Not only the muscles, ligaments and tendons are more or less stressed during sports, but also the joints. Each joint is surrounded by a capsule, which can be injured by a wrong movement. One of these forms of injury is the capsule tear or the joint capsule tear.
What is a capsular tear?
Capsular tears are tears of the joint capsule sustained during a dislocation or sprain that often occur in combination with ligament injuries. Capsular tears not infrequently occur in the fingers and toes, as well as in the ankle or knee. Typical symptoms of a capsular tear are severe pain, bruising, and a clearly visible swelling of the affected joint. The joint capsule is a connective tissue sheath that surrounds the joint cavity filled with synovial fluid. Together with the ligaments, it ensures the stability of the joint. The outer capsule protects the inner capsular layer, which ensures that the joint can move smoothly by producing synovial fluid.
Causes
If an abrupt, extreme movement occurs, such as during sports, that overstretches the joint or forces it in a direction that is outside its normal range of motion, in many cases not only are the ligaments injured, but the capsule is also damaged. Such a capsule tear can be caused by a fall, by twisting the ankle, or even by a poorly hit ball. Foreign impacts such as punches or kicks can also lead to a capsule tear. Since the medial ligament in the knee is fused to the joint capsule, a torn medial ligament can also be causative for a capsule tear.
Symptoms, complaints and signs
The exact symptoms and symptoms of a torn capsule depend on where in the body the injury occurs. In general, a capsular tear manifests itself at the moment of injury by a sharp, usually stabbing pain in the affected part of the body. This can subsequently no longer be moved without pain and swells. If smaller blood vessels are injured, bruising may occur. In the area of the capsular tear, a larger hematoma may form under certain circumstances, which only subsides slowly. This often limits the mobility of the joint and causes further pain. Occasionally, a capsular tear can be detected by the typical cracking of the joint. The symptoms of a capsular tear usually develop gradually. After the acute pain reaction, the affected body part swells very slowly, often over days or weeks, and the aforementioned signs of injury appear. With appropriate treatment, the joint heals within a few weeks. The discomfort subsides slowly, with the pain changing to a dull throbbing as it progresses and often persisting for a long time. If a capsular tear is not treated comprehensively, chronic joint, muscle and nerve damage can occur.
Diagnosis and course
At the moment of injury, a sharp, later pulsating pain indicates a capsular tear. Severe swelling of the joint is another characteristic symptom. Here, the swelling is caused by synovial fluid flowing out of the injured capsule. Often, a capsular tear is also accompanied by a hematoma, which forms as a result of injury to smaller vessels and can lead to limited mobility of the joint. In some cases, a cracking sound occurs when moving a joint affected by a capsular tear. A torn capsule is often not easy to diagnose because overstretching of the joint can also result in other injuries, such as a stretched ligament or torn ligament. An x-ray often does not accurately determine whether the ligaments are injured or the capsule. However, a ligament injury can be largely ruled out by ultrasound examination. If the nature of the injury is still not clear after this examination, magnetic resonance therapy can help provide clarity.
Complications
As a rule, a capsular tear results in relatively severe and, above all, stabbing pain. These are particularly noticeable in the patient’s joints and can also spread to other regions of the body, causing pain and discomfort there as well. The patient’s quality of life is significantly reduced by a capsular tear and bruising or swelling occurs.Similarly, there are considerable restrictions in movement, so that ordinary running or walking is no longer possible. The capsular tear may also prevent the patient from performing a professional activity or sport. If the joint continues to be moved, a cracking sound is usually heard. Furthermore, a torn ligament can also occur. A torn capsule must be treated by a doctor in any case, because no independent healing will occur. With the help of various therapies and painkillers, the discomfort can be limited and reduced. Furthermore, the patient is dependent on bed rest and must avoid various movements. Furthermore, a capsular tear can also lead to arthrosis in the joint. Life expectancy is not limited by the capsular tear.
When should you go to the doctor?
