procedures

Ligament Tear Injury

Knee Ligament Tear Injury Singapore

Ligaments are tough, fibrous connective tissues that hold bones together, providing stability and restricting excessive joint movements. They are composed primarily of collagen fibres, which give them strength and flexibility.

While the ligaments are strong, a sudden stretch or twist beyond their normal capacity may result in a ligament injury, usually a ligament tear or sprain. This is commonly caused by a fall or a direct blow to the joint, or it may develop gradually over time due to repetitive stress on the ligament.

Common locations for ligament tears include the ankle, knee, thumb, wrist, neck, and back.

What are Symptoms of Ligament Tears?

Depending on the location and severity of the injury, common signs and symptoms include:

  • Sharp or intense pain
  • Swelling or bruising
  • Snapping or popping sensation
  • Joint instability
  • Limited range of motion
  • Difficulty bearing weight on the affected joint or limb

What are Common Causes of Ligament Tears?

  • Trauma or Injury: Extreme force or trauma to a joint, such as a fall, trip, or accident, can stretch or tear the ligaments, particularly in the knees, ankles, and wrists.

  • Sports Activities: Engaging in high-impact sports that involve sudden changes in direction, jumping, or contact with other players can place great stress on the ligaments, making them more susceptible to tears.

  • Overuse or Repetitive Strain: Engaging in repetitive activities, such as running or jumping, without adequate rest and recovery can weaken the ligaments and make them prone to tearing.

  • Ageing: As individuals age, the ligaments naturally lose their elasticity and become more vulnerable to tears, even with minimal force or stress.

  • Improper Movement or Technique: Incorrect movements or techniques during physical activities, such as forceful twisting or turning, can strain or tear the ligaments.

What are Some Common Ligament Injuries?

Knee
  • ACL Tear: An anterior cruciate ligament (ACL) tear is a common injury that occurs during sports, such as soccer and basketball, which involves sudden stops and abrupt changes in direction.

  • MCL or LCL Sprain: These injuries involve damage to the inner side (medial collateral ligament) or outer side (lateral collateral ligament) of the knee joint.

Ankle
  • Ankle Sprain: This refers to the stretching or tearing of the ligaments that support the ankle joint beyond their normal range due to the foot twisting or rolling awkwardly.

Shoulder
  • AC Joint Injury: This refers to damage to the acromioclavicular joint, located at the top of the shoulder where the collarbone meets the highest point of the shoulder blade. An injury to this joint usually involves a separation or sprain of ligaments supporting the joint.

Hand & Wrist
  • Finger Sprain or Thumb Sprain: This refers to injuries to the ligaments in the finger or thumb caused by a forceful impact during sports, accidents, or falls.

Spine
  • Neck Sprain: This occurs when ligaments in the neck area become overly stretched due to sudden movement or trauma.

  • Back Ligament Sprain: This refers to the stretching or tearing of the ligaments in the back, resulting in sprains or strains.

  • Whiplash: This neck injury occurs when one’s head abruptly jerks backward and forward, usually due to car accidents; and can involve various structures in the neck, including the ligaments.

  • Text Neck: This refers to a repetitive stress injury to the neck from looking down at electronic devices, such as smartphones, for a prolonged period.

How is a Ligament Injury Diagnosed?

A ligament injury can be diagnosed through a combination of physical examination, medical history review, and imaging tests before coming to a conclusive diagnosis.

Ligament injuries can be categorised into different grades depending on their severity:

  • Grade 1: There is mild stretching or microscopic tearing of the ligament that causes mild pain, tenderness, and swelling in the affected area, but the joint remains stable.
  • Grade 2: It involves a partial tear of the ligament, along with moderate pain, swelling and bruising. The joint may exhibit instability and limited range of motion.
  • Grade 3: This involves severe pain and swelling with a complete tear of the ligament. The affected joint may give up or feel completely unstable, making weight-bearing activities almost impossible.

How is a Ligament Injury Treated?

Non-Surgical Treatments

R.I.C.E. Therapy Protocol: This approach, which stands for rest, ice, compression, and elevation, is the first-line treatment used to manage mild to moderate ligament injuries:

  • Rest the injured joint by reducing stress on the affected area
  • Apply ice packs to the injured area to minimise pain and swelling
  • Wrap the injured area with an elastic bandage or compression sleeve for better support
  • Elevate the limb above the heart level to reduce inflammation
Surgical Treatments

If conservative treatments have failed to provide adequate relief, the orthopaedic doctor may recommend surgical intervention. This includes:

  • Keyhole Surgery: Also known as arthroscopy, this minimally invasive procedure involves using a flexible tube with a camera at its tip (arthroscope) and specialised instruments inserted through small incisions to visualise and access the inside of the joint.

  • Ligament Repair: This procedure is suitable for partial tears and involves using sutures or stitches to reattach the torn ends of the ligament back together. The aim of ligament repair is to promote healing without having to replace it with other tissues.

  • Ligament Reconstruction: When the ligament is completely torn, the surgeon may perform a reconstruction using a graft, a piece of healthy tendon tissue taken from another part of the patient’s body or from a donor, to replace the damaged ligament altogether.

How Can One Prevent Ligament Injuries?

You may reduce your risk of developing a ligament injury by following these steps:

  • Proper Warm-Up: Proper warm-up exercises and stretching before physical activity can help prepare the body for increased demands and movements.

  • Practise Proper Technique: Use correct techniques when participating in sports, such as maintaining good form and body mechanics, to minimise strain and the risk of injury.

  • Adequate Rest: Give your body sufficient time to rest and recover between workouts or intense activities to prevent overuse injuries.

  • Wear Protective Gear: Use appropriate gear, such as knee pads and ankle braces, when engaging in high-risk activities to provide additional support.

  • Gradual Progression of Activity: Gradually increasing the intensity, duration, or difficulty of physical activity allows the body to adapt and strengthen ligaments, reducing the risk of tears.

  • Maintain a Healthy Weight: Being overweight can cause joint strain, increasing the risk of ligament injuries.

FAQs
  • Can a Ligament Tear Heal on its Own?

    Minor tears with microscopic damage may be able to heal on its own after weeks, with proper care. However, a more severe tear should be treated or it can lead to chronic instability, joint dysfunction, and an increased risk of future injuries. It is best to seek medical attention no matter the perceived severity, so as to obtain a proper diagnosis.

  • How Long Does it Take for a Ligament Tear to Heal?

    The recovery time from a ligament injury varies depending on the type, severity and location of the injury and the patient’s overall health and adherence to rehabilitation.

    For mild or moderate ligament injuries, it may take three to six weeks to return to regular activity, while severe ligament tears may require a more extended period of recovery between six and twelve months.

  • Can a Person Walk with a Torn Ligament?

    Some individuals with mild to moderate ligament tears might still be able to walk, even though it can be painful and challenging, especially if the injury affects a weight-bearing joint such as the knee or ankle. Using crutches or other assistive devices may be necessary to alleviate stress in the affected joint and facilitate movement.

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