To keep us moving, our bones, muscles, and joints work together perfectly, providing motion and stability. But behind the scenes, tendons and ligaments play equally vital roles.
Written by
Angel Rigueras
Pain Management Specialist
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Written by
Angel Rigueras
Pain Management Specialist
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Tendons connect muscles to bones, allowing us to move, while ligaments act as the body’s natural stabilizers, holding everything in place.
Ligaments are the unsung heroes of movement. Whether you’re an athlete chasing a personal best or simply enjoying life’s everyday moments, healthy ligaments are key to staying mobile, stable, and pain-free.
Did you know your body has over 900 ligaments, most of them located in your arms and legs? While there are many ways to protect them, ligament injuries, like sprains, can still happen. Sprains are one of the most common injuries, especially in the ankle, wrist, back, and neck. Here’s a surprising fact: nearly 25,000 people sprain their ankles every day in the U.S. alone!
In this article, we’ll explore the causes of ligament injuries, the treatments available, and practical tips to keep your ligaments healthy and strong. Let’s dive in and learn how to take care of these crucial components of your body.
Ligaments are remarkable structures made of connective tissue, primarily composed of strong collagen fibers. These tough yet elastic bands connect bones within your joints, acting as the body’s natural stabilizers. Think of them as durable, stretchy cords that keep your joints aligned while allowing smooth movement.
Ligaments come in various shapes and sizes, tailored to their specific roles. Some resemble thin strings, while others are wider, like bands or ropes. Certain ligaments even arch gracefully, adapting to the unique demands of their location in the body. Their colors range from pink to yellow or white, reflecting the specific composition of fibers and tissues.
The primary job of ligaments, along with tendons, is to support and transmit the forces applied to your musculoskeletal system. These resilient tissues are designed to handle decades of wear and tear. However, injuries or connective tissue diseases can weaken their integrity, making them less effective and potentially causing instability or pain.
Some ligaments are not connected to bones. Some make sure that internal organs are kept in place. For example, the womb, which is kept in the right position in the pelvis by ligaments. Additionally, ligaments may also connect two or more organs to each other, for instance, the liver, intestine, and stomach are held in place by ligaments in the abdominal cavity. These ligaments often have sensitive structures like blood vessels or gland ducts running through them. The strong connective tissue in the ligaments protects these structures and prevents them from bending, twisting, or tearing.
Regardless of whether they connect bones or organs to each other, ligaments help to maintain stability in the body. By understanding how ligaments work and how essential they are, we can better appreciate the importance of keeping them healthy and strong.
The most common ligament injuries often occur at the knee (including ACL injuries), ankle, foot, shoulder, elbow (ulnar collateral ligament (UCL) complex), neck, thumb or finger, back, and wrist. For example, you can sprain and twist your ankle if you step on a sidewalk curb the wrong way. If you catch yourself on an outstretched hand, you can injure ligaments in the wrist. People sometimes injure ligaments from impact during a car or bike accident.
Simply, ligament injuries can be classified into two categories:
When a ligament is stretched or torn, this injury is called a sprain. In this case, the injury occurs because the ligament is forced to move in the wrong direction or stretches too far. Prevalence studies indicate that females were at a higher risk of sustaining an ankle sprain compared with males and children compared with adolescents and adults, with indoor and court sports the highest risk activity.
Sprains can be classified depending on the severity of the injury:
Ankle sprains are among the most common types of injuries, particularly lateral ankle sprains (LAS), which are more prevalent in individuals who participate in sports. These injuries carry a risk of developing chronic ankle instability (CAI). CAI is characterized by persistent symptoms such as pain, swelling, or a feeling of instability, along with recurrent sprains for at least 12 months following the initial injury. This condition can result in long-term absenteeism from work and sports activities.
Another notable injury involves the medial ankle ligament complex (MALC), the functional unit of the deltoid ligament. Sprains of the MALC are significantly less frequent than lateral ankle ligament injuries. The deltoid ligament plays a critical role in maintaining medial ankle stability and contributes substantially to the rotational stability of the ankle joint. However, a severe ankle sprain or the development of chronic ankle instability can lead to ligamentous post-traumatic ankle osteoarthritis (OA), which is the second most common cause of ankle OA
Ligament tears refer to injuries involving the partial or complete rupture of the fibrous connective tissues that connect bones within a joint. These injuries often occur as a result of excessive stretching, twisting, or sudden trauma, such as during sports, falls, or accidents.
