In our previous blog, we talked about muscle strains. In today’s blog, we want talk about ligament sprains.

The term sprain is associated with an injury to a ligament. The function of a ligament is to connect two bones in order to provide stability and sensory feedback to the brain.

Ligament sprains occur in the presence of a force that exceeds the ability of the ligament to maintain joint integrity at the end range of a motion. This results in overstretching of the ligament.

Common areas of ligament sprains in the lower body:

  • Knee – ACL (anterior cruciate ligament) , PCL (posterior cruciate ligament), MCL (medial collateral ligament), LCL (lateral collateral ligament)
  • Ankle – ATFL (anterior talofibular ligament)

Common areas of ligament sprains in the upper body:

  • Shoulder: acromioclavicular ligament (A-C lig)
  • Wrist and thumb

Ligament Sprains are classified under 3 Grades:

Grade 1

Grade 2

Grade 3

mild sprain with a small number of fibers affected

nearly half of the fibers are affected

complete tear of the ligament

None to Mild joint instability

Moderate joint instability

Significant joint instability

Possible swelling, tenderness, mild pain

swelling and moderate pain

swelling and severe pain

 

*Ligament sprains Graded at 1 and 2 can be treated conservatively with physiotherapy.

*Ligament sprains Graded at a 3 may require surgery depending on the individual’s level of activity.

Factors that can contribute to a ligament sprain:

  • Acute trauma/direct force to the joint
  • Weak muscles
  • unsupportive muscles can expose a joint to greater ranges of motion than it can tolerate
  • Reduced Proprioception/Balance
  • decreased ability to sense where your joint is in space can affect your ability to activate your muscles in a timely manner to prevent injury
  • Previous injuries to that area or surrounding areas
  • Even in the absence of pain, previous injuries, if not rehabbed properly, can still lead to further injury due to muscle weakness and/or tightness, decreased balance

In the presence of a ligament sprain, what can you expect with physiotherapy at Movement Performance Centre?

  • Activity Modification: Modification of activities to allow for healing and prevent further injury to the muscle
  • Game Ready Pro – intermittent pneumatic compression and ice to reduce excessive formation of swelling and pain management
  • Modalities – ultrasound and electrical current for healing and pain management
  • In the presence of ligament injury, muscle spasm/tightness and/or weakness can occur. Even if pain is no longer present, it is important that the surrounding muscles around the joint regain flexibility and strength to accommodate for the decreased support from the ligaments.
  • After an injury to a ligament, balance and proprioception is often affected and thus must be retrained to prevent/minimize risk of re-injury

How do we identify and measure progress?

By using multiple tests such as range of motion, force testing, the Selective Functional Movement Assessment and Functional Movement Screens, we can identify areas of concern that need to be addressed and note whether progress is  truly translating into function and daily life.

Author: Zachary Hum MScPT BAKin