A ligament sprain is a stretch or tear in a ligament. Ligaments are bands of fibrous tissue that connect bones to bones at joints. They help to stabilise the joint, but still allow enough movement so the joint can perform its function.
A sprain to a ligament usually happen when a person falls, twists or there is an external contact that forces the body out of its normal position. For example, if you are tackled playing sport and you twist your knee or you land badly on your ankle. These can then result in some or all of the fibres that make up the ligament being torn or damaged.
As with muscle strains, ligament sprains can be graded on a 3-point scale.
Grade 1 sprain: Mild ligament tear, there will be a few fibres torn (less than 10%), some tenderness and swelling. However, the joint will not feel unstable or give way during activity. Ligament testing will not show any laxity or instability.
Grade 2 sprain: Moderate ligament tear, there will more than 10% of the fibres torn however the ligament is still intact. There will be a fair degree of swelling and tenderness directly over the injured ligament. There also may be a degree of instability, and ligament testing may reveal a degree of instability, however not marked instability. This can be difficult to assess immediately post injury due to the swelling and muscle spasm that is often present.
Grade 3 sprain: Complete rupture, as the name suggests the ligament is completely torn and there is no structural integrity. Therefore, the ligament will not be able to control movement around the joint. Ligament testing will be positive for laxity and the joint may be unstable, and gives way in everyday life. Ironically despite the severity of the injury there may be little pain. Despite this, there will be swelling and tenderness over the affecting ligament.
A therapist can diagnose ligament sprains by a series of tests for each joint of the body, however in some cases imagery may be used to help with diagnosing between a grade 1 and grade 3 sprain. Imagery can also help with choosing the right treatment method and whether there needs to be surgical intervention.
Minor sprains can usually be treated with PRICE therapy (protection, rest, ice, compression and elevation).
Generally speaking, you should try to start moving a sprained joint as soon as possible, pain dependent. Painkillers such as paracetamol, can be used to help ease any pain. If your pain is more severe, stronger medication can be prescribed.
Physiotherapy is a great way to find out exactly what exercises you should be doing and what stage in your rehab.
If you have a more severe ligament sprain, a surgical intervention may be needed.
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