If a sudden extreme movement results in a sharp pain near a joint on the body, a doctor should be consulted. If a short sharp pain sensation occurs especially during sports activities, a fall or an accident, this is an indication of an existing damage in the organism. If the affected person experiences a pulsating sensation in the affected area, he or she should consult a doctor. If there is a sudden drop in performance, restriction of movement or discoloration of the skin, medical care is necessary. Often, in addition to the capsular tear, a hematoma develops due to the damage to the surrounding vessels. The existing strength diminishes and touch is perceived as unpleasant. A few minutes after the incident, the first sensory disturbances of the skin appear. To prevent further spread of the symptoms, a doctor should be consulted immediately. Within a short time after the onset of pain, severe swelling sets in. In these cases, it is helpful to cool the injured area as quickly as possible. Nevertheless, the rule of thumb for a torn capsule is that the sooner a doctor is consulted, the better the future course of the disease. To avoid further damage, the injured region should be rested immediately after the damage.
Treatment and therapy
A capsular tear is initially treated according to the PECH rule: In the coming days and weeks, the affected joint should be largely rested. Cooling relieves pain in acute injuries and prevents the affected joint from swelling too much. A compression bandage can also counteract excessive swelling of the joint. The affected body part should be elevated as often as possible to prevent excessive blood flow. Painkillers can be used to counteract the severe pain caused by a torn capsule. However, blood-thinning agents should be avoided, as these increase the blood flow to the tissue. If a capsule tear is suspected, a doctor should always be consulted. Usually, after making the appropriate diagnosis, he or she will immobilize the joint, since moving it too soon can lead to a permanent restriction of range of motion. Special exercise training under the guidance of a physical therapist may also be used to help reduce the bruise more quickly. It usually takes at least six weeks for a torn capsule to heal permanently. Cooling and decongestant medication can have a positive effect on the healing process. However, it can happen that the mobility of the joint remains limited even after a capsular tear has healed. Especially in the fingers, the capsule may remain thickened. A torn capsule can also cause joint arthritis in the long term.
Outlook and prognosis
The prognosis for a torn capsule is favorable. If the affected person acts early and seeks medical care, a full recovery occurs within a few weeks. The affected physical region must be immobilized immediately and should be sufficiently cooled. During the treatment process, severe lifestyle restrictions are to be expected. Sports as well as professional activities cannot be performed as usual. In addition, various activities in the everyday process cannot be performed without discomfort. This can lead to disturbances in coping with everyday life or psychological stress. If the patient adheres to the doctor’s instructions, most patients are free of symptoms after about six weeks.Consequential symptoms are not to be expected. If no medical treatment takes place, the capsule tear also heals. However, severe pain and thus additional impairment of the health condition can be expected along the way. Since the affected physical region automatically continues to move without immobilization, this makes the healing process immensely more difficult. Delays in the recovery process occur and the likelihood of complications occurring increases. In the course of life, a capsular tear can occur again at any time. The prognosis remains favorable if a new diagnosis is made and medical and medical care is provided.
Prevention
The elasticity of tendons, ligaments and capsules decreases from about the age of 30. Therefore, they are particularly susceptible to tears. To prevent a torn capsule, a thorough warm-up is recommended before sports activities. Special stretching exercises can help with this.
What you can do yourself
Acutely, a torn capsule is treated using the so-called PECH rule: Rest from exercise, ice and compresses for pain and swelling, elevation to regulate blood flow in the affected joint. The measures patients can take after initial treatment for a torn capsule depend on the doctor’s diagnosis. For the first two to three weeks, immobilization of the joint is the best therapy. Subsequently, the affected joint should be slowly reintroduced to the usual range of motion. In addition, targeted joint exercises are sometimes recommended. Under the guidance of a physiotherapist, suitable movement training can be carried out, which promotes the healing of a capsular tear and the reduction of hematomas. Cooling and sparing support this process. In addition, the affected joint should be taped during the first days and weeks. A suitable bandage distributes the force and thus relieves the joint. In consultation with the doctor, various natural remedies can also be tried. Arnica, for example, helps with severe pain and swelling. Preparations with the active ingredients Bryonia and Ledum also have a pain-relieving effect and promote the healing process in the case of a torn capsule.
