Read the following passage and answer the questions that follow. During an inter-school football match, Arjun

Concept understanding — Ligament Injury Classification

Ligament Injury Classification

Think of a ligament like a strong, slightly stretchy rubber band that holds two bones together at a joint. Your knee, ankle, wrist — every joint has these bands keeping things stable. When that rubber band gets overstretched or torn, you have a ligament injury. But not all such injuries are the same. The difference matters because it decides how long you rest, whether you need a brace, or even surgery.

The Three-Grade System

Doctors classify ligament injuries into three grades. This is not a random numbering — each grade tells you how much of the ligament's fibre has actually been damaged.

Grade I — Mild (Stretch)

The ligament has been stretched beyond its normal limit, but no fibres are torn. There is some pain and mild swelling, but the joint still feels stable. You can usually walk or move with some discomfort. Think of it like pulling a rubber band too far — it goes back to shape, but it was stressed.

Grade II — Moderate (Partial Tear)

Some of the ligament fibres are torn, but not all. The joint feels loose or wobbly. There is moderate pain, swelling, and often bruising. You may not be able to put full weight on that leg or use that hand properly. The rubber band now has a few snapped strands — it still holds, but it is weaker.

Grade III — Severe (Complete Tear)

The ligament is completely torn into two pieces. The joint becomes unstable — it may feel like it is going to give way. Pain can be intense initially, though sometimes a complete tear actually hurts less than a partial one because the nerve fibres are also severed. Swelling and bruising are significant. The rubber band is now in two separate pieces.

Important

Grade III does not always mean surgery. Many complete ligament tears, especially in the ankle or knee, heal with rest and physiotherapy. The classification tells you the severity of tissue damage, not automatically the treatment plan.

Why This Classification Exists …

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Arjun has suffered a Grade II lateral ankle sprain (inversion injury), damaging the anterior talofibular ligament. The teacher must follow the PRICE protocol — Protection, Rest, Ice, Compression, Elevation — applying ice for 15–20 minutes and a compression bandage that is snug but not tight enough to cause numbness or discolouration. In the first 48 hours, avoid heat (which worsens swelling) and weight-bearing (which delays healing).

(i) Name the injury Arjun has most probably suffered and state which tissue has been damaged.

The injury is a lateral ankle sprain, specifically a Grade II inversion sprain. The tissue damaged is a ligament — most commonly the anterior talofibular ligament on the outside of the ankle. When the foot rolls inward (inversion), this ligament is stretched beyond its normal range and tears partially. The swelling, bruising, inability to bear weight, and the sensation that the joint will 'give way' are classic signs of a Grade II sprain (moderate tear with some loss of function, but no complete rupture or bone deformity).

Note

A Grade I sprain involves only microscopic stretching without joint instability; Grade III is a complete ligament tear with significant instability. Arjun's 'give way' feeling and inability to weight-bear point to Grade II.

(ii) Name the protocol the teacher should follow for immediate management and expand its abbreviation.

The protocol is PRICE, which stands for:

P – Protection (prevent further injury)
R – Rest (stop activity, avoid weight-bearing)
I – Ice (apply cold to reduce swelling and pain)
C – Compression (wrap with a bandage to limit swelling)
E – Elevation (raise the injured ankle above heart level)

Important

PRICE is the standard first-aid protocol for acute soft-tissue injuries in sports. It should be initiated within minutes of the injury and continued for the first 48–72 hours.

(iii) Describe how the teacher should apply the ice and the compression bandage, mentioning the correct duration of the ice application and one sign that the bandage is too tight.

Ice application: The teacher should place the ice pack (or crushed ice in a plastic bag wrapped in a thin cloth) directly over the swollen area of the ankle. The ice should be applied for 15–20 minutes at a time, then removed for at least 45–60 minutes before reapplying. Never apply ice directly to bare skin — always use a barrier (cloth/towel) to prevent frostbite.

Compression bandage: Using the crepe bandage, the teacher should start wrapping from the toes (distal) upward toward the calf (proximal), overlapping each turn by about half the bandage width. The wrap should be firm but not tight — snug enough to limit swelling, but not so tight that it cuts off circulation.

One sign the bandage is too tight: The toes become numb, tingly, or turn pale/blue (cyanosis). If the athlete reports pins-and-needles or the toes look discoloured, the bandage must be loosened immediately.

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