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What are ligaments?
Ligaments are fibrous tissues that attach from one bone to another across a joint. The tissue is very strong, varies in thickness and is dense with nerve receptors. Its role is to provide stability, guide movement, maintain joint shape and act as position sensors for the joint.
Previously ligaments were thought of as inactive structures, they are in fact complex structures that influence the localised joint and the entire body once injured (1).
How are ligaments injured?
Ligament sprains are the result of loads exceeding the maximum strength of the ligament with little/no time to recover. This force causes acute tears of the ligament fibres.
These structures can be damaged through several mechanisms, like contact or direct trauma, dynamic loading, repetitive overuse, structural vulnerability and muscle imbalance (2). A sprain of ligaments usually affect the following joints:
How does it affect us?
As with most soft tissue damage there will be the typical acute pain and swelling. Injury to a ligament will compromise joint stability and ability to control movement. It can also reduce our balance, proprioception and muscle reflex time (3). With poor joint position comes restriction in movement and weakness of the surrounding muscles.
What types of ligament sprains are there?
The severity of ligament injury is graded using various clinical classifications. The most common is a three-level system that determines structural involvement.
- Slight stretching and microscopic tearing of the ligament fibres
- Mild tenderness and swelling around the ankle
- Heals within 1-2 weeks
- Partial tearing of 10-90% of the ligament fibres
- Moderate tenderness and swelling around the ankle
- Partial structural instability when tested by Physio or doctor
- Healing takes up to 6 weeks
- Complete tear of the ligament
- Significant tenderness and swelling around the ankle
- Complete instability when put under stress
- Poor weight bearing
- Conservative treatment can take 12-16 weeks
- Potential reconstructive surgery is required
*Timeframes are based upon the guidance of a professional. Treating injuries on your own poses a risk of not fully recovering and a greater chance of re-injury.
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- Frank, (2004) Ligament structure, physiology and function. J Musculoskelet Neuronal Interact
- Gabriel (2002) Ligament injury and Repair: Current concepts. Hong Kong Physiotherapy J
- Hauser (2013) Ligament Injury and Healing: A Review of Current Clinical Diagnostics and Therapeutics. The Open Rehabilitation Journal