How Is a Sprained Ankle Graded?

How Is a Sprained Ankle Graded?

You have an ankle sprain. It’s a total inconvenience, especially if it affects your right foot and your ability to drive. At Intermountain Foot & Ankle Associates, Dr. Kerry Berg, a board-certified podiatrist, sees many patients with sprained ankles. She determines the severity of your sprain and prescribes the most effective treatment to get you back in the game again as quickly as possible. 

What is an ankle sprain? 

Sprain vs. strain. What’s the difference? A strain injures a tendon or muscle. A sprain injures one or more ligaments that support and stabilize a joint. Ligaments are flexible, fibrous bands of connective tissue — a lot like super-strong rubber bands — that connect one bone to another and bind the joint together. 

Your ankle is a complex joint: After all, it helps keep you upright. The ankle joint has several ligaments, including three on the outside of the ankle. These vital bands of tissue help you move normally but restrict excessive movement, particularly extreme side-to-side motion. If you’ve sprained your ankle, you’ve overstretched or torn one or more ligaments, usually because of a sudden, twisting movement or an intense impact. 

You have an ankle sprain, join the crowd 

Ankle sprains are the most common joint injury. It’s a weight-bearing and high-use joint, making it more susceptible to injury. A sprained ankle is usually caused by one of the following: 

Sports injury

If you play a sport that involves a lot of twisting and turning with rapid directional changes (tennis, basketball, football, and soccer), you’re more at risk of an ankle sprain. It’s a frequent sports injury. 

Repetitive stress 

Any repetitive motion increases your risk of injury to a joint, whether for work or when playing a sport. Improper biomechanics (poor form) and lack of conditioning make a sports-related ankle sprain more likely.  

Impact injury

If you're injured when playing a contact sport, are in a vehicle accident, or suffer a fall, these traumatic events can result in an ankle sprain. It’s easy for your ankle joint to be twisted or bent into an unnatural position.


Sometimes all it takes is a simple misstep to overextend the ligaments in your ankle joint and sustain a sprain. A sudden impact doesn’t always cause an overextension injury.  

Diagnosing and grading the ankle sprain 

Depending on the severity of your ankle sprain, you’ll experience most or all of these symptoms, although they’ll vary in intensity: 


Ankle sprains are graded as mild, moderate, or severe based on the amount of trauma and the number of ligaments involved. The grading system moves from least to most severe injury. 

Grade I sprain 

A Grade 1 sprain is mild. Your ankle joint ligament is overstretched and/or sustains minor, tiny tears. Some pain, mild swelling, and slight joint stiffness are normal; bruising isn’t expected.  

Grade 2 sprain 

A Grade 2 sprain is a medium-level sprain classified as moderate. One or more of the stabilizing ligaments in your ankle joint have sustained partial tears. This type of sprain is more likely to cause bruising, continuous pain, and swelling, making it difficult to move your ankle.    

Grade 3 sprain 

A Grade 3 ankle sprain is classified as a severe sprain. The ligament tears entirely or ruptures, resulting in a complete loss of joint stability and integrity. Immediate, severe pain and swelling are common; you may also hear a “pop” when it happens. Bruising often appears later.

Treating an ankle sprain 

Before getting to our office, use the “RICE” approach: rest, ice, compression, and elevation. Following this strategy helps protect your ankle from further injury.  

Prompt treatment yields proper healing. Depending on the severity of your sprain, you may need crutches, a brace, or surgery. Seeing a foot and ankle specialist right away helps you get back in the game faster. 

Call Intermountain Foot & Ankle Associates or book an appointment online if you have a foot or ankle injury and for all of your foot and ankle care needs. 

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