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Ligaments are a crucial part of our musculoskeletal system. They connect bones and provide both stability and mobility in the joints. When a ligament is injured, it’s not only painful but can significantly limit movement. After an acquaintance of mine recently tore his anterior cruciate ligament (ACL), I decided to dive deeper into this topic. Here, I’d like to share the key takeaways with you.

The Healing Process of Ligaments

Ligament healing is a complex process that occurs in three phases: the inflammatory phase, the proliferative phase, and the remodeling phase.

In the first phase, which can last from several days to a few weeks, inflammatory cells flood the injured area. They clear away damaged tissue and release cytokines that stimulate the growth of new blood vessels, kickstarting the healing process.

The following proliferative phase, lasting from weeks to months, involves the multiplication of cells like fibroblasts and endothelial cells to repair the damaged area. Initially, the scar tissue formed during this phase is denser, the collagen fibers are less organized, and the tissue is filled with new capillaries.

In the remodeling phase, which can take months or even years, cell density decreases, excess capillaries are resorbed, and the ratio of Type I to Type III collagen shifts. Despite this extensive remodeling, the ligament rarely regains its original strength and functionality.

Immobilization vs. Joint Mobilization

Prolonged immobilization can do more harm than good. It often leads to muscle atrophy, tissue weakening, and even bone loss around the injury site.

A better approach is careful mobilization of the joint—whether passively or actively. This can have positive effects, not only reducing pain but also increasing the joint’s load-bearing capacity.

Moderate Exercise to Aid Healing

The protein TGFB (Transforming Growth Factor Beta) plays a key role in tissue healing. Moderate physical activity can positively influence TGFB activity, which in turn promotes a stronger collagen structure and improves the mechanical properties of the ligament.

However, it’s important to only begin these specific exercises once the ligament is sufficiently stabilized to avoid further injury. Recommended exercises include gentle stretching, strength training, and balance and coordination exercises. Regular practice of these exercises can help improve ligament strength and accelerate the healing process.

Ligament Tear vs. Ligament Strain

The appropriate treatment for a ligament injury depends on whether it’s a strain or a tear. A strain typically involves overextension of the tissue, whereas a tear refers to a complete rupture of the ligament.

A ligament tear usually requires strict rest for the affected joint. Any undue strain can delay healing or even worsen the injury. While moderate movement may be beneficial for strains, a tear might require surgery if the joint remains unstable.

Diagnosis is typically made through a clinical examination, often supplemented by imaging techniques like an MRI. Left untreated, a ligament tear can lead to long-term issues like instability or even arthritis.

A ligament tear often results from sudden changes in direction, abrupt movements, or external factors like falls. Poor warm-up routines, lack of coordination, or weak muscles can further increase the risk.

Closing Words

Healing from ligament injuries is a complex process that depends greatly on the severity of the injury. While mild injuries can benefit from movement, rest and professional care are crucial for a ligament tear. With targeted rehabilitation, joint function can largely be restored, and the risk of future injuries significantly reduced.