Ligament Injuries

What are ligaments?

If you were to build a human, you would start with the bones. The bones are rigid structures that carry most of our weight. Bones come together in joints and those joints are held together by connective tissues. The connective tissue that attaches bone to bone is called a ligament. While muscles, and tendons, also play a supportive role in joint stabilization, the ligament is the most important structure for joint stability second to the bones themselves.

Types of ligament Injuries

When a ligament is damaged, we call that damage a sprain. There are three different grades we assign to sprains to identify how much damage has been done. The grades are 1, 2, and 3.

Grade 1 ligament Sprain

A grade 1 ligament sprain would cause discomfort in the forms of pain and swelling. If you had vision that could see internally you would not see and visible damage to the ligament, but the damage would exist on the microscopic level in the form of tearing of some of the structures that compose the ligament. This type of injury is obtained from stretching a ligament slightly farther than it can stretch causing stress on the microscopic level. This could be done by hyperextending a joint or pulling the bones of the joint apart from the joint from impact. For example, turf toe and whiplash. Repetitive use injury could also be a possibility. Grade 1 sprains can often be treated at home with Rest, Ice, Compression, Elevation, NSAIDs for pain, and possibly a splint or sling. The important factor in healing is going to be preventing further injury, therefore rest is the key to the equation here; the ice, compression, elevation, and NSAIDs are for your comfort as they address the swelling and pain.

Grade 2 ligament Sprain

A grade 2 sprain is a partial tear of the ligament. This tearing opposed to a grade 1 would be seen with the naked eye if we were to open the joint and look. A grade 2 sprain is visible on an MRI. There will be swelling and pain that last longer than a grade 1 sprain. Grade 2 sprains are worth having a physician monitor your healing and you may consider physical therapy eventually to fully recover flexibility and strength of the joint.

Grade 3 ligament Sprain

A grade 3 ligament sprain is also called a ligament rupture. This grade is reserved for a complete tear of the ligament and can be quite serious. Often a grade 3 sprain will destabilize the joint and may require surgical reconstruction to regain the integrity of the joint. Reconstructions are often done with donor tissue, called allograft, but they can also be done by harvesting some of your own tissue, called autograft, from other parts of your body if available. Reconstruction of ligaments is often recovery intensive and may last up to a year for competition level performance requirements.