About Sprains

Muscles usually cross joints and attach to bones. At this point, they are converted into ligaments and attach to the bones, and the joints that move the human body are formed as bones come into contact with one another in various ways. The joint capsule and ligaments connect the bones that make up a joint, creating a stable joint.

The stability of these joints is the most important factor for normal joint movement. Among the soft tissues surrounding the bones, muscles and tendons move the joint and mainly provide active stability, while ligaments do not move the joint but connect the bones that make up the joint to provide passive stability.

In other words, tendons are connected to muscles and move the joint, while ligaments connect the bones that make up the joint more stably and play a role in limiting joint movement so it occurs within the allowed range. Therefore, when joint movement goes beyond the allowed range, for example, when you twist your ankle or when your finger bends backward while trying to catch a ball, the ligaments are injured.

A sprain means an injury to a ligament, and it includes all degrees of ligament injury, from mild damage (partial tear or stretching of the ligament) to complete rupture. Depending on the severity, it can be classified from grade 1 to grade 3.

A grade 1 injury means the ligament itself has not torn, but there are microtears in the ligament fibers and swelling. Because the ligament has not been torn, there is pain but no joint instability, and weight-bearing and walking are possible.

A grade 2 injury is a tear in the ligament tissue or at the site where the ligament attaches to the bone. It is not a complete tear, but a partial tear. Therefore, there is no instability in the normal state, but instability may appear when artificial force is applied in the direction of the injury (stress test).

A grade 3 injury means the ligament connecting the bones has completely ruptured. Instability can be observed even visually, and if not properly treated, it is an injury that can cause serious problems.

The goal of treatment for ligament injuries is to prevent chronic instability of the affected joint due to loss of ligament function. Most grade 1 and 2 injuries can be treated non-surgically using a cast or brace so that the ligament can maintain its anatomical position and length during the healing process.

In the case of grade 3 injuries, the treatment method varies depending on the situation. For the ankle, temporary immobilization and early exercise produce better treatment results, but for knee cruciate ligaments, surgical treatment is more recommended.

In general, complete tears in young patients or athletes are more likely to be treated surgically. When surgery is performed, it is important to restore the ligament's position and length to their original state. If the ligament becomes too long, the joint will loosen and instability will remain, which can lead to degenerative arthritis over the long term. If the ligament becomes too short, joint movement may be limited.

So far, I have explained sprains. In the next part, we will look at the main diseases and symptoms of sprains.

Source: Korea Disease Control and Prevention Agency, National Health Information Portal

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