Tendon & Ligament Injuries: Sprains, Tears and Ruptures

Tendons and Ligaments Explained

Tendons and ligaments are strong bands of tissue that hold your body together and let it move.

• Tendons connect muscles to bones. When a muscle tightens, its tendon pulls the bone and moves the joint.
• Ligaments connect bones to each other inside a joint. They keep the joint stable and stop it moving too far.

Both can be stretched, partly torn or completely torn, during sport, a fall, a twist on an uneven step or a road accident. They can also become inflamed from overuse.

Types of Injury

Strain

A strain is an injury to a muscle or its tendon, in which some of the fibres tear. The muscles of the back and thighs, such as the hamstrings, are the most frequent sites.

Sprain

A sprain is an injury to a ligament. The ankle is the most common place, often after rolling the foot inwards. Sprains are graded by how badly the ligament is damaged:

• Grade 1: the ligament is stretched, with mild pain and swelling.
• Grade 2: the ligament is partly torn, and the joint may feel loose.
• Grade 3: the ligament is completely torn, and the joint is unstable.

Tendon Rupture

A tendon rupture is a partial or complete tear of a tendon. The Achilles tendon at the heel is a common site. Many ruptures need tendon repair surgery.

Tendinitis

Tendinitis, sometimes called tendinopathy, is irritation and inflammation of a tendon caused by overuse. It mainly affects the shoulder, heel, knee, elbow, wrist and hip. Tennis elbow is a familiar example.

Bursitis

Bursitis is inflammation of a bursa, a small fluid-filled sac that reduces friction between a tendon and a bone. The shoulder, elbow, hip, knee and foot are common sites.

Common Ligament Tears

• ACL tear in the knee, often from a twisting sports injury, with a pop and fast swelling.
• Ankle ligament tears, after a bad sprain.
• Rotator cuff tears in the shoulder, which are tendon tears that become more common with age.

Common Symptoms

Typically, a tendon or ligament injury causes:

• Pain of varying strength, described as dull, throbbing or sharp
• Swelling of the area; the faster it appears, the more severe the injury tends to be
• Bruising, whose size also hints at how bad the injury is
• Being unable to use the injured part normally
• Stiffness and loss of movement

First Aid in the First Two to Three Days

For most minor sprains and strains, follow the PRICE steps:

Avoid heat, alcohol and vigorous massage for the first two to three days, as they can increase swelling.

How These Injuries Are Diagnosed

Dr. Gadkari examines the joint to see how stable it is and which structures are painful. An X-ray rules out a broken bone, which can feel just like a bad sprain. An ultrasound or MRI scan shows exactly which tendon or ligament is torn and how badly.

Treatment Options