Which grade of sprain/strain is associated with extremely painful, inevitable loss of function and swelling?

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Severe injuries show the most tissue disruption. When a ligament or muscle-tendon is torn through and through, pain is intense, swelling is prominent, and the joint cannot function normally. This is the most severe grade, reflecting a complete tear and substantial instability. Milder injuries involve a simple stretch with little swelling and preserved function, or a partial tear with some swelling and partial loss of function, or a sprain without a tear. The description of extreme pain, swelling, and nearly total loss of function best fits the complete tear—the most severe grade.