Sprain Grades Explained: Identify & Treat Grade 1, 2, 3 Sprains

Got a twisted ankle, wrist, or knee and wondering how bad it really is? Sprains come in three grades, and knowing the grade helps you decide what to do next. This guide breaks down each grade in plain language and gives you easy steps to start feeling better.

What Are Sprain Grades?

A sprain means a ligament – the tissue that ties bones together – got stretched or torn. Doctors sort sprains into three grades based on how much damage there is. Grade 1 is a mild stretch, Grade 2 is a partial tear, and Grade 3 is a full tear. The higher the grade, the more pain, swelling, and loss of function you’ll notice.

How to Tell Which Grade You Have

Grade 1: You feel a dull ache, a little swelling, and maybe some stiffness. You can still move the joint, and the pain eases with a few days of rest. Grade 2: Swelling is bigger, bruising appears, and moving the joint hurts more. You’ll notice weakness and the joint feels wobbly. Grade 3: The joint is very painful, swollen, and you can’t move it without sharp pain. The joint may feel unstable, and you might hear a pop at the time of injury.

Besides pain, look at how much the joint moves. If you can bear weight or use the joint almost normally, it’s probably Grade 1. If you can’t put weight on it or the joint gives way, think Grade 2 or 3.

For a quick check, try the pickle test: gently pull the joint apart. If there’s only a slight stretch and no big gap, it’s likely Grade 1. A noticeable gap means the ligament is partially torn (Grade 2). A large gap or empty space indicates a full tear (Grade 3).

Now that you can spot the grade, here’s how to treat each one.

General first‑aid steps (R.I.C.E.) work for all grades: Rest the joint, Ice for 15‑20 minutes every 2‑3 hours, Compress with a bandage, and Elevate above heart level. These steps cut swelling and pain within the first 48 hours.

Grade 1 treatment: After R.I.C.E., do gentle range‑of‑motion exercises after a day or two. Light stretching and walking help the ligament heal stronger. Most people feel better in a week and can return to normal activity.

Grade 2 treatment: Keep R.I.C.E. for 3‑5 days, then start supervised physical therapy. A brace or splint may be needed for a week or two to keep the joint stable. Strengthening exercises take longer—usually 3‑4 weeks—before you go back to sports.

Grade 3 treatment: This level often needs a doctor’s help. An X‑ray or MRI checks if the ligament is completely torn. A brace, crutches, or even surgery may be recommended. After any surgery, rehab can last 6‑12 weeks, so patience is key.

When you should see a professional: If you can’t bear weight, the swelling gets worse after 48 hours, you see a lot of bruising, or the joint feels unstable, get it checked ASAP. A doctor can rule out fractures and decide if you need imaging or a referral to a physical therapist.

Remember, the right treatment depends on the sprain grade. Use R.I.C.E., watch your symptoms, and don’t hesitate to get help if the injury feels serious. With proper care, most sprains heal fully, and you’ll be back to your daily routine in no time.