It happens all the time with children. They are playing a sport or just running around with their friends. An ankle twists and the child goes down in pain. The ankle may swell, become black and blue. The common symptom is pain mostly on the outside part of the ankle. An x-ray is taken and there is no fracture seen, and your child is diagnosed with an ankle sprain. Or is it? Growing children have a growth plate in the outside part of the ankle. Sometimes this plate shifts ever so slightly and causes significant pain. This pain is from a fracture not from a sprain ! Make sure when your child is diagnosed with a sprain, that is not a growth plate fracture called a Salter Harris fracture.