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L i s te n to T h e A B M P Po d c a s t a t a b m p.co m /p o d c a s t s o r w h e reve r yo u a cce s s yo u r favo r i te p o d c a s t s 29 ligaments, it is not as easy to identify the primary motions they resist. The severity of ligament damage depends on the size of the ligament and the force it can withstand. Some ligaments, such as the medial collateral ligament of the knee, are large and can withstand high tensile loads. Others are much smaller because they are not resisting such high forces. If the tensile stress is minor, the ligament can absorb the force with minor elastic deformation (fiber stretching) and is called a first-degree sprain (Image 1). If the force is significant, the ligament fibers stretch past the tissue's initial ability and undergo plastic deformation, meaning the tissue stretches but does not recoil to its original length. A permanent degree of tissue elongation can occur (Image 1); this plastic deformation represents a second-degree sprain. If the ligament is stretched beyond plastic deformation, it will tear; these are called third-degree sprains. Ligament sprains frequently occur in sports or traumatic accidents due to high and rapid force loads. However, prolonged stress on the ligaments can also weaken them, making them more susceptible to injury from smaller loads. Ligament sprains are more prevalent in people with systemic disorders such as Ehlers-Danlos or Marfan syndromes because these conditions lead to weakness in connective tissues. In addition, women in the later stages of pregnancy experience a greater number of ligament sprains due to increased ligamentous laxity resulting from elevated levels of the hormone relaxin. There are various approaches to treating a ligament sprain with massage. If the ligament is accessible, deep friction massage has beneficial results. Originally, the idea behind friction massage was that the transverse movement of the friction helped realign scar tissue and prevent fibrous adhesions between fibers. That specific narrative is being challenged, but the technique still gets beneficial results. We also know that friction massage may aid in fibroblast proliferation, which helps the restoration of damaged tissue. Other treatments claim to "release" ligaments, though it is unclear what that means. For a tissue to release, it would first have to contract, and because ligaments do not have any contractile properties, there isn't anything to release. It is possible that in the effort to reach a ligament with manual therapy, other neurologically responsive Anterior cruciate ligament. Image courtesy of Complete Anatomy. Ligaments involved in shoulder separation. Image courtesy of Complete Anatomy. 2 3 Anterior cruciate ligament Acromioclavicular Trapezoid Conoid Sternoclavicular