A stretching or tearing of the ligament occurs when joints are moved beyond their normal range of motion and the collagen fibers within the ligament are pulled apart. Joint “sprains” most frequently occur at the knee (medially), the ankle (laterally), and the acromioclavicular joint of the shoulder (shoulder separation).
Ligament injuries are graded by physicians:
Grade 1 (mild): Ligament is stretched but still intact. Bleeding is minimal, some mild pain and swelling with no instability.
Grade 2 (moderate): Involves a partial rupture of the ligament. Moderate bleeding, pain and swelling. Inability to walk on the limb.
Grade 3 (severe): Complete tear of the ligament. Extensive bleeding, severe pain and swelling. The athlete is usually unable to bear weight on the limb. Potential feeling of complete dislocation (even though that may not have happened).
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Signs and symptoms include varying degrees of pain. Athletes will often report a “popping” or “snapping” sound at the time of the injury. Immediate discoloration and swelling is often indicative of a more severe ligament sprain.
If the athlete is unwilling to move the area, a fracture should be suspected. The shoe (in the case of an ankle) or other equipment/clothing should not be removed as this may cause further damage.
Follow the PRICE principle. PROTECT the area from further injury (wrap). REST the area to promote healing. ICE the area to reduce inflammation. After 72 hours, use both hot and cold treatment to encourage bad blood away from the area. COMPRESSION helps with inflammation. For a knee or ankle ligament injury, ELEVATE the area to promote circulation towards the heart.
With a severe sprain, attention by a physician is necessary. All athletes should be referred to a therapist for a comprehensive rehabilitation program consisting of strength and flexibility exercises, as well as soccer-specific return to activity drills.
After receiving medical clearance, wraps, taping and/or bracing is always a good idea to protect the injured area.
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