Tendons and Ligaments Injuries Chiropractic Rehabilitation

Tendons and Ligaments: A tendon is a fibrous flexible, strong tissue similar to a rope that attaches the muscles to the bones. Tendons allow for the movement of the body’s limbs and help prevent muscle injury by absorbing muscles’ impact when running, jumping, or performing other actions. Ligaments are bands of solid elastic tissue that connect bone to bone, hold structures together and keep them stable, support the joints and limit their movement.

Tendons and Ligaments

• Tendons are strong and non-flexible.
• Ligaments are flexible and elastic.
• Both comprise collagen and living cells, essential in joints and bones and integral to locomotion.
• Tendons allow body movement by transmitting force from muscle to bone, allowing the body to stand, walk, and jump.
• Ligaments work by allowing for the full range of motion.
• Ligaments are around the knees, ankles, elbows, shoulders, and other joints.

Connective Tissue

• The collagen connective tissue that makes up tendons and ligaments is the same; their patterns are different.
• Tendon fibers are laid out in a parallel pattern.
• Tendon connective tissue needs to have more elasticity to help move the muscles.
• Ligament fibers are laid out in a crisscross pattern. 
• Ligament connective tissue stabilizes and strengthens the bones’ joint structure.

Tendon Injury

A tendon that gets overstretched or torn is known as a strain. Common areas affected by strains are the:

• Leg
• Foot
• Back

Strains often result from repetitive work movements, intense physical activity, and sports. Individuals who overuse their bodies without proper rest and muscle repair recovery have an increased risk of injury. Symptoms include:

• Inflammation
• Swelling
• Pain
• Cramping
• Weakness

Ligament Injury

A ligament that gets overstretched or torn results in a sprain. Sprains can happen suddenly from a fall, awkward movement, or trauma. Sprains commonly occur in the:

• Ankle
• Knee
• Wrist

Examples include:

• Misstep causing the ankle to twist in an awkward position, snapping a ligament and causing unstableness or wobbliness.
• There could be a popping sensation or the feeling of a tear when the injury occurs.
• Wrist sprains often happen when reaching out and extending the hands to break a fall, and the wrist hyperextending back.
• The hyperextension overstretches the ligament.

Symptoms of a sprained ligament include:

• Inflammation
• Swelling
• Bruising
• Pain
• The joint may feel loose or weak and unable to take on weight.

The intensity of symptoms varies depending on whether the ligament is overextended or torn. Sprains are classified by grade:

• Grade 1 – a mild sprain with slight stretching of the ligament.
• Grade 2 – a moderate ligament tear, but not a complete tear.
• Grade 3 – a complete ligament tear, making the joint unstable.

Chiropractic Care

Tendons and ligaments do not receive full blood circulation like other soft tissues. Depending on the severity of the injury, and the slower transfer of oxygen and nutrients, ligament and tendon injuries can take six to twelve weeks to heal, and repeatedly stressing the injured area from overuse can extend recovery. Chiropractic adjustments, and massage therapy, combined with corrective exercises and stretches, will reduce inflammation, decrease pain, improve the range of motion, increase nerve and muscle function, and strengthen the muscles. Chiropractic treatment involves:

• Soft tissue work
• Percussive massage
• Cross friction massage
• Deep tissue massage
• Trigger point therapy
• Rest
• Ice
• Compression
• Elevation
• Ultrasound
• Anti-inflammatory nutritional recommendations

Knee Injuries Adjustment

References

Childress, Marc A, and Anthony Beutler. “Management of chronic tendon injuries.” American family physician vol. 87,7 (2013): 486-90.

Fenwick, Steven A et al. “The vasculature and its role in the damaged and healing tendon.” Arthritis research vol. 4,4 (2002): 252-60. doi:10.1186/ar416

Leong, Natalie L et al. “Tendon and Ligament Healing and Current Approaches to Tendon and Ligament Regeneration.” Journal of orthopedic research: official publication of the Orthopaedic Research Society vol. 38,1 (2020): 7-12. doi:10.1002/jor.24475

orthoinfo.aaos.org/en/diseases–conditions/sprains-strains-and-other-soft-tissue-injuries

Scalcione, Luke R et al. “The athlete’s hand: ligament and tendon injury.” Seminars in musculoskeletal radiology vol. 16,4 (2012): 338-49. doi:10.1055/s-0032-1327007