An Overview of Ligament Tears

A ligament is a tough band of fibrous tissue that connects bone to bone or bone to cartilage. While ligaments are extremely strong, they can be stretched or even torn, resulting in different grades of sprains. A ligament tear usually occurs due to extreme force to a joint such as in fall or another high impact event. Common ligament tears are to the ankle, knee, wrist, thumb, neck, or back ligaments.

A ligament tear is painful and tender to the touch. You may see swelling and bruising. It may be difficult to move the joint. In the case of some ligaments, you may hear a pop or feel tearing at the time of the injury. You may also experience muscle spasms.

Ligaments support and strengthen joints. Their main function is to keep the bones of the skeleton in proper alignment and prevent abnormal movements of the joints. This will be impaired when a ligament is torn, resulting in looseness in the joint or being unable to move the joint normally.

Forcing a joint out of its normal position can result in a ligament tear. This can occur in a fall, sudden twisting, or a blow to the body.

Injuries to a ligament are especially common during athletic activity. Ligaments in the ankle, knee, and wrist are consistently in action during athletic activity and thus are under a lot of stress. The stretching or even tearing of a ligament is very possible.

Injuries to the neck ligaments can occur in whiplash and back ligaments can be torn when lifting something too heavy.

The diagnosis of a ligament tear begins with a physical examination and medical history. Your health care provider will ask what you were doing when you experienced the injury and examine the site. Palpating the site and moving the joint can give the health care provider information on the extent of the injury. The next step is often to perform an X-ray to look for fractured or broken bones.

Magnetic resonance imaging (MRI) may be done to determine whether there is a partial or complete ligament tear.

Sprains are graded, with criteria including the extent of tearing of the ligament.

• Grade 1: This is a mild sprain that damages the ligament but does not cause significant tears.
• Grade 2: This is a moderate sprain which includes a partial tear of the ligament. As a result, the joint may show abnormal looseness.
• Grade 3: This is a severe sprain with a complete tear of the ligament. It results in instability of the joint and loss of use.

A common acronym for the initial treatment of a ligament injury is RICE, which stands for rest, ice, compression, and elevation.

• Rest: Getting proper rest is an extremely important aspect of injury recovery, regardless of if the injury occurred to a muscle, tendon, ligament, or bone. Once injured, further activity that stresses the injured area must be stopped until the injury is allowed to recover over a period of time. Recovery time varies based on the particular injury, but the need for rest following an injury is universal. Be sure to give your body plenty of time to recover following any injury issues.
• Ice: Cold contact provides short-term pain relief to an injured area, and also works to limit swelling by reducing the overall amount of blood flow to the injured area of the body. When applying ice to an injured area, do not apply the ice directly to the skin or body. Instead, wrap the ice in a towel or paper towel before applying. It is suggested that ice is applied to an injured area for 15-20 minutes after an injury occurs, but no longer.
• Compression: Compression is also important for post-injury treatment. Compression helps to reduce and limit overall swelling. Compression also occasionally works to ease the pain. Wrapping an injured area in a bandage is a good way to provide consistent compression to an injured area.
• Elevation: Elevating an injured area after an injury occurs can also help to control overall swelling. Elevating is most effective when the injured area of the body is raised above heart level. This helps to control blood flow to the area, and thus reduce swelling.

Your health care provider may recommend an over-the-counter medication (such as ibuprofen) or a prescription medication for the pain and swelling.

If a sprain is Grade 2, it may need bracing to allow for the healing of the partial ligament tear. The location and extent of the injury will determine how long a brace is needed. Grade 3 sprains involving a complete tear may require surgery to repair.

Once the pain and swelling have subsided, your health care provider may recommend physical therapy or home exercises to help restore the function of the ligament and joint. The recovery time can be a few weeks or up to a year depending on the severity of the ligament tear.