Ligament tears can cause joint instability, pain, swelling, and restricted movement.
The severity of ligament tears is typically categorized as follows: partial tears, where some of the ligament fibers are disrupted, and complete tears, which involve the total separation of the ligament structure.
Common ligament tears include those affecting the ankle ligaments, the anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) in the knee, shoulder ligaments during dislocations, rotator cuff tears in the shoulder, as well as ligament tears in the fingers, wrists, and neck.
Pain and discomfort are common after an injury, but certain symptoms should never be ignored. Lingering pain, joint instability, or an inability to move the joint may indicate a serious ligament injury that requires medical attention. Orthopedic specialists, sports medicine doctors, and physical therapists can assess the damage and recommend the best course of treatment to ensure proper healing and long-term joint stability. We are here to help you.
The doctor will begin by asking about your symptoms and when they started. A physical examination is typically performed with care, as patients often present with tenderness and hematoma formation around the site of the ligament injury. The affected area will be visually inspected and assessed for range of motion and functionality.
To further evaluate the injury, blood tests may be ordered to rule out possible infections. Imaging tests are often necessary for a more detailed assessment. For example, an MRI can provide detailed images of the ligament, helping to identify the extent of the injury. In some cases, conventional X-rays (radiographs) are used to rule out fractures.
For specific injuries, such as a deltoid ligament injury, a CT scan can be particularly useful. It allows for detailed evaluation of the ankle joint’s congruency and the medial clear space, as well as the exclusion of other pathologies, such as ankle fractures or coalitions.
As treatments, the RICE method (Rest, Ice, Compression, Elevation) is a common conservative approach. While the individual components of ice and compression have been the subject of numerous scientific studies, there is limited evidence supporting their efficacy in significantly reducing symptoms following ligament injuries. When combined with exercise therapy, cryotherapy has shown short-term benefits, including significant improvements in joint function. This allows patients to bear weight and increase loading during recovery more effectively compared to standard functional treatments.
Medications may also be prescribed. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain associated with ligament injuries. Examples include selective NSAIDs like celecoxib (200 mg twice daily) and non-selective NSAIDs such as ibuprofen, naproxen, or diclofenac.
Functional supports are another valuable treatment option. Devices such as ankle braces or tape are often used during recovery. These external supports differ from rigid immobilization, as they allow the patient to load the damaged tissues in a protected manner. Treatment with proper external supports has been shown to be more effective than using less adequate options, such as compression bandages or tubigrips. However, the effectiveness of functional treatment depends on the severity of the injury. For example, if a sprain is complicated by a ligament avulsion fracture, treatment outcomes may differ compared to an isolated ligament injury.
Exercise therapy is often a critical component of treatment. These programs typically include neuromuscular and proprioceptive exercises, which are most effective when initiated early after a ligament injury. Exercise therapy has been shown to reduce the likelihood of recurrent injuries and the development of functional joint instability.
However, surgical intervention may be recommended in specific cases, such as when persistent or severe pain, functional impairment, or failure to respond to comprehensive exercise-based physiotherapy occurs. The type of surgery depends on the injury and the patient’s condition, with common options including:
Other non-common therapies and less frequently used by doctors are massages, ultrasound, Laser therapy, electrotherapy, shortwave therapy, acupuncture, Bioptron light therapy between others.
Each approach is tailored to the patient’s specific needs, ensuring optimal recovery and long-term joint stability.
Ligament injuries should never be ignored, as timely medical assistance is essential for proper healing and preventing long-term complications. If you experience persistent pain, swelling, instability, or difficulty moving a joint, don’t hesitate to consult us at (866) 962-1744 or conveniently request an appointment online.
Here, at University Orthopedic Care, we offer specialized, advanced treatment provided by board-certified orthopedic surgeons, utilizing the latest surgical technologies. Early diagnosis and treatment, whether through conservative methods like exercise therapy and functional support or advanced surgical options, can significantly improve recovery and restore joint function.
By seeking professional care and following a tailored treatment plan, you can ensure a faster, safer recovery and maintain an active, healthy lifestyle.
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