A sprain is defined as an injury to a joint where the ligaments are carried beyond their normal range of motion without dislocation or fracture which usually involves some kind of trauma. They can be graded depending on the degree of damage sustained to the ligament (Grade I – stretch, Grade II – moderate tear, Grade III – full tear).
Typically, joint sprains fall into the category of musculoskeletal injuries. Chiropractors, particularly those treating sports-related injuries, manage sprains in athletes and others using traditional manual therapies.
Diagnosis of ligament injuries are derived from the patient’s history and physical exam with an unremarkable neurological exam and no indicators of potentially serious pathology.
Chiropractors perform a thorough history of complaint and examination (orthopaedic, neurological and chiropractic testing). Assessment may also include the use of diagnostic imaging including X-ray and MRI.
More seriously damaged ligament injuries (Grade III) usually need referral for surgical repair.
Back-in-Action Clinical Comment
Chiropractic treatment of ligament injury problems are initially based on reducing inflammation and improving the movement, position and stability of the knee and surrounding structures in order to reduce the risk of stress and further tissue damage.
Self help recommendations of using ice or heat is often given in the acute stage and limiting of aggravating activities. Rest, elevation and support may also be recommended. Ligaments can take about 2 months to recover 60-80% of their strength and take 6-12 months to fully heal. Nutritional approaches can be beneficial to help support soft tissue healing. Chiropractic adjusting techniques (manipulation) and mobilisation may be applied to improve the function of the knee joint itself and other functionally related joints in the lower back and leg. Various muscle release techniques may be applied. An emphasis is placed on self help exercise which might include self mobilisation, stretching, strengthening and balance training. Core stability exercise often is useful for improving the position of the low back, pelvis and hip. Areas of severe muscle spasm may also benefit from massage or acupuncture. Foot orthotics, heel lifts, sitting advice and other ways to improve postural problems affecting the knee may be suggested. Functional neurological treatment and exercises can be helpful.
More seriously damaged meniscal injuries may need referral for surgical repair.
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