How is a Sprained Ankle Graded?

How is a Sprained Ankle Graded?

Ankle sprains make up about 25% of all sports injuries. They can also affect non-athletes who step off of a curb wrong or trip while walking. If not treated properly and allowed to heal, ankle sprains can recur and cause long-term ankle instability.

Podiatrist Sean Rosenblum, DPM, of Foot and Ankle Care of Passaic in Lodi, New Jersey, evaluates and treats acute joint injuries on a regular basis, including sprained ankles.

Here’s how he determines the severity of your injury and customizes your care plan. 

What is an ankle sprain?

Ligaments are flexible, fibrous bands of connective tissue that connect one bone to another and help bind joints together. If a ligament sketches too much or tears, it’s called a sprain.

Your ankle is a complex joint that has multiple ligaments that help support and stabilize it. The three major ones on the outside of your ankle make up the lateral ligament complex. These important tissue bands facilitate normal motion and restrict excessive movement, especially extreme side-to-side motion.

Quick, twisting movements or powerful impact can damage a ligament and lead to a tear or stress. Do know that you shouldn’t confuse a sprain with a strain, as strains affect muscles rather than ligaments. 

How do sprains happen?

Ankle sprains are common during sports play or practice, but that’s not the only time you may suffer this injury. Frequent causes of ankle sprains include:

Directional changes

Sprained ankles usually happen during high-impact activities that involve sudden directional changes. These activities can include tennis, basketball, football, and soccer.


Repeatedly stressing your ankle, especially if you have poor biomechanics (bad form), can put you at risk of spraining your ankle. 

Lack of conditioning

If you haven’t been exercising and start suddenly and intensely, you can put yourself at risk of an ankle sprain.

Injuries caused by impact

A fall or collision event can forcefully twist or quickly bend your ankle into an unusual position, causing damage to the ligaments.


If you overextend the ligaments of your ankle joint during a slight misstep, you may experience a sprain.

How do you determine the grade of my ankle sprain?

Ankle sprains are classified using a simple grading system, depending on how many ligaments are affected and the severity of the damage. With each successive grade level, the damage and symptoms worsen, and treatment and recovery is more involved:

Grade I sprain 

This is the mildest type of ankle sprain. It’s diagnosed when an ankle joint ligament becomes overstretched and/or sustains small, microscopic tears. Bruising is uncommon, although manageable pain, moderate swelling, and slight joint stiffness are typical.

Grade 2 sprain 

We diagnose your sprain as a Grade 2 when one or more of your ankle's ligaments have partial tears. This type of injury is more likely to result in bruising, ongoing pain, and swelling, making it difficult to move your ankle.

Grade 3 sprain 

When an ankle ligament tears or ruptures completely, you lose all ankle joint stability and integrity. It's normal to experience immediate, acute pain and swelling, as well as hear a “pop” sound when it happens. Bruising usually shows up later.

How do you care for a sprained ankle?

If you think you’ve sprained your ankle, you should take action right away. Use the PRICE protocol, which stands for protection, rest, ice, compression, and elevation. These techniques can help you manage discomfort, reduce swelling, and protect your injured joint until you can get a correct diagnosis and treatment.

Even if you think your sprain is mild, it’s important to contact our office to get a definitive diagnosis. We offer therapies that can help you recover faster and reduce your chances for recurrent sprains. Depending on your situation, you may need crutches, a brace, surgical correction, physical therapy, or all of the above.

If you’ve sprained your ankle or want to see if you have, get the care you need by calling 973-218-5720 or booking an appointment online with Foot and Ankle Care of Passaic today.

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