There are three grades of ankle sprains. Grade 1 is classified as a mild ankle sprain. It involves microscopic tearing of ligaments within a joint. Signs (what the body does) and symptoms (what the person feels) are characterized by mild (little to none) swelling, slight pain with daily movements (walking, climbing stairs), minimal loss of motion at the affected joint, mild loss of strength to the injured area. Treatment for a grade 1 sprain involves applying ice to the injury (no more than 20 minutes at a time), use of an ACE wrap for compression and support, and rehabilitation (physical therapy) exercises to increase strength.
Grade 2 and Grade 3 injuries are more extensive and require an evaluation by a licensed healthcare professional (physician, athletic trainer, nurse practitioner, physical therapist). These grades of ankle sprains involve partial to complete tearing of a ligament. The patient will experience a large amount of swelling and bruising to the affected area. There will be a significant loss of movement and strength. The patient will be unable to place either partial or full weight on the affected area. Treatment for these injuries includes treatments described for a Grade 1 sprain, and also the use of an X-Ray and/or MRI to rule out a fracture of surrounding bone, as well as visualize the extent of damage to the ligament and surrounding soft tissue structures. The patient will either be placed on crutches and/or placed in a walking boot. Surgery may also be necessary to repair damaged tissue, especially in a Grade 3 tear.
There are three grades of ankle sprains, ordered from one to three with the least serious sprain categorized as "one." A Grade 1 ankle sprain, then, is considered a minor injury with some swelling and pain, but only very minor damage to tendons or ligaments. Treatment of a Grade 1 ankle sprain is generally limited to rest (including minimizing the amount of weight brought to bear on the ankle in question) and the application of a cold compress to reduce any swelling. A Grade 2 ankle sprain is characterized by moderate pain and swelling and by greatly diminished range of motion. In contrast to a Grade 1 sprain, which may not involve more than very tiny tearing of tissue, a Grade 2 sprain involves more substantial, but not necessarily severe, tearing of ligaments and tendons. Range of motion, of course, is more restricted than with a less severe Grade 1 sprain. Treatment for a Grade 2 ankle sprain involves immobilization of the ankle through use of a brace, application of a cold compress for swelling, and physical therapy to restore lost mobility.
Finally, a Grade 3 ankle sprain is, by definition, far more severe than the other grades, and is characterized by major damage to tissue, "significant swelling and tenderness" of the ankle and lower leg (see the link below to the American Association of Orthopedic Surgeons), and considerable pain. Treatment of a Grade 3 sprain could, in the most severe case, require surgery to repair ruptures and tears of tendons and ligaments. In less severe Grade 3 sprains, treatment or management involves immobilization through the use of a splint or brace, and physical therapy.