Partial tendon rupture, a condition better known as a sprain, is one of the most common sports injuries in almost all sports.
Sprains require treatment that must be correct and timely. Much attention should also be paid to strengthening the ligaments and preventing sprains.
Tendons or ligaments are connective tissue cords that connect muscles to bones, as well as bones to bones (the articulation of the articular processes of bones), which ensures joint stability and strict trajectories of movement.
For example, the knee can perform only flexion and extension, as well as minor rotation, while abduction or adduction is impossible.
The most common sprains of the ankle, shoulder, knee, and toes. The course of treatment lasts three to five weeks, and full recovery takes up to nine weeks. More severe cases require particularly long-term treatment, including surgery.
Mechanism of injury
Most often, tendon stretching occurs as a result of twisting movements in the bent state of the joint. For example, a partial rupture of the ankle tendons often occurs in basketball and football players with a sharp rotational movement.
In bodybuilding and powerlifting, partial tears occur when lifting heavy weights and sudden movements, against the background of an unprepared tendon apparatus.
The clinical picture of the injury and its severity largely depend on the degree of ligament rupture. Three degrees are distinguished:
1 degree – part of the tendon fibers are torn, but its continuity and mechanical integrity are preserved, there is no hemorrhage.
Virtually no swelling or swelling of the damaged joint is detected, and manifests itself mainly in moderate pain. This is the most common type of stretching. Duration of treatment is 1-2 weeks.
Grade 2 – most of the fibers of the ligament are torn, the capsule can also be involved. Bruising, swelling is possible. Joint movement is limited and quite painful.
Slight instability (pathological mobility) in the joint may be detected. Duration of treatment is 3-6 weeks.
Grade 3 – complete rupture of the tendon. There is severe swelling, bruising under the skin, joint instability (severe pathological mobility).
There is no resistance during the stress test, pain is expressed. The treatment takes over 6 weeks. Self-healing does not always occur, so an operation to restore integrity is required.
Sometimes, grade 2 and 3 sprains cause complications that persist even after full recovery. For example, small nodules can form in a damaged tendon, which cause constant friction in the joint and chronic inflammation. Therefore, even after complete recovery, pain may remain.
Another complication is the rupture of the nerves that pass through the tendon. If it does not grow together properly, chronic pain and a tingling sensation may occur.
Quite rarely, as a result of painful shock, vasospasm occurs, which reduces blood flow in the damaged area and leads to tissue degeneration.
Reasons for ligament damage
The cause of the sprain is a strong tension in the deep layers of the connective tissue of the joints, as a result of which they break at the weakest point.
In powerlifting, it is mainly the shoulder joints, lower back and knee that are at risk. In bodybuilding, which includes strength exercises for all muscle groups, injuries to the lower back and knees are also common.
Exercises in which there is a high risk of ligament rupture or sprain:
- Squats with a heavy barbell – in a bent position, the knee is subjected to a very strong load. Preventive measures: thorough warm-up, smooth performance of squats, bandaging the knees, with problem knees, you can do a warm-up on a Smith machine – it helps to relieve this area.
- The barbell deadlift can lead to partial rupture of the lumbar ligaments. It is sometimes difficult to distinguish them from sprains of the back muscles, the treatment is the same.
- Bench press and shoulder press. Overworking these simple exercises is a common cause of rotator cuff tears.
- Presses. The elbow joint is often traumatized, and changes can occur imperceptibly. Joint fixation is recommended.
- Pull-ups on the bar, press of the bar with a rise from the position from the floor are uncomfortable for the hands and force to twist the hands. There is a risk of injury anywhere in the forearm, including stretching the wrist.
Treatment and prevention of sprains
Grade 1 sprain treatment is carried out at home in compliance with the following rules and methods:
Special orthopedic bandages are made for each joint: shoulder, elbow, knee and ankle. The support protects the damaged ligaments, allowing them to recover without hindrance.
Instead of a caliper, you can use an elastic bandage in mild cases, this will reduce swelling and reduce mobility. Do not apply the elastic bandage too tightly, as this can interfere with venous return.
Take off the bandage before bed. In more severe cases, splint is used. Special shoes are often used to treat sprains of the ankle.
Damaged ligaments need to be protected from stress and mobility. Therefore, keep the joint and the surrounding muscles at rest (still) for 48-72 hours after injury.
After that, you need to gradually increase mobility, do a light warm-up and, depending on the degree of damage, connect strength exercises.
Do not keep the joint at rest for an excessively long time – this can lead to decreased mobility and muscle dystrophy. The main reference point is pain. You can increase the load if it does not cause severe pain.
Immediately after injury, it is advisable to apply ice wrapped in a damp towel to the damaged area for 15-20 minutes. Cold suppresses inflammation, reduces bruising, and reduces pain. Apply ice every 2-3 hours for the first day after stretching.
Do not apply ice without a towel or a special bag and do not leave it on for a long time – this can cause frostbite.
Try to keep the damaged joint in the most elevated position – this is especially true if the ligaments of the legs are damaged.
Use chairs, pillows, and other available means on which to place the injured limb. It improves venous return, reduces swelling and reduces pain.
Ligament and Joint Supplements and Warming Ointments
Used for both treatment and prevention
Try to avoid, for at least the first 72 hours, when treating sprains:
- Heat – bath, sauna, hot bath, hot compresses, etc.
- Alcohol – drinking alcohol increases swelling, bleeding and slows recovery
- Movement in an injured joint or muscle can cause further damage. Exercises are shown only during the recovery (rehabilitation) phase.
- Massage – increases swelling and bleeding. Indicated only at the stage of recovery (rehabilitation).
Most qualified professionals do not recommend immobilizing a damaged joint or muscle for a long time.
With 1 degree of damage, rehabilitation begins within 48 hours. With 2 degrees of sprain, rehabilitation treatment begins in 3-4 days.
Begin to gradually include warm-up movements without burdening, but do not perform them “through pain.” Then start working with light weights, gradually moving to heavier ones, until you are fully recovered.
Your attending physician should familiarize you with the rehabilitation program in more detail.
Don’t start loading injured tendons too early. Studies in 2009 showed that after an ankle ligament injury, splint for 10 days led to faster recovery than people who started physical activity earlier.
Long-term immobilization is also required in the case of a complete rupture of the tendon until the mechanical strength of the connecting structures is restored.
Don’t forget that the treatment for sprains and muscles will be different. So with a partial rupture of a muscle, complete immobilization is required, which is much longer.
Pharmacological agents are also often used to stretch tendons. First of all, these are non-steroidal anti-inflammatory drugs such as ibuprofen, diclofenac or ketans.
These drugs help reduce pain and suppress inflammation. Do not use drugs of this group for a long time (more than 1 week), as this is fraught with various side effects (stomach and duodenal ulcers). You can use ointments and creams based on them, but the effectiveness of these forms is much lower.
Combination drugs are sometimes used, which include opioid analgesics (most often codeine), these drugs are more effective in relieving pain.