Injuries To Ligaments Called Sprains

I’m often asked what the difference between a strain and sprain injury is, how long they take to fully heal.  Both strain and sprain injuries are considered acute soft tissue injuries.  Both strain and sprain injuries can occur from traumas yet they also can occur from repetitive motion.  Sprain injuries can also happen due to deconditioned or weak muscles that can no longer support a joint. As the muscle weakens more load stress is placed onto the ligaments which are not designed to take load but are designed to essentially hold the 2 bones making up the joint together.

A sprain is an injury to a ligament as I said. Every joint has ligaments that hold the two bones together to prevent excess movement. All joint have ligaments that encapsulate a joint. There called capsular ligaments. Inside this capsular ligament is a fluid called synovial fluid. Think of synovial fluid as the oil of a joint keeping it lubricated. We have 2 kinds of ligaments fibers in the body. White ligament fibers which are for strength, an example would be the anterior cruciate and posterior cruciate ligaments that prevent the tibia or lower leg bone from moving to far forward or backwards on the femur or thigh bone. Perhaps you have heard of an athlete suffering an ACL injury to the knee there talking about the anterior cruciate ligament. We also have yellow ligament fibers; these ligaments are more elastic than strong still they hold a joint together. An example yellow ligament would be your finger joints. You can stretch your fingers backwards far beyond their normal range of motion. The percentage of fibers is based on what the body needs to do with the joint. Amazing how the body adapts to so many things isn’t it.

When ligaments are subjected to repetitive overloading stress or traumatic injury, the ratio of yellow and white fibers is altered. The body creates a more flexible ligament with more yellow fibers compared to white fibers to withstand the stress. This is a normal adaptation response and although the ligament is less likely to tear with from trauma, the joint is weaker and more susceptible to dislocation and arthritic degeneration.  This same adaptation the body does also works in reverse, When joints are not stressed enough as in constantly wearing knee braces and lumbar back braces the body adapts by decreasing the flexible yellow fibers which can make the joint more susceptible to decrease range of motion and the start of restrictive joint issues.

Joints should be taken through their normal range until one feels restriction due to muscle tightness and not going beyond that point stressing into ligaments. One should always increase joint motion by increasing muscle elasticity only. It’s a slow process I know but, will help to avoid both ligament and muscle injuries.

Sprains are classified by the degree of insult to a ligament. First degree sprains are where ligaments are over stretched. No tearing of the ligament has happened. Passive range of motion of the joint is intact and associated with some pain and swelling though the motion. Ice is used to decrease swelling and pain. Healing time can be a week to a few weeks. A second degree sprain happens when there is some tearing of the ligament and still attached to the bone. Passive joint motion is more painful and swelling is more prominent perhaps some bruising of the area can be seen. Again ice to decrease inflammation perhaps a brace to give stability to the joint will be needed. Healing time is can be a few weeks to a few months. The more you try to use the joint the longer it will take to heal. I always find people have a hard time understanding that or are is it they don’t want to? Time heals plain and simple. The third degree sprain is where the ligament has been torn away from the bone. Usually there will be joint laxity and requires surgery to repair and extensive rehabilitation.

Joint dysfunction will also start to happen as inflammation sets in. Muscles become hypertonic or tight you feel stiff due to that muscle tightness and the resulting inflammation around the joint capsule. If the sprain injury has occurred to the back or neck associated stress to the nerve exiting the spine can occur. A subluxation has occurred. If not treated the compromise to the area of the body that nerve innervates will continue causing other symptoms. Chronic pain, degenerative joint changes, joint instability the weakening of that joint causing flair ups can happen without proper treatment. These changes can also happen in other area besides the spine. Just the absence of symptoms is not enough, making sure the alignment of the joint is intact is crucial for proper rehabilitation to occur.

Joint dysfunction will also start to happen as inflammation sets in. Muscles become hypertonic tight you feel stiff due to that muscle tightness and the resulting inflammation around the joint capsule. If the sprain injury has occurred to the back or neck associated stress to the nerve exiting the spine can occur. A subluxation has occurred. If not treated the compromise to the area of the body that nerve innervates will continue causing other symptoms. Chronic pain, degenerative joint changes, joint instability the weakening of that joint causing flair ups can happen without proper treatment. These changes can also happen in other area besides the spine. Just the absence of symptoms is not enough, making sure the alignment of the joint is intact is crucial for proper rehabilitation to occur.

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