Digital Health Assistant & Symptom Checker | Symptoma
0%
Restart

Are you sure you want to clear all symptoms and restart the conversation?

About COVID-19 Jobs Press Scholarship Terms Privacy Imprint Medical Device Language
Languages
Suggested Languages
English en
Other languages 0
2.1
Ligament Sprain
Sprain of Ligament

A ligament sprain is defined as a damage of the ligamentous structures due to excessive stretching and is one of the most frequently encountered musculoskeletal injuries. In fact, ankle sprains include a major share of the injuries seen in the emergency setting. In addition to the ankle, the knees, elbows, and hands are notable sites where ligament sprain occur. Typical complaints include pain, weakness, limited range of motion, and swelling. A thorough history and a proper physical examination can make the initial diagnosis, but imaging studies are necessary to rule out more serious ailments, such as fractures.

Presentation

Ligaments sprains are very common injuries in the athletic population and various joints may be affected [1] [2] [3] [4] [5] [6] [7] [8]:

  • Ankle sprain - About 80% of all ankle sprains develop as a result of excessive and abrupt inversion or supination of the ankle joint when landing to the surface [3]. This phenomenon can be seen in many individual and team sports, particularly among basketball players [2]. The ligaments of the lateral aspect of the ankle are the principal sites affected by ankle sprains and signs such as weakness, reduced joint mobility, swelling, and pain are common, which may last up to 1 year after injury [1]. A significant risk exists towards reinjury of the ankle, particularly in the absence of proper treatment for the initial injury, whereas inadequate stretching prior to exercise is also identified as a risk factor [1] [2].
  • Knee sprain - Various ligaments of the knee are at risk, including the collateral (medial and lateral, or MCL and LCL, respectively) and the cruciate (anterior and posterior, or ACL and PCL) ligaments [5] [6]. Studies show that teenagers (between 15-19 years of age) who engage in sports activities are most susceptible to knee sprains and increased body weight and body mass index (BMI), along with several other structural and mechanical factors that predispose to this type of injury [5] [6]. Similarly to ankle sprains, ligamentous injury of the knee is suspected if joint pain, instability, effusion, or weakness is present [5].
  • Elbow and hand sprains - The medial (or ulnar) collateral ligament of the elbow can be abnormally stretched when exposed to direct force from the lateral side [7]. Athletes such as javelin throwers, or those who participate in overhead sports (volleyball, water polo, tennis, or baseball) develop this type of injury, and medial elbow pain is the principal symptom [7]. On the other hand, rock climbing is associated with ligament sprains of the hand [8].

Entire Body System

  • Falling

    Falling, twisting, or getting hit can force your joint out of its normal position. This can ligaments around your joint to stretch or tear. Sprains usually happen when you: Fall and land on an arm. Fall on the side of their foot. Twist a knee. [niams.nih.gov]

    But for runners, the medial collateral ligament (MCL) and the lateral collateral ligament (LCL) are more prone to injury because they tend to get overstretched, especially if we slip or fall. [runnersworld.com]

    Risk Increases With Contact sports (football, rugby) and sports in which falling on an outstretched hand results in an elbow dislocation Throwing sports, such as baseball and javelin Overhead sports, such as volleyball and tennis Poor physical conditioning [csosortho.com]

    Soft-tissue injuries fall into two basic categories: acute injuries and overuse injuries. Acute injuries are caused by a sudden trauma, such as a fall, twist, or blow to the body. Examples of an acute injury include sprains, strains, and contusions. [orthoinfo.aaos.org]

  • Fever

    NSAIDs, such as ibuprofen, help decrease swelling, pain, and fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. [drugs.com]

    […] following signs, it is even more important that you seek care: If you or the injured person heard a “popping” sound as the injury took place, if there is significant swelling, it is hard to feel or use the extremity, you cannot walk or you have a high fever [damfirm.com]

    Seek medical care immediately if an odor emanates from within the cast or if a fever, which may indicate infection, develops. [merckmanuals.com]

  • Localized Pain

    Both involve localized pain, ankle swelling, and instability, but the location and side effects of that pain and instability can differ depending on whether a muscle or ligament is involved. [sports-health.com]

    While hand ligament injuries are often obvious due to the local pain and swelling that accompanies them, the severity of such injuries is easy to misjudge. [newyorkorthopedics.com]

    Instead of localized pain, patients with these fractures may have diffuse, vague pain along the medial longitudinal arch or dorsum of the foot. 13 This stress reaction may be misdiagnosed as medial longitudinal arch pain or plantar fasciitis. [aafp.org]

  • Rigor

    Sprain, strains and tears can generally be prevented by adequately warming up and stretching prior to rigorous activity, wearing protective equipment, wearing proper fitting shoes that provide stability and building and maintaining muscle and joint strength [sciencedaily.com]

Musculoskeletal

  • Muscle Spasm

    Associated muscle spasm, if present, may be treated with muscle relaxants. Physical therapy, such as mobilization exercises or manipulation of the sacroiliac joint may be useful. [healthcentral.com]

