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About Ligament Injuries

A ligament is a tough band of fibrous tissue that connects bone to bone or bone to cartilage. The primary function of a ligament is to provide passive stabilization to a joint and support and strengthen joints so as to keep the bones of the skeleton in proper alignment and prevent abnormal movements of the joints.
A sprain is usually caused by the joint being forced suddenly outside its usual range of movement and the inelastic fibres are stretched through too great a range. A severe sprain may look and feel like a break (fracture), and it can be difficult to tell the difference between the two. A ligament rupture can occur at the midsubstance of the ligament or at the ligament-bone junction. Sometimes an avulsion fracture also occurs (the ligament pulls a piece of bone with it on injury).

The severity of a sprain is graded according to how badly the ligament has been damaged and whether or not the joint has been made unstable. The joint can become unstable when the damaged ligament is no longer able to give it the normal support.
• Grade I – structural damage only on microscopic level, with slight local tenderness and without joint instability.
• Grade II – partial tear (rupture) of the ligament, visible swelling and noticeable tenderness, but without joint instability (or with mild instability).
• Grade III – a severe sprain: complete rupture of the ligament with significant swelling and with instability of the joint.

Different Types of ligament injuries include the following:

A) Knee Ligament Injuries
• ACL Injury
• PCL Injury
• MCL Sprain
• LCL Sprain
• Posterolateral Corner Injury
• Patella Dislocation
• Superior Tibiofibular Joint Sprain

B) Ankle Ligament Injuries
• Sprained Ankle
• High Ankle Sprain

C) Shoulder Ligament Injuries
• AC Joint Injury
• Dislocated Shoulder

D) Wrist and Hand Ligament Injuries
• Wrist Sprain
• Skier’s Thumb
• Gamekeeper’s Thumb
• Finger Sprain

E) Spinal Ligament Injuries
• Neck Sprain
• Text Neck
• Whiplash

Common Ligament Injuries and Disorders :

1. Torn ACL
Most common of knee injuries, the anterior cruciate ligament (ACL) attaches to the tibia and femur to help form the knee joint. The cruciate ligaments (anterior and posterior) are situated in the middle of the joint and form the shape of a cross (hence the name “cruciate”). The ACL acts as a stabilizer of the knee, preventing the tibia from sliding forward, so a tear to the ligament causes instability and, in some cases, the knee to “give out.”

2. TMJ Disorder
The temporomandibular joint (TMJ) is where the mandible and temporal bone articulate. The ligaments of the joint reinforce it. The joint—a hinge joint, to be specific—allows for all kinds of movement, such as flexion, extension, and rotation.
TMJ Disorder (TMJD) is an umbrella term for various issues with the joint, usually involving the muscles of mastication and the surrounding nerves and ligaments. The most common symptoms are a restriction of movement in the joint, as well as pain.

3. Sprained Ankle
Sprained ankles are one of the most common injuries to the body, and can be caused by simply stepping the wrong way on an uneven surface. An ankle sprain occurs when one or more of the ligaments on the outer side of the ankle are stretched or even torn. Symptoms of an ankle sprain include swelling of the ankle, pain, and the inability to bear weight on it.
Most sprains will heal with the help of rest and the application of ice packs, but in severe cases surgery may be needed to help repair the ligament(s).

4. Plantar Fasciitis
Also known as “jogger’s heel,” plantar fasciitis is the pain and inflammation of the plantar fascia—the thick, strong band of connective tissue stretched along the bottom of the foot, connecting the calcaneus to the toes.
While the plantar fascia is very strong, repetitive stress can cause micro-tears in the ligament, which can lead to stabbing pain usually focused at the heel or the arch of the foot. Plantar fasciitis is common in joggers and runners, and contributing factors include obesity, strenuous activity without proper stretching, high arches, and tight calf muscles.

5. Shoulder Separation
If you receive a blow to the shoulder or fall on your hand , you may experience an injury called shoulder separation. Also known as acromioclavicular or AC separation, it’s a common injury to the acromioclavicular joint. It is not the same as a dislocated shoulder, in which the humerus pops out of the glenoid cavity, but rather a tearing of the ligaments connecting the scapula to the clavicle. The acromioclavicular ligament in particular is the ligament commonly torn with this sort of injury.

Symptoms

A ligament tear is painful and tender to the touch. You may see swelling and bruising. It may be difficult to move the joint. In the case of some ligaments, you may hear a pop or feel tearing at the time of the injury. You may also experience muscle spasms. Movement will be impaired when a ligament is torn, resulting in looseness in the joint or being unable to move the joint normally.

Treatment

In case of minor sprains, Rest, ice, compression, and elevation (R.I.C.E.) is the initial treatment protocol for a ligament injury. The amount of rehabilitation and the time needed for full recovery after a sprain or strain depend on the severity of the injury and individual rates of healing. For example a moderate ankle sprain may require 3 to 6 weeks of rehabilitation before a person can return to full activity. A severe sprain can take 8 to 12 months before the ligament is fully healed. Extra care should be taken to avoid re-injury.
A grade 2 sprain may need bracing to allow for the healing of the partial ligament tear. The location and extent of the injury will determine how long a brace is needed. A grade 3 sprain may require surgery to repair the ligament.

At the clinic of Dr Arunava Lala, ligament injuries are treated with utmost care and most patients recover fairly quickly.

 

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