Common Ligament Tears and How They Are Treated (2024)

A torn ligament is a painful injury that may be accompanied by swelling and bruising. Torn or stretched ligaments are also called sprains. They usually occur due to extreme force to a joint, such as with a fall or another high-impact event. Common ligament tears happen in the ankle, knee, wrist, thumb, neck, or back.

Symptoms of a torn ligament can include pain and swelling, bruising, and difficulty moving the affected joint. Depending on the severity, these injuries may be treated conservatively with rest and bracing, with physical therapy, or with surgery.

This article walks you through the symptoms of a ligament tear and the activities that may cause it. It also discusses treatment for the different grades of sprains.

What Is a Torn Ligament?

A ligament is a tough band of fibrous tissue that connects bone to bone. It also connects bones to cartilage, a key element of the joints in your body.

Ligaments are quite strong but can be stretched or even torn. This results in various grades, or levels, of sprain injury.

Forcing a joint out of its normal position can result in a ligament tear. This can occur with a fall, a sudden twist, or a blow to the body.

These injuries are common during athletic activity since joints are in constant motion and under a lot of stress. Ligaments in the ankle,knee, and wrist are commonly affected.

Sprains are graded to describe the extent of the tearing:

• Grade 1: A mild sprain that damages the ligament but does not cause significant tearing.
• Grade 2: A moderate sprain that includes a partial tear. The joint may be abnormally loose.
• Grade 3: A severe sprain with a complete ligament tear. The joint is unstable and cannot be used.

Symptoms of a Torn Ligament

A torn ligament can have a few different symptoms. These may include:

• Pain and tenderness to the touch
• Swelling and bruising
• Difficulty moving the joint
• Trouble putting weight on the joint
• Symptoms that get worse over time

For some ligaments, you may hear a pop or feel tearing at the time of the injury. A torn ligament may also cause you to have muscle spasms.

Where Ligament Tears Are Most Common

• Ankle: Ligament tears are most common toward the outer side of your ankle at what's called the lateral ligament complex. It includes the anterior talofibular (ATFL), the calcaneofibular (CFL), and posterior talofibular (PTFL) ligaments. The medial deltoid ligament, toward the inside, is injured less often. A high ankle sprain is more often seen in competitive athletes.
• Knee: The four major knee ligaments are the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). The ACL tear is the most common of these injuries. Besides pain and swelling, symptoms of a torn ligament in your knee may include knee instability and a popping sensation.
• Wrist: There are 20 ligaments in the wrist. Tears will most often occur when you fall on an outstretched hand. The scapholunate and the triangular fibrocartilage complex (TFCC) are the most common ones injured.

Other common sites of ligament tears and the possible causes behind them include:

• Thumb: The ulnar collateral ligament can be torn when skiing (the injury is often called skier's thumb) or in a fall when the thumb is bent in an extreme position. A sprained thumb does not always cause immediate pain. Bruising, swelling, and tenderness may appear at the base of the thumb and there may be a lump on the inside of the thumb. You may have weakness and a sensation of instability when grasping objects.
• Neck: The neck's ligaments can be torn during whiplash injuries, as in a car accident. The hard speed-and-stop is an extreme motion that injures the cervical spine, the part of the spine in the neck. The ligament tear is just one part of a whiplash injury. It may also damage muscles, nerves, and bones. Besides pain and reduced motion, a torn ligament in the neck may also cause muscle spasms, headache, and numbness in the arm or hand.
• Back: The ligaments in your back can be torn by lifting something that is too heavy. A back sprain may cause stiffness and lower back pain that radiates to the buttocks. You may have a reduced range of motion and trouble maintaining an upright posture. Muscle spasms may also occur.
  
• Shoulder: A torn ligament in the shoulder can occur as a result of direct injury to the shoulder, often from falling onto an outstretched arm. This injury can cause bruising, typically appearing a couple of days after the injury. With severe tears, the tip of the collarbone may look prominent.

Diagnosis

The diagnosis of a ligament tear begins with a physical exam and medical history. Your healthcare provider will ask what you were doing when you were injured. Feeling the site and moving the joint can tell them more about the extent of the injury. Some other tests that may be done include:

• X-ray: A torn ligament will not show up on an X-ray, but an X-ray can find fractured or broken bones that might occur separately or alongside a ligament injury.
• MRI: Magnetic resonance imaging (MRI) may be done to see if there is a partial or complete ligament tear.
• Arthroscopy: This invasive procedure is sometimes done to diagnose a torn ligament. It involves inserting a device called an arthroscope into the joint so your healthcare provider can see the ligament.
  

Treatment

It is possible for a torn ligament to heal on its own with only conservative treatment, but this injury should always be evaluated by a healthcare professional. You may need surgery to help speed healing and improve your chances of regaining complete mobility.

The amount of time it takes for a torn ligament to heal depends on the severity of the injury and its location. A grade 2 ankle sprain with a partial tear, for example, may take around three to six weeks to heal, while a grade 3 sprain with a full tear may take a few months.

Self-Care

The R.I.C.E. approach—rest, ice, compression, elevation—is one of the most popular "first" treatments for ligament injuries.

• Rest: First, stop any activity that stresses the injured joint. This allows time for it to recover.
• Ice: To minimize the swelling and pain, apply an ice pack to the injured area.
• Compression: To further reduce the swelling, wrap the injured area with an elastic bandage.
• Elevation: Raise the injured area above heart level to help control blood flow and minimize swelling.

Medications

Your healthcare provider may recommend an over-the-counter medication like Advil (ibuprofen). They may also prescribe medication for pain and swelling.

Physical Therapy

Once the pain and swelling improve, your healthcare provider may recommend physical therapy or home exercises to help restore the function of the ligament and joint. The recovery time can be a few weeks or up to a year, depending on the severity of the ligament tear.

Bracing

A grade 2 sprain may need a brace to support it. This allows for healing of the partial ligament tear. The amount of time you'll need to wear it will vary based on the specific injury.

Surgery

Some sprains may require surgery to repair the ligament. A separated shoulder that causes prolonged pain, for example, may be treated with surgery to help repair the torn ligament.

Summary

A ligament tear is a sudden and painful injury, caused by activities like playing sports or lifting heavy objects. It causes a sprain, with the severity ranging from grade 1 to grade 3.

Your healthcare provider can determine just how serious the injury is. In many cases, the tear will heal with simple R.I.C.E. measures: rest, ice, compression, and elevation. More severe cases may require immobilization, physical therapy, or surgery.

By Elizabeth Quinn
Elizabeth Quinn is an exercise physiologist, sports medicine writer, and fitness consultant for corporate wellness and rehabilitation clinics.