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The Three Ankle Sprain Grades — and How We Treat Them

The Three Ankle Sprain Grades — and How We Treat Them

Calling ankle sprains common is an understatement, as 25,000 occur each day in the United States. These injuries can range from mild to severe, but one point to consider is that up to 70% of all acute ankle sprains can turn into an ongoing problem, such as ankle instability.

To avoid dealing with lifelong issues on the heels of an ankle sprain, it’s important to promptly determine the severity of the injury so you get the right treatment in the earliest stages of the injury.

To help, our board-certified orthopedic surgeon, Dr. William Schell, pulled together a primer on the three grades of ankle sprains and what your treatment options are with each.

Defining an ankle sprain

When we discuss an ankle sprain, we’re referring to strains and/or tears in the ligaments that support your ankle. Ligaments are connective tissues that connect bone to bone, and in your ankle there are four main ligaments.

Ninety percent of ankle injuries involve an inversion injury (your foot turns inward), which can strain or tear the ligaments on the outside of your ankle.

Grades of ankle sprains

One of our first orders of business when you have an ankle sprain is to grade the injury, which will dictate our treatment to a great extent. There are three grades of ankle sprains, which include:

Grade 1

With a grade 1 sprain, you’ve only mildly injured your ankle by overstretching your ligaments (or incurring a small tear). This mild sprain typically leads to some discomfort in your ankle, as well as minor swelling and tenderness.

Grade 2

If you have a partial tear in one of the ligaments in your ankle, we consider this to be a grade 2, or moderate, ankle sprain. With a grade 2 ankle sprain, you experience pain when trying to move your ankle and there is likely some swelling and tenderness.

Grade 3

If one or more of the ligaments in your ankle ruptures completely, this is a grade 3, or severe, ankle sprain. As a result of the torn ligament, you may have trouble bearing weight on your foot and there will be considerable swelling, tenderness, and even visible bruising.

Treating your ankle sprain

To avoid long-term disability because of an ankle sprain that didn’t heal properly, we urge you to come see us anytime you think you may have sprained your ankle. Of course, with an extremely mild sprain in which you’ve simply twisted your ankle, you may want to try the RICE method first:

In most cases, the discomfort and swelling should decrease in a few days.

If your symptoms persist after 2-3 days, it’s time to come see us. You should see us sooner if you’re unable to bear weight on your foot and there’s significant swelling and bruising.

Once we determine the degree of the ligament damage, we devise an appropriate treatment plan, which may include:

If the sprain is severe and doesn’t respond to conservative treatments, Dr. Schell may recommend surgery to repair the torn ligament, though this isn’t common.

If you have more questions about ankle sprains or you’d like to schedule an appointment for an evaluation of your ankle injury, please contact our New York City office on the Upper West Side on Columbus Circle.

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