    Symptoms include pain, muscle spasms, swelling, and trouble moving the muscle. At first, treatment of both sprains and strains usually involves resting the injured area, icing it, wearing a bandage or device that compresses the area, and medicines. [nlm.nih.gov]

  • Knee Pain

    The location of the pain can help to determine which knee ligament you have sprained. 1) Medial Knee Pain: pain on the inner side of the knee usually indicates a Medial Collateral Ligament tear - see MCL Tear 2) Lateral Knee Pain: pain on the outer side [knee-pain-explained.com]

    It can provide continuous ice cold water and compression for 6 hours - and significantly reducing knee pain and knee swelling. [physioroom.com]

    A clip to the outer knee may create initial pain only on the lateral knee, but hours later the medial knee pain may exhibit itself. 1 Clipping represents a contact injury, but more often the injury is of a non-contact variety such as skiing where the [dynamicchiropractic.com]

  • Elbow Pain

    In addition to the ankle, the knees, elbows, and hands are notable sites where ligament sprain occur. Typical complaints include pain, weakness, limited range of motion, and swelling. [symptoma.com]

    Elbow sprains can happen when: You fall with your arm stretched out, such as when playing sports Your elbow is hit very hard, such as during a car accident You may notice: Elbow pain and swelling Bruising, redness, or warmth around your elbow Pain when [medlineplus.gov]

    Examples of conditions treated by an upper extremity specialist are: Tennis elbow Upper arm and forearm Fractures Biceps tendon tear Ulnar nerve entrapment Elbow pain/ dislocation Sports injuries If you have pain in your elbow or any of the conditions [resurgenssportsmedicine.com]

  • Joint Stiffness

    They are also more likely to recur and leave you with: abnormal scar tissue formation joint stiffness muscle weakness It's important to remember that symptoms lasting longer than three months become habitual and are much harder to solve. [physioworks.com.au]

  • Joint Effusion

    Plain x-rays show primarily bone (and joint effusion secondary to bleeding or occult fracture) and thus are useful for diagnosing fractures. They should include at least 2 views taken in different planes (usually anteroposterior and lateral views). [merckmanuals.com]

Psychiatrical

  • Fear

    Some patients fear the worst, especially when pain is acute or severe. [spineuniverse.com]

Neurologic

  • Irritability

    If your knee feels sore while you are doing these exercises, you should proceed slowly to prevent further irritation. [ucsfhealth.org]

    This is to ensure that subjects with a history of these syndromes are not included as a safety issue) History of recurrent peptic (gastric or duodenal) ulcer (Rationale: It is well established that NSAID's have gastric irritation, gastritis, and ulceration [clinicaltrials.gov]

    Rest may mean complete rest or for longer term chronic injuries discontinue with the sport or activity that irritates the injury or causes pain. Wear a hinged knee brace to support and protect the joint, particularly for grade 2 and 3 injuries. [sportsinjuryclinic.net]

    Proliferants are nothing more than irritants. [diagnose-me.com]

Workup

To make the diagnosis of a ligament sprain, the physician needs to perform a comprehensive clinical assessment [4] [5] [6]. Firstly, the circumstances under which the injury occurred needs to be disclosed, together with the present complaints and their severity. The physical examination is, perhaps, the crucial component of the workup. Confirmation of reduced range of motion, palpation of the affected area, as well as directed tests can further solidify the diagnosis [3]. Valgus instability (application of valgus stress when the elbow is in 20°-30° degree flexion) and the milking maneuver (induction of valgus stress by pulling the patient's thumb with the forearm in flexion beyond 90° and in supination) are probes used to assess of elbow ligament injury [7], whereas the anterior drawer test and the talar tilt test some of the most widely used exams for evaluating ligamentous structures of the ankle [4]. The role of imaging studies, such as X-rays, arthrography, ultrasonography, or magnetic resonance imaging (MRI), is focused on excluding more serious injuries (mainly fractures) and confirming clinical findings [4] [5], meaning that the physician plays a key role in raising suspicion toward this injury based on signs and symptoms obtained during history-taking and physical examination.

Treatment

TREATMENTS – this suggests that the athlete should seek treatments such as physiotherapy (or physiotherapy) who may also utilise other modalities with the aim of stimulating blood flow and healing. [thesportsphysiotherapist.com]

Grade III MCL or LCL sprain treatment For most Grade III MCL and LCL sprains, doctors will use many of the same conservative treatments as they do for less severe knee sprains. These treatments may include: R.I.C.E. [upmc.com]

The mean duration for recovery with conservative treatment of isolated, complete tears of the MCL is normally 4-8 wk. [ncbi.nlm.nih.gov]

Physiotherapy treatment for an iliolumbar ligament sprain. Physiotherapy is very important in the treatment of an iliolumbar ligament sprain. Initially, your physiotherapist can diagnose your problem and determine its severity. [physio.co.uk]

