How Is a Sprained Ankle Graded?

How Is a Sprained Ankle Graded?

Making up about one-third of all sports injuries, ankle sprains are the most common musculoskeletal injury reported to primary care physicians. Since an ankle sprain can lead to chronic ankle instability, it’s important to seek out treatment from professionals.

With offices in Arlington, Irving, Fort Worth, and Flower Mound, Texas, podiatrists Jarna Rathod-Bhatt, DPM, and Rahul Bhatt, DPM, of Apple Podiatry Group, evaluate and treat acute joint injuries on a regular basis — some are sports-related mishaps or the consequence of an unintentional fall, while others are a slowly growing product of repetitive stress or strain. 

Many clients who come to our offices with excruciating ankle problems are diagnosed with ligament sprains after a comprehensive examination. Here we’ve gathered some helpful information about ankle sprains, including how we evaluate them for severity. 

About ankle sprains

An ankle sprain occurs when one or more of the ligaments that support and stabilize your joint are injured. Ligaments are flexible, fibrous bands of connective tissue that connect one bone to another and bind the joint together, similar to super-strong rubber bands.

There are multiple ligaments in your ankle joint, including three major ones on the outside of your ankle that make up the lateral ligament complex. These important tissue bands facilitate normal motion while restricting excessive movement, especially extreme side-to-side motion.

A sprain occurs when one or more ligaments are strained or torn, frequently as a result of a quick, twisting movement or a powerful impact. A strain, on the other hand, affects muscles rather than ligaments and should not be mistaken for a sprain.

Common sprain injuries

Weight-bearing and high-use joints are more susceptible to sprain injuries than other joints. Sprains of the ankle, knee, wrist, thumb, and elbow are the most common. Here are the most frequent causes of ankle sprains:

Injuries in sports

Sprained ankles are one of the most common sports injuries, and they usually happen during high-impact activities that involve sudden directional changes like tennis, basketball, football, and soccer.

Repetitive strain

Overuse of your joints raises the danger of a sprained ankle; poor biomechanics (bad form) and lack of conditioning can also enhance the likelihood of a sports-related ankle sprain.

Injuries caused by impact

An ankle sprain can also occur when your joint is forcefully twisted or quickly bent into an unusual position due to a violent impact (fall, collision event).


An overextension injury isn't always caused by a quick impact; a slight misstep might overextend the ligaments in your ankle joint, resulting in a sprain.

Diagnosis and grading of ankle sprains

Each of the five basic symptoms of an ankle sprain varies in intensity depending on the amount and severity of your injury:

Ankle sprains are classified as mild, moderate, or severe based on the degree of stress and the number of ligaments implicated, using a simple grading system. With each successive grade level, the damage and symptoms worsen, and therapy becomes more involved:

Grade I sprain 

An ankle joint ligament becomes overstretched and/or sustains small, microscopic rips, resulting in a moderate grade 1 sprain. Bruising is uncommon, although manageable pain, moderate swelling, and slight joint stiffness are typical.

Grade 2 sprain 

A grade 2 sprain occurs when one or more of your ankle's supporting ligaments incur major partial rips. 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 

A severe grade 3 ankle sprain occurs when a ligament tears or ruptures completely, causing your joint to lose all stability and integrity. It's normal to experience immediate, acute pain and swelling, as well as hear a "pop" when it happens. Bruising usually shows up later.

Ankle sprain care and recovery

If you think you've sprained your ankle, start self-care right away by following the PRICE protocol: 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.

It's critical to see an orthopedic specialist as soon as possible to promote complete and quick healing. A moderate or severe sprain may necessitate the use of crutches, the use of a brace, surgical correction, or all of the above. Physical therapy can help you regain joint strength, stability, and function.

We can assist you if you have a painful joint injury. Call your local Apple Podiatry Group office to schedule a visit with one of our providers. Existing patients can also use our convenient online scheduling feature to make an appointment. 

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