How Is a Sprained Ankle Graded?

Sprains are one of the most common injuries, especially in the foot and ankle. They may occur from playing sports, going too fast up or down a flight of stairs, or even planting your foot wrong getting out of bed. Fortunately, there are treatments to help you rehab the sprain and get back to the activities of daily life.

At Optima Foot and Ankle, expert podiatrists Dr. Laura Schweger and Dr. Evan Ross specialize in the treatment of sprains and strains. The appropriate treatment for your ankle sprain, though, depends on how it’s graded. Keep reading to learn all about it.

The nature of ankle sprains

Ligaments are fibrous bands of connective tissue that connect one bone to another and help stabilize all the moving parts in a joint. They also allow for normal motion but restrict excessive movement, especially from side-to-side.

An ankle sprain is an acute injury of the ankle where one or more of the ligaments become stretched beyond their capability and tear. Sprains often occur due to a sudden, twisting movement or forceful impact.

Typical symptoms of a sprain include pain, swelling, and bruising around the torn area, and you probably won’t be able to bear weight on the joint without pain.

Strains are also common, but they’re not the same as a sprain. Strains involve stretching or tearing of a muscle, not a ligament, usually by overextending it. They can occur from repetitive motion or due to running, jumping, or quickly changing direction. Symptoms include sudden, severe pain, followed by an immediate decrease in the joint’s range of motion.

Common causes of ankle sprains

Any joint in the body can sustain a sprain, but joints that bear weight or are used a lot are more susceptible. Sprains of the ankle are the most common, followed by the knee, wrist, thumb, and elbow. Sprained ankles are usually caused by:

Sports injury

Sprained ankles are one of the leading sports injuries, frequently seen in tennis, basketball, football, and soccer, which are all high-impact and require quick directional changes.

Repetitive stress

Repetitive stress, such as pounding the pavement when you run, leads to an overuse injury that increases your risk for sustaining a sprain. In addition, improper biomechanics, failure to warm up properly, and an overall lack of conditioning can make a sports-related ankle sprain more likely.

Impact injury

Ankle sprains can also occur from a sudden impact, such as a fall or collision, which forcefully twists or briefly bends the ankle joint into an unnatural position.


An overextension injury can occur even if you don’t play sports or aren’t terribly active. Rolling your ankle while stepping off a curb or getting out of bed can overextend the ligaments in your ankle joint and lead to a sprain.

Ankle sprain grading

Ankle sprains are graded into three categories — mild, moderate, or severe — based on the extent of the trauma and the number of ligaments involved. Damage and symptoms are worse with each progressive grade level, and the treatment regimen becomes more involved.

Grade I sprain

Grade 1 sprains are mild. They occur when a ligament becomes overstretched and/or sustains minor, microscopic tears. Symptoms include mild swelling, manageable pain, and slight joint stiffness. Bruising isn’t common.

Grade 2 sprain

Grade 2 sprains are moderate. They occur when one or more of the ligaments in your ankle joint have sustained significant partial tears. This higher level of trauma causes bruising, continuous pain, and swelling that limits your range of motion.

Grade 3 sprain

Grade 3 ankle sprains are severe. They occur when a ligament suffers a complete tear or rupture, and you may hear a “pop” when the tear occurs. This level of trauma results in a complete loss of joint stability, with immediate, severe pain and swelling. Bruising may occur after-the-fact.

Ankle sprain care and recovery

If you suspect you’ve sprained your ankle, start immediate self-care with the “RICE” method: rest, ice, compression, and elevation. These work to alleviate pain, reduce swelling, and protect your injured joint until you can get to the doctor’s office.

At Optima Foot and Ankle, we recommend initially staying off the ankle. Once it’s had some time to recover, you may benefit from physical therapy to regain strength and restore mobility, laser treatment with the FX 635, or, in severe cases, surgery to repair the damaged ligament.

If you’ve suffered a sprain, don’t wait to get it looked at — the doctors at Optima Foot and Ankle specialize in diagnosing and treating sprains and strains, and we can give you the tools you need to get you back in your game or to your daily activities. Give our office in Bend, Oregon, a call at 541-383-3668, or book your appointment online with us today.

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