The initial treatment for foot sprains consists of the RICE treatment, or rest, ice, compression and elevation. RICE treatments aim to reduce swelling at the injury site. [livestrong.com]

Prognosis

Prognosis Most people recover full function following a course of conservative care that includes physical therapy, medication and/or injections. [twinboro.com]

Maintain appropriate conditioning: Arm, forearm, and wrist flexibility Muscle strength and endurance Use proper protective technique when falling and throwing Functional braces may be effective in preventing injury, especially re-injury, in contact sports Prognosis [csosortho.com]

The prognosis for a patient with ankle sprains and other traumatic injuries is related to the prognosis for the other injuries. [emedicine.medscape.com]

Prognosis of an ankle sprain In cases of a minor to moderate medial ligament ankle sprain (grades I and II), return to sport or normal activity can usually occur in 3 – 8 weeks with appropriate management. [physioadvisor.com.au]

Etiology

Etiology Medial collateral ligament injuries occur in response to a direct valgus load applied on the lateral knee or twisting mechanisms. The direct blow is more apt to cause a higher grade injury. [orthopaedicsone.com]

Etiology Mechanical forces exceeding the tensile limits of the ankle joint capsule and supportive ligaments cause ankle sprains. [emedicine.medscape.com]

Background & Etiology The lower back can be divided functionally and anatomically into three separate areas, the lumbar spine, the sacrum, and coccyx. The lumbar spine includes five lumbar vertebra (L1-L5), and five intervertebral discs. [twinboro.com]

Specific populations and sports display an increased incidence of medial ankle sprains: 7 male gender higher competition levels young populations intercollegiate rugby gymnastics soccer Potential Etiologies: Mechanism of Injury 2 Excessive pronation Excessive [morphopedics.wikidot.com]

Epidemiology

Epidemiology Medial collateral ligament sprains are thought to be the most common sprains about the knee. Precise numbers are difficult to obtain. [orthopaedicsone.com]

Re-injury is also very common. [27] Epidemiology [ edit ] Adolescents vs general population ankle sprain instances Ankle Sprain Epidemiology- U.S. [en.wikipedia.org]

Epidemiology Most ankle sprains are probably self-treated and are never reported to a health care provider; therefore, many ankle sprains are not documented. [emedicine.medscape.com]

Pathophysiology

Pathophysiology A disruption of the medial collateral ligament will lead to valgus instability of the knee, that is, medial gaping when a valgus force is applied. [orthopaedicsone.com]

Pathophysiology The lateral ankle complex, which is composed of the anterior talofibular, calcaneofibular, and posterior talofibular ligaments, is the most commonly injured site. [1, 2, 3, 4] Approximately 85% of such sprains are inversion sprains of [emedicine.medscape.com]

Prevention

It links the thigh bone and the shin bone and acts to prevent excessive inward movement of the knee joint. [physioroom.com]

The ligament will heal on its own, and the main thing to do is to prevent re-injury to the ligament during its healing. [healthline.com]

Small and simple changes to your movements, combined with adequate treatments and following the Physio-4 for Strains n Sprains tips below, can prevent muscle strains and ligament sprains from becoming chronic injuries and prevent future episodes. [garibaldiactivewellness.com]

References

  1. McGovern RP, Martin RL. Managing ankle ligament sprains and tears: current opinion. Open Access Journal of Sports Medicine. 2016;7:33-42.
  2. McKay GD, Goldie PA, Payne WR, Oakes BW. Ankle injuries in basketball: injury rate and risk factors. Br J Sports Med. 2001;35(2):103–108
  3. Fong DT, Chan YY, Mok KM, Yung P, Chan KM. Understanding acute ankle ligamentous sprain injury in sports. Sports Med Arthrosc Rehabil Ther Technol. 2009;1:14
  4. Polzer H, Kanz KG, Prall WC, et al. Diagnosis and treatment of acute ankle injuries: development of an evidence-based algorithm. Orthop Rev (Pavia). 2012;4(1):e5.
  5. Logerstedt DS, Snyder-Mackler L, Ritter RC, Axe MJ, Godges JJ. Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain: Clinical Practice Guidelines Linked to the International Classification of Functioning, Disability, and Health from the Orthopaedic Section of the American Physical Therapy Association. J Orthop Sports Phys Ther. 2010;40(4):A1-A37.
  6. Gray AM, Buford WL. Incidence of Patients With Knee Strain and Sprain Occurring at Sports or Recreation Venues and Presenting to United States Emergency Departments. J Athl Train. 2015;50(11):1190-1198.
  7. Rahman RK, Levine WN, Ahmad CS. Elbow medial collateral ligament injuries. Curr Rev Musculoskelet Med. 2008;1(3-4):197-204.
  8. Kubiak EN, Klugman JA, Bosco JA. Hand injuries in rock climbers. Bull NYU Hosp Jt Dis. 2006;64(3-4):172-177.
Languages
Suggested Languages
English en
Other languages 0
2.1
About Symptoma.ie COVID-19 Jobs Press Scholarship
Contact Terms Privacy Imprint Medical Device