Ligament injuries are most common in the ankle and knee and can also occur in the wrist and elbow. Ligament injuries are often called “soft tissue” injuries as they do not involve any injury to the bones like in a fracture (or broken bone). Ligaments help support joints by linking two or more bones in a joint together to provide stability. They are typically injured by twisting or bending the joint inappropriately such as twisting the ankle or knee. Swelling, bruising, and pain are common symptoms that may be experienced.
Ligament injuries, or sprains, are classified as grade 1, 2, or 3. Grade 1 ligament sprains are when the fibrous ligament that connects the bones of a joint together are stretched more than normal, but no tearing of the ligament occurs. Grade 2 is when there is partial tearing of the ligament. Finally, grade 3 is when there is complete tearing of the ligament. The higher the grade the more severe the injury. This translates into more pain and a longer recovery time.
Imaging is usually not required for mild to moderate ligament sprains. MRI or ultrasound may be used in a severe injury in which surgery may be considered. Mild to moderate injuries are usually managed with conservative therapy including rest, ice, NSAIDs, physical therapy, and bracing. Again, if a grade 3 injury is present, surgery may be necessary to reattach the ligament and stabilize the injured joint. Examples of this include ACL repair in the knee and UCL repair in the elbow. The latter injury is probably better known as Tommy John surgery, named after the first Major League Baseball pitcher who underwent the surgery and successfully recovered from it to eventually pitch again in the majors. However, countless other athletes have suffered from both ACL and UCL tears in the past and have gone on to make successful recoveries in their respective sports, from football to basketball to soccer to baseball.