How Is a Sprained Ankle Graded?

How Is a Sprained Ankle Graded?

Given the role your ankle plays in movement, it’s subjected to extreme conditions, even if you’re not an elite level athlete. Loose footwear or uneven walking surfaces are enough to roll and overextend your ankle. 

A sprained ankle is one of the most common foot injuries that board-certified podiatrist David J. Kaplan, DPM, sees at FootCare Specialists in San Mateo and Half Moon Bay, California. Every injured ankle is graded based on its severity and treated accordingly. 

What happens during an ankle sprain? 

An ankle sprain is an acute injury affecting one or more of the ligaments that support and stabilize the joint. Fibrous bands of connective tissue, ligaments are flexible, a lot like super-strong rubber bands that connect bones to each other, binding the joint together. 

There are three major ligaments on the outside of the ankle comprising the lateral ligament complex. These bands of tissue permit normal motion while restricting excessive movement, particularly motion from side to side.

Sprains happen when one or more ligaments are overstretched or torn, typically because of a sudden, twisting motion or heavy impact. A sprain isn’t a strain, which affects muscles rather than ligaments.

The ankle is sprain central

While any joint can be sprained, weight-bearing and high-use joints suffer more frequently. The ankle is the most common joint affected, followed by the elbow, knee, thumb, and wrist. Sprained ankles usually happen for the following reasons: 

Sports injury

One of the most frequent sports injuries, sprained ankles occur more often during high-impact activities that require quick directional changes (basketball, football, soccer, and tennis). 

Repetitive stress 

Overuse of the joint increases the risk of sustaining a sprained ankle in the game. Improper form and poor conditioning can also contribute to a sports-related ankle sprain.

Impact injury

Sudden impact such as a fall or collision accident can forcefully twist or bend the ankle into an unnatural position.


Overextension injuries aren’t always the result of sudden impact. Sometimes, all it takes is a misstep to stretch the ligaments in your ankle joint beyond their natural range, causing a sprain. 

How is a sprained ankle graded?

Ankle sprains generate five main symptoms, each varying in intensity. These are:

Using a grading system, ankle sprains may be mild, moderate, or severe based on the severity of trauma and number of ligaments involved. Damage and symptoms are worse and require greater treatment with each progressive grade level. 

Mild sprain 

Grade 1 sprains occur when an ankle joint ligament is overstretched and/or develops micro-tears. Pain is manageable, swelling is mild, and the joint is slightly stiff. Bruising isn’t common.

Moderate sprain 

Moderate Grade 2 sprains mean one or more stabilizing ligaments have sustained partial tears. Bruising is more likely, pain is continuous, and swelling makes it difficult to move your ankle.

Severe sprain 

Grade 3 ankle sprains are the most severe, occurring when a ligament tears completely or ruptures, resulting in total loss of joint integrity and stability. Severe pain and swelling are common at the time of injury, and you may hear or feel a popping sound or sensation when it occurs. Bruising is likely later.

When a sprain occurs, get off your feet, apply cold packs, wrap your foot to stabilize it, and elevate it above your heart. 

Then contact us to schedule an appointment. Sprained ankles and ankle fractures have similar symptoms, so medical assessment assures proper care, no matter what grade of sprain you have. Book your consultation now.

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