Who does not know that? Once inattentively stumbled over a stone and you are already bent over painfully. Fortunately, the pain usually disappears after a few minutes, but a ligament tear can also be the result. Find out about typical symptoms of torn ligaments and common treatment options here.
What is a ligament tear?
Ligaments are firm connections between bones, made of solid connective tissue and stabilizing the intervening joint. Almost every joint is secured in this way, but in some joints, the ligaments are more stressed by our movements than others and are therefore more prone to injury in some movements.
Just like ligaments, tendons are made of solid connective tissue, but they attach the muscles to the bone. They vary in length and can transmit muscle power over longer distances: Many of the muscles that move the hand are on the forearm and only the long tendons pull into the area of the hand.
There is often a connection between tendons and ligaments, as they merge into one another: a long thigh muscle ends with its tendon in the ligament, which protects the kneecap. It is easy to imagine that ligaments on the knee and leg are additionally stressed by our weight, and that there is more serious consequences for an unfortunate movement than on the arm or shoulder.
Origin: how does the ligament rupture occur?
Ligaments are often named medically according to the particular bone they connect - the ligaments on the ankle of the foot are called the anterior and posterior ligaments (anterior and posterior band between the fibula and the talus) and the fibulocalcaneus ligament (band between the fibula and heel bone).
In a ligament tear (also called ligament rupture), the force acting on the band is so great that the tight connective tissue tears. It must always be checked by means of an X-ray, where the tape is torn. When it has ruptured with its bony attachment, the bone structure appears irregular in the radiograph.
If a ligament does not tear, but is greatly stretched by a careless movement, it is called a sprain or distortion (distortion). It can be more painful than a torn ligament.
Causes: What causes a torn ligament?
Because the connective tissue of a ligament is usually very strong, ligament tear only occurs when disproportionate force is applied to the ligament. Unfortunately, we are able to apply this force to our body weight, be it a fall on the hand, a wrong move with the knee or foot.
Torn ligament on the foot (ankle, ankle)
Theoretically, any ligament in our body can rupture, but in practice torn ligaments on the foot - they affect the upper ankle joint - or the most common at the knee. In recent years, it is also possible to more frequently observe torn ligaments on the thumb, the so-called ski thumb.
Luckily, multiple ligament ruptures are more rare in a polytrauma, as occurs in serious car accidents. In addition to many other life-threatening injuries, there are often fractures or joint injuries that result in lengthy treatments.
As already mentioned, there are three ligaments on the upper ankle joint that can all tear: however, the front outer band tears most frequently, then the middle one, which pulls to the heel bone, and the torn seldom the outer outer band tears. That all three outer ligaments tear, is rare, but for the further therapy of importance. In all running sports there is a risk to provoke a torn ligament by choosing unsuitable footwear - however, you can just as well fall over when going to the bakery unhappy.
Torn ligament on the knee
At the knee, there are four ligaments that can be injured: the inner and outer ligaments and the anterior and posterior cruciate ligaments. In addition, the knee joint is something very special. Here, the bands not only pull around the outside of the joint, but also have a connection to the interior of the joint.
There are also two cartilage disks, the menisci, which lie between the thigh and lower leg bones. But that's not all: The inside meniscus has a connection to the inner band, so that in a torn ligament and the meniscus is affected. Often the inner ligament or the cruciate ligaments are torn, the outer ligament is almost never affected.
A typical sport for knee ligament injuries is skiing.
Ski thumb: ligament tear on the thumb
The ski thumb is a typical band injury for this sport. If you do not get your thumb out of the loop of the ski pole and twist your thumb, the band on the inside of the thumb base joint may tear.
Symptoms: How does a ligament tear manifest?
Often the band break causes an audible noise. Otherwise, the affected joint hurts, it swells and a bruise occurs. The most important sign, however, is the changed flexibility of the joint, which is checked during the medical examination. Especially with ankle or knee injuries, you feel insecure on the affected leg - the joint is unstable.
Both the severity of the pain and the bruise are individually very different. It may happen that the X-ray and the examination of the doctor alone give the diagnosis of ligament rupture, although the patient, for example, has little discomfort except for a slight insecurity when walking.
Diagnosis of ligament tears
The held for the diagnosis held radiographs are often very uncomfortable for the patient. The affected ankle is clamped in a device that reminds a bit of a torture instrument. However, the doctor can detect by properly performed X-ray images, if and which type of ligament is present.
At the knee joint, there are various tests (Lachmann test, drawer phenomenon, pivot shift test), which show which band structures are torn. In addition to x-rays, the computed tomography (CT) and magnetic resonance imaging (MRI) imaging techniques are used to clarify whether bones or menisci are also injured.
Treatment for ligament rupture
While ligament tears on the upper ankle were generously treated a few years ago, the procedure has since changed. It is only operated on athletes, when all three outer bands are torn. In this case, the ligamentous apparatus is restored with a periosteal flap.
Otherwise, the conservative therapy has proven itself: In addition to relief, a decongestant ointment bandage and protection, the joint is stabilized with a splint or well-wound tape tapes. Physiotherapy exercises are used early to train the long foot muscles.
At the knee, internal ligament tears are treated conservatively: in addition to relief and early mobilization in a splint, physiotherapy is also used here, so that the sedated thigh muscles do not completely come out of practice.
Treatment of a cruciate ligament tear
The situation is different with a cruciate ligament tear. Only elderly patients who move a little will not be proposed surgery. Since a cruciate ligament rupture leads to permanent instability of the knee joint and the cartilage surfaces are no longer exactly aligned due to the lack of ligament guidance, joint arthrosis occurs more quickly, that is, to wear out the articular cartilage.
Since you can not sew cruciate ligaments, a so-called cruciate ligament surgery must be performed surgically, in which a piece of endogenous tendon is used instead of the cruciate ligament. Mobilization is also started quickly here, otherwise scar formation can restrict complete mobility in the knee joint. However, it usually takes almost a year until you can do any sport after a cruciate ligament injury again. In order to avoid thrombosis in the little-moved leg, thrombosis prophylaxis (usually in the form of a syringe) is carried out until complete mobilization.
Treatment of the ski boot
The ski thumb only needs to be operated if the thumb joint can be opened too much. Otherwise, a three-week immobilization of the joint is usually sufficient for the torn ligament to heal.
What complications can occur?
If a ligament tear is not detected and the ligament can not heal again, the joint may become chronically unstable. In the upper ankle this leads to an increased bending over with the foot, at the knee to pain and gait instability and at the thumb to reduced power when Zufassen.
If such an instability has occurred, there is usually no way around the operation - so you should not take lightly an injury that can lead to ligament rupture, but let the doctor clarify whether there is a torn ligament and the Then treat the ligament with the injured ligament conservatively or surgically according to the doctor's instructions.