Ligament Sprain

A ligament sprain is one of the most common injuries that can happen to anyone, from athletes to people going about their daily activities. Understanding what happens when a ligament is injured and how to care for it properly can help you recover faster and avoid long-term problems.

Table of contents

• What is a ligament sprain?
• Understanding ligaments in your body
• What causes ligament sprains?
• Signs and symptoms
• Types and severity grades
• Most commonly affected joints
• When to seek medical care
• How sprains are diagnosed
• Treatment and home care
• Recovery time and healing
• Prevention tips

What is a ligament sprain?

A sprain is an injury that happens when one of your ligaments (the tough bands of tissue that connect bones to each other) is stretched or torn^[1]. This type of injury occurs when a joint is forced to move too much or in the wrong direction^[2].

Your body has almost 1,000 ligaments, which are short bands of tough, flexible, fibrous tissue that help hold your bones in place^[3]. These structures act like strong ropes that keep your joints stable and prevent them from moving too far^[2].

It’s important to understand that a sprain is different from a strain. While a sprain affects ligaments that connect bones to other bones, a strain affects muscles and tendons (the flexible tissue that attaches muscles to bones)^[3].

Understanding ligaments in your body

Ligaments are connective tissues made mostly of collagen and elastin, which makes them both strong and flexible^[5]. They look like ropes, cords, or bands, and their colors can range from pink to yellow or white^[5].

These structures serve several important functions in your body. They connect bones together and hold your skeleton in place, bind the ends of bones in joints while allowing controlled movement, and reinforce joints to prevent them from twisting or moving in the wrong direction^[5].

There are more than 900 ligaments throughout your body, with many located in your limbs, especially around joints where movement happens^[5]. Some ligaments also help hold organs like your intestines, liver, stomach, and uterus in their proper positions^[5].

What causes ligament sprains?

Ligament sprains result from trauma to the ligament^[3]. Anything that forces your joint to move too much or too far can cause a sprain^[2]. The injury happens when sudden twists or jolts apply greater force than the tissue can handle, resulting in a tear or rupture of the fibers^[7].

The most common causes of ligament sprains include sports injuries, falls, slipping and catching yourself suddenly, and rolling an ankle or twisting a knee while walking, running, or jumping^[2]. Other causes can be car crashes or simply stepping off a curb awkwardly^[3].

Sprains can also develop from repetitive strain injuries, which occur when you overuse a joint or perform the same motion repeatedly for work, sports, or hobbies^[2]. Not warming up before exercising, having tired muscles, and playing sports are also common contributing factors^[6].

Signs and symptoms

The symptoms of a ligament sprain vary depending on how severe the injury is^[3]. The most common symptoms include pain, swelling, and bruising or discoloration at the injured area^[1].

You may also experience a feeling of instability, as if you can’t put weight on the joint or move comfortably^[2]. Many people notice a reduced range of motion, meaning it’s hard or painful to move the joint as far as usual^[2]. Some people hear or feel a “pop” in the joint at the time of injury^[1].

The injured area may be tender to touch, and you might have difficulty putting weight on it or using it normally^[6]. In some cases, especially if you’ve had previous sprains in the same area, you might not experience much swelling or pain, but instead just feel that the joint is unsteady or wobbly^[4].

Types and severity grades

Healthcare providers classify ligament sprains into three grades based on their severity^[2]:

Grade 1 sprains are the least serious and involve a stretched ligament with very little or no tearing^[2]. These sprains typically heal within one to two weeks using home treatment^[3]. Symptoms include mild pain and swelling, with no joint instability or difficulty bearing weight^[3].

Grade 2 sprains are more serious and involve a partial tear of the ligament, though not all the way through^[2]. The healing process takes longer, usually one or more months^[3]. These sprains cause moderate pain, swelling, tenderness, and possibly bruising, along with mild to moderate joint instability and some loss of range of motion^[3].

Grade 3 sprains are the most severe and involve a completely torn or ruptured ligament^[2]. These create instability in the joint and can cause severe pain, swelling, tenderness, and bruising^[3]. People with Grade 3 sprains usually cannot bear weight or walk, and recovery may take up to several months^[3].

Most commonly affected joints

While any joint supported by ligaments can be sprained, certain areas of the body are more commonly affected^[2]. Ligament sprains are particularly common in the ankle and knee, but you can sprain a ligament anywhere in your body, including your wrist, elbow, shoulder, neck, and back^[3].

The most commonly sprained joints include ankle sprains (including high ankle sprains), wrist sprains, knee sprains, finger sprains (sometimes called jammed fingers), and thumb sprains^[2]. In fact, the ankle is the most common location for sprains, with about 25,000 people spraining their ankles every day^[1].

Ankle sprains often occur when the foot rolls inward, placing extreme tension on the ligaments of the outer ankle^[4]. Wrist and thumb sprains are also common, particularly in sports like skiing, where it’s not unusual to fall and land on an outstretched palm^[1].

When to seek medical care

While mild sprains can be treated at home, certain situations require immediate medical attention^[1]. You should seek medical care at the emergency department if you are in severe pain or if the joint appears to be dislocated^[3].

