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Want more treatment options? Visit www.abmp.com to see Whitney Lowe's webinars, where he explores specific treatment approaches for common pathologies. 1 Primary fiber direction: most fibers of the ligament tissues run in one direction, with some fibers running crosswise. A sprain is an injury in which the ligament is torn or stretched beyond its capacity. Most ligament sprains arise from acute injuries that occur when a short-duration, high-intensity load is placed on the tissues (e.g., twisting an ankle). Image 2 shows the relationship between increased load on a ligament and the length change, or degree of tissue damage. When a moderately small load is placed on the ligament, the ligament slightly stretches. When the load is removed, the ligament regains its normal resting length. This ability to recoil from stretching is known as elastic deformation, shown in the "elastic region" in Image 2. If the force load during a short-duration injury is significantly higher, the ligament will overstretch but not return to its normal resting length. This is known as plastic deformation, meaning that when the length of the ligament is changed, some of that change is permanent. This region of change is represented on the graph as the "plastic region." In a more severe injury, the force load is enough to cause a complete rupture of the ligament fibers. These three segments of the ligament-stress curve correspond pretty closely to the three categories of ligament sprain: mild or first degree (elastic damage), moderate or second degree (plastic damage), and severe or third degree (complete rupture). Second- and third-degree ligament sprains often include complications in which fibrous adhesions develop, adhering the healing ligament to adjacent tissues. For example, in a lateral ankle sprain, the anterior talofibular ligament will often attach to the underlying joint capsule or adjacent tissues, and further complicate and lengthen the rehabilitation process (Image 3). Ligament sprains can happen at virtually any joint. However, they are most common where joints are exposed to high velocity and high load, such as the knee and ankle. Sprains may also happen to the small ligaments of the spine, which play a major role in maintaining stability during heavy-lifting activities. 2 The ligament damage load-to-length ratio (reproduced with permission from Orthopedic Assessment in Massage Therapy, Daviau-Scott, 2006). Anterior Talofibular Ligament Ankle Joint Capsule 3 In an ankle sprain, the anterior talofibular ligament may adhere to the underlying joint capsule. 3D anatomy images. Copyright Primal Pictures Ltd. www.primalpictures.com. Managing Ligament Sprains In ligament sprains, swelling from the injury accumulates around the joint. Ligaments are not highly vascularized, and therefore bruising is usually not as significant as it is in a muscle injury where highly vascularized tissue has been damaged or disrupted. Ligament injuries are also routinely painful; any active or passive motion, even if it is well within the joint's normal range, may cause pain. www.abmp.com. See what benefits await you. 107