La fisioterapeuta cree que no es una fractura, sino un esguince con algo de hinchazón.

In Spain, fisioterapeuta means physiotherapist (roughly the same as physical therapist in US English).

It is a common-gender noun, which means the word itself stays the same for both men and women. The article tells you the gender:

• la fisioterapeuta = the female physiotherapist
• el fisioterapeuta = the male physiotherapist

So in your sentence, La fisioterapeuta tells us the therapist is female.

La is the definite article, meaning the.

So La fisioterapeuta means the physiotherapist. Spanish often uses the article where English does too, and sometimes even where English would be slightly less explicit.

Here it refers to a specific physiotherapist, probably one already known from context.

Compare:

• La fisioterapeuta = the physiotherapist
• Una fisioterapeuta = a physiotherapist
• Mi fisioterapeuta = my physiotherapist

After verbs like creer, pensar, decir, and saber, Spanish normally uses que to introduce the following clause.

So:

• cree que... = believes/thinks that...
• dice que... = says that...
• sabe que... = knows that...

In English, that is often optional, but in Spanish que is usually required.

So:

• La fisioterapeuta cree que no es una fractura
  = The physiotherapist thinks that it isn’t a fracture.

Because creer que in an affirmative statement normally takes the indicative, not the subjunctive.

So:

• Cree que no es una fractura = She thinks it is not a fracture.

The verb inside the clause is es because this is presented as something she believes to be true.

You would usually get the subjunctive after no creer que:

• No cree que sea una fractura = She doesn’t think it’s a fracture.

So the choice between es and sea depends on the structure around creer.

They are very similar in meaning, but not identical in structure or nuance.

• Cree que no es una fractura = She thinks it is not a fracture.
• No cree que sea una fractura = She doesn’t think it’s a fracture.

The first one sounds a bit more like a positive judgement: she actively believes the injury is not a fracture.

The second one is framed as a lack of belief that it is a fracture.

Grammatically, they also differ:

• cree que → usually followed by indicative
• no cree que → usually followed by subjunctive

Sino is used after a negative statement to correct it and replace it with the right idea.

Here:

• no es una fractura, sino un esguince
  = it isn’t a fracture, but rather a sprain

This is a correction: not X, but Y.

Use pero for general contrast, not for direct correction.

Compare:

• No es una fractura, sino un esguince.
  = It’s not a fracture, but rather a sprain.
• No es una fractura, pero duele mucho.
  = It’s not a fracture, but it hurts a lot.

Use sino when what follows is not a full conjugated clause.

Here, what comes after it is:

• un esguince con algo de hinchazón

That is a noun phrase, not a new clause with a conjugated verb.

So sino is correct.

You use sino que when a new clause follows:

• No es una fractura, sino que parece un esguince.
  = It isn’t a fracture, but rather it seems to be a sprain.

Because the nouns have different grammatical gender:

• fractura is feminine → una fractura
• esguince is masculine → un esguince

The article must agree with the noun.

Also, the indefinite article is natural here because this is a diagnosis being identified as one type of injury, not a specific previously mentioned fracture or sprain.

Esguince means sprain.

A sprain is an injury involving a ligament, usually from twisting a joint such as an ankle or wrist.

This is different from an English strain, which usually involves a muscle or tendon. In Spanish, that would not normally be esguince.

So if you want the precise medical sense:

• fractura = fracture
• esguince = sprain

Con algo de hinchazón means:

• with some swelling
• with a bit of swelling

Algo de is a very common way to talk about a small or unspecified amount of something.

Examples:

• algo de dolor = some pain
• algo de fiebre = some fever
• algo de hinchazón = some swelling

It sounds natural here because hinchazón is being treated as an amount or degree, not as a countable item.

Because after algo de, Spanish normally uses the noun without an article.

So:

• algo de hinchazón
• algo de dolor
• algo de inflamación

This is similar to saying some swelling rather than a swelling.

If you wanted to describe it more as a distinct, noticeable condition, you might say something like:

• una hinchazón importante = significant swelling
• la hinchazón = the swelling

But in this sentence, algo de hinchazón is the most natural phrasing.

In Spain, esguince is pronounced roughly like ez-GWEEN-theh.

A few useful points:

• the e at the beginning is pronounced
• gui here gives a hard g sound
• the c before e is pronounced like th in most of Spain

So in Spain:

• esguince ≈ ez-GWEEN-theh

In most of Latin America, the last part would sound like seh instead of theh.

In Spain, hinchazón is pronounced roughly like een-cha-THON.

Key points:

• the h is silent
• ch sounds like English ch
• the written accent on ó shows that the stress falls on the last syllable: -zón

Without the accent mark, Spanish stress rules would suggest a different pronunciation, so the accent is necessary.

So the stress is:

• hin-cha-ZÓN