Torn Ligament

Ligament Tear

Article by John Miller

Ligament Tears

What is Ligament?

Ligaments are small bands of tough, flexible tissue, made up of lots of individual fibres, which connect the bones of the body. Ligaments connect most of the bones in the body. The function of a ligament is to provide a passive limit to the amount of movement between your bones.

What is a Torn Ligament?

Ligament injuries in athletes are common and can occur at any joint. The knee and ankle are particularly vulnerable, but it is sport-specific.

Ligaments sprain when the joint is stressed beyond its normal range, causing overstretch or tearing of the ligament. Common causes of a ligament injury include twisting or landing awkwardly.

The most common sprained ligaments are knee ligaments and ankle ligaments. Why? Probably because the joints are weight-bearing and under high stress with any change of direction sports or full-contact sports.

The 3 Grades of Ligament Injury are:

  • Grade I – mild ligament tear
  • Grade II – moderate ligament tear
  • Grade III – complete ligament tear

What are the Symptoms of a Torn Ligament?

Ligament injuries are typically related to trauma that overstresses the ligament beyond its load capacity.

  • Traumatic cause
  • Sudden onset of pain and severe swelling
  • Subsequent joint instability
  • Impaired function (e.g. inability to walk, run or weight-bear)

Do Ligaments Heal?

Yes. Ligaments have a blood supply, and most will heal. For routine healing to occur, you need to protect the damaged ligament needs from stretching or pulling apart. Otherwise, your ligament will remain elongated and vulnerable to reinjury. This ligament protection can be via a device (e.g. brace), technique (e.g. strapping) or decreasing weight-bearing loads. The normal orthopaedic cycle for ligaments to heal is a 6-week period.

It is crucial to safely restore joint range of motion to ensure that your joint is neither too stiff nor hypermobile once you return to your sport. You will also need to strengthen your muscles and restore point proprioception during this period. Due to the need to respect the optimal ligament repair period, your physiotherapist is the best person to guide your safe exercises during this period for your best post-ligament healing outcome. Please seek their advice.

What’s the Healing Time of a Ligament Injury?

Treatment of a ligament injury varies depending on its location and severity.

Grade I sprains usually heal within a few weeks. Maximal ligament strength will occur after six weeks when the collagen fibres have matured. Resting from painful activity, icing the injury, and some anti-inflammatory medications are useful. Physiotherapy will help to hasten the healing process via electrical modalities, massage and exercise.

Your physiotherapist will guide your strengthening and joint range of motion exercises to return you to function quickly and help you to prevent a future reinjury.

Grade II sprains are more significant and disabling. These injuries require load protection during the early healing phase. Depending on the ligament injury, this may include the use of a weight-bearing brace or supportive taping in the initial treatment. This support helps to ease the pain and avoid stretching of the healing ligament. Your physiotherapist or surgeon will guide you.

After a grade II injury, you can usually gradually return to activity once the joint is stable, and you have sufficient muscle strength and control. This process may commonly take 6 to 12 weeks, depending on your injury and what sport or activity you wish to resume. Please seek the advice of your Physiotherapist or Orthopaedic Surgeon for what they recommend correctly for you and your injury.

We recommend physiotherapy guidance for all grade II ligament sprains to restore full post-injury function and prevent future instability that may predispose you to further injury.

Grade III injury is a very significant injury, and we recommend the opinion from an Orthopaedic Surgeon to determine whether early surgical repair is required. If surgery is needed, your surgeon and physiotherapist will direct your post-operative rehabilitation.
In non-surgical ligament injuries, you will usually need to protect the damage from weight-bearing stresses. The aim is to allow for ligament healing in a short/non-stressful position. Your rehabilitation will slowly progress as the repairing ligament as you and gradually return to normal activities.

Your optimal outcome will result from well-informed and specifically guided physiotherapy. Depending upon your ligament injury, you may not return to your full level of activity for 3 to 4 months or even up to 12 months. Very severe ligament injuries can also take longer. Please consult your Physiotherapist or Orthopaedic Surgeon for all grade III ligament injuries.

For more ligament injury advice, please consult your trusted healthcare professional.

Ligament Treatment

Ligaments are treated depending upon the location and severity of the damage. Please seek the professional opinion of your trusted physiotherapist or doctor.

How Do You Strengthen Ligaments?

Ligaments are passive restraints that limit excessive joint motion. Unlike muscles, there is no specific ligament strengthening exercise. Instead, your ligaments will naturally strengthen as a direct response to your body’s load requirements based on the exercise or functional demand that you place upon your joints.

While you do need to protect ligaments during healing phases. ligaments will naturally grow additional fibres as a response to your increased exercise load and functional demands. Keep up regular exercise and your ligaments will strengthen in response.

However, please remember that ligament injury occurs due to excessive or awkward forces placed on your joints, so avoiding ligament injury positions and postures are advised to avoid weakening your ligaments.

For specific advice regarding exercises to keep your joints, ligaments and muscles strong and posture so ligament sstressing posturers to avoid, please seek the professional advice of your trusted physiotherapist.