving anywhere.

For most breaks, you need to immobilise the break and keep the bone in place using a makeshift splint until you can get to hospital. You also need to keep weight off the break, which means using a makeshift crutch of some sort. I think they’re the two key things in an adventure. Oh, and something to kill the pain, but that might not be so easy to find.


What do you want to kill the pain with?

Violence isn't the answer to this one.

Maybe a compromise: Make it automatic, but still add the verb for players who don’t realize it’s automatic, so the game can at least reply with “You’re already leaning on that” or “You don’t see that here” instead of “I don’t understand what that means”.


Potential research resources:

You broke a bone in the middle of nowhere. Now what? | Popular Science.


I wouldn’t want to make it automatic, since you need to give it up and then the player’s like “oh I was using it?!”

So maybe there’s a part where you have to get on the crutch, but if you’re holding the stick, you slip into a comfortable position where you’re leaning on it, but lose your balance. And then it gives you a little hint on leaning on it. (I can also do >GET ON THE STICK or more complex commands.)

I sprained my ankle and it turned purple and was the size of a grapefruit and everyone thought it was broken and the doctors at the ER thought it was broken and everyone was surprised on X-ray that it was not broken, and the docs said it’s better to break it than to sprain it so badly because it takes less time for a break to heal. It took a year to recover completely. It was the second most painful thing that has ever happened to me. I used crutches for a few weeks, and then I was in a walking boot for months. MONTHS. Maybe you should consider a boot for your game?


I actually am that person who managed to sprain both ankles at once. How? Trying to lift a moderately heavy box onto a shelf standing on tip-toes, I lost my balance and rolled both ankles to the side. As your ER said it was luckily a sprain and not a break, and luckily minor sprains so the pain didn’t last long but my ankles and lower legs swelled during the healing process so I had to wear compression socks for a couple weeks. Silver lining: I learned that those advertisements about panty-hose putting a “spring in your step” are totally true! Having your legs compressed and supported while walking is a unique experience.


I think this goes to common sense consideration. There is an old game, I forget the name, that have you cross a chasm across a rope. The game solution is to break down a ladder you’re carrying into a balancing staff. Of which, I say “hogwash!”

If you can create a staff for balancing against a tight rope walk, then you can certainly use the ladder as-is to do so! No need for disassembly.

If you carry a stick, then you’ll certainly use it as a crutch automatically. If you want to be so detailed as to make it a puzzle, I suppose you can. However, that leans the game into puzzle fest more as opposed to narrative work.

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Oh, it’s definitely a puzzle fest.