Ankle Sprains: Different Types & Grades

Ankle sprains are one of the most common orthopaedic injuries. So common, in fact, they’re the top reason for missed participation in athletics, according to the American Academy of Orthopaedic Surgeons. A sprained ankle occurs with the ankle twists, turns, or rolls beyond its limits. It can cause symptoms like pain/tenderness, bruising, and swelling. However, ankle sprains can vary greatly in type and severity. In this post, we’ll explain what a sprained ankle is, as well as the different types and grades of ankle sprains, and when you should see a doctor.

What is an ankle sprain?

An ankle sprain involves the stretching or tearing of the tough, fibrous bands of tissue (ligaments) that hold the ankle bones in place. Some ankle sprains are much more severe than others. Essentially, the severity of a sprained ankle depends on the number of ligaments involved, as well as if the ligament is stretched, partially torn, or completely torn.

Ankle sprains should not be confused with ankle strains, which affect muscles rather than ligaments. Additionally, ankle sprains are not the same as ankle fractures, which impact bones instead of ligaments. We explain how to tell the difference in our blog post, ‘Ankle Sprain vs. Ankle Fracture: What’s the Difference?’.

What are the different types of ankle sprains?

Basically, the ankle area is composed of three sections, which are each susceptible to sprains:

  • Lateral (inversion) ankle sprains. This is the most common type of sprain. It occurs when someone damages one or more of the ligaments on the outside (lateral side) of the ankle.
  • Medial (eversion) ankle sprains. This type of sprain happens when a person injures the deltoid ligament, located on the inside (medial side) of the ankle.
  • High ankle sprains. This type of sprain is also often referred to as a “tib” or “fib” sprain. A high ankle sprain occurs when a person damages the ligaments that hold the two leg bones (tibia and fibula) together at the top of the ankle. Usually, a powerful, upward motion of the foot/ankle causes this type of sprain to occur.

What are the different grades of ankle sprains?

Ankle sprains range in severity, depending on the amount of ligament damage. Following the exam, your doctor will determine the ‘grade’ of your sprain, which will help them develop an appropriate treatment plan. Ankle sprain classification includes the following grades:

  • Grade 1 (mild) ankle sprain. This type of sprain involves minor stretching and/or small tearing of the ligament fibers. It may cause mild tenderness, bruising, and swelling. Typically, a person with a Grade 1 sprain experiences little to no instability or pain when bearing weight.
  • Grade 2 (moderate) ankle sprain. This type of sprain involves a partial ligament tear. Grade 2 sprains can cause moderate tenderness, bruising, and swelling. A person with this grade of a sprain may also experience mild pain when bearing weight and minor instability.
  • Grade 3 (severe) ankle sprain. This type of sprain involves a complete tear of a ligament. Grade 3 sprains can cause substantial tenderness, bruising, and swelling. A person with this grade of a sprain may also experience severe pain when bearing weight and significant instability.

When should I consult a physician?

If you can bear weight on your ankle but the bruising and swelling persist longer than one to two weeks, you should consult a physician. If you cannot bear weight on your ankle at all, you should consult your physician immediately.

The vast majority of patients will do well with nonsurgical treatment. Typically, most patients will only need a walking boot or brace to stabilize the ankle while it heals. However, if the ankle continues to feel weak after a little time and rest, we often recommend physical therapy to help enhance and accelerate the healing process.

Dr. Roger Passmore is a board-certified, fellowship-trained orthopaedic foot and ankle surgeon at Advanced Ortho and Spine. He provides a full spectrum of foot and ankle care. Contact us today for more information or to request an appointment. 






With two locations near Nashville in Mt. Juliet and Hermitage, Advanced Ortho and Spine provides patients with high-quality, personalized care while advancing orthopaedic excellence. Contact us today to learn more or to schedule your appointment.

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