Call emergency services or go to the emergency room if you heard a crack when you had your injury, if the injured body part has changed shape or is pointing at an odd angle, if the injured part is numb, tingling, or has pins and needles, or if the skin around the injury has changed color (such as looking blue or grey) or is cold to touch^[6]. These signs may indicate that you have broken a bone^[6].

You should visit an urgent care center or contact your healthcare provider if you can’t manage your pain level with home care, if your symptoms remain the same or worsen after 24-48 hours even with treatment, if the joint feels unstable or “gives out” when you use it, or if the injury affects your ability to do your usual activities^[3].

It’s also important to get medical help if the pain is very bad or getting worse, if there’s a large amount of swelling or bruising that’s increasing, if it hurts to put weight on the injury, if it feels very stiff or difficult to move, or if it’s not feeling better after treating it yourself^[6].

How sprains are diagnosed

A healthcare provider will diagnose a sprain with a physical exam^[2]. During the examination, your provider will check for swelling and points of tenderness in your affected limb^[8]. The location and intensity of your pain can help determine the extent and nature of the damage^[8].

You should tell your provider when you first noticed symptoms, especially if you know exactly what caused the injury^[2]. Your healthcare provider will evaluate your injury and obtain a comprehensive history of your symptoms^[4].

You might need imaging tests to take pictures of your joint and the tissue around it^[2]. X-rays can help rule out a fracture or other bone injury as the source of the problem^[8]. These tests can show damage inside your joint and help diagnose other injuries like bone fractures^[2].

Other imaging tests that may be used include ultrasound and magnetic resonance imaging (MRI), which may be used to help diagnose the extent of the injury^[8].

Treatment and home care

Most people with mild sprains can treat these injuries at home^[2]. For minor sprains, doctors recommend following the RICE method for the first 24-48 hours after the injury^[3].

RICE stands for Rest, Ice, Compression, and Elevation^[1]. Rest means avoiding the activity that caused your injury and trying not to use the injured part of your body while it heals^[2]. Ice involves applying a cold compress or ice pack to the injury for 15-20 minutes at a time, every two to three hours while you’re awake for the first few days^[8]. It’s important to wrap ice packs in a towel to protect your skin^[3].

Compression means wrapping a bandage around the injury to support it and help stop swelling^[8]. However, don’t wrap it too tightly as this may hinder circulation^[8]. Elevation involves keeping the injured area raised above the level of your heart, especially at night, which allows gravity to help reduce swelling^[8].

To help prevent swelling, try to avoid heat (such as hot baths and heat packs), alcohol, and massages for the first couple of days^[6]. After 2 or 3 days, you can try applying heat to the area that hurts for 10 to 20 minutes at a time, several times a day^[3].

Over-the-counter pain medications such as ibuprofen and acetaminophen can also be helpful^[8]. When you can move the injured area without pain stopping you, try to keep moving it so the joint or muscle does not become stiff^[6].

For more severe sprains, you may need additional treatment. Your healthcare provider might prescribe a stronger painkiller, and you may need an ankle cast, walking boot, or crutches^[6]. Physical therapy and rehabilitation exercises often help recovery^[8]. In some cases, particularly for Grade 3 sprains, surgery might be needed to repair the torn ligament^[1].

Recovery time and healing

Healing depends on various factors including the type of tissue and severity of injury, treatment undertaken, previous injuries, and the age and general health of the person^[7].

After 2 weeks, most sprains and strains will feel better^[6]. Grade 1 sprains usually go away within one to two weeks with home treatment^[3]. Grade 2 sprains take a bit longer to heal, usually one or more months^[3]. Grade 3 sprains can take up to several months to recover^[3].

You should avoid strenuous exercise such as running for up to 8 weeks, as there’s a risk of further damage^[6]. Severe sprains and strains can take months to get back to normal^[6]. You should see a gradual, progressive improvement in the joint’s ability to support your weight or your ability to move without pain^[8].

Rehabilitation is critical with a sprained ligament and should be started right away^[4]. Physical therapy at the beginning of your rehabilitation program can help increase range of motion and promote healing^[4]. It’s essential to complete your rehabilitation program to ensure a successful outcome and to make sure the function of your joint is restored and it heals properly^[4].

Without proper treatment and rehabilitation, a severely injured joint may not heal well and could lose its range of motion and stability, resulting in repeated sprains and more problems in the future^[1].

Prevention tips

While you cannot always prevent sprains and strains, there are steps you can take to reduce your risk^[6]. As you age, your ligaments can start to weaken and become more likely to be injured, but you can help keep them healthy and strong by getting regular exercise and avoiding sitting too much^[5].

Several risk factors can increase your chances of spraining a joint. Athletes, workers with physically demanding jobs, and people who have hobbies or activities that require repetitive motions are more likely to experience sprains^[2].

Certain exercise habits can also increase your injury risk. These include suddenly increasing your workout or activity intensity, starting a new sport or activity without proper equipment or training (such as working out with poor form or wearing the wrong kind of shoes), and playing the same sport year-round with no offseason^[2].

You are also more prone to this type of injury if you wear inappropriate shoes, participate in sports, or run or walk on uneven surfaces^[4]. Some people may be born with weak joints or have had previous injuries that leave them more vulnerable to sprains^[4].

Sprains and strains often happen when you overstretch or twist a joint^[6]. Taking proper precautions, warming up before exercise, and being mindful during physical activities can help protect your ligaments from injury.