During sports, not only our muscles, tendons and ligaments are stressed, but also our joints. Each joint is encased in a capsule. Incorrect movement can cause an injury to this capsule. Capsule tears occur particularly frequently in the fingers and toes, as well as in the knee and ankle. Typical symptoms that indicate a capsular tear are severe pain, marked swelling of the joint, and bruising.
Causes of a torn capsule
The joint capsule, along with the ligaments, provides stability to a joint. It is composed of two different layers: The inner capsule ensures that our movements can work smoothly by producing synovial fluid. The outer capsule protects the inner layer. If a sudden, extreme movement occurs during sports that causes the joint to overstretch or move in a direction it is not actually designed to move, this can lead not only to injury to the ligaments, but also to a capsule injury. Capsule tears are often caused by twisting the ankle, a fall or a poorly hit ball. However, outside impacts such as a punch or kick can also result in a capsule tear. In the knee, a capsule injury can also result from a torn inner ligament. This is because the inner ligament is fused to the joint capsule.
Capsule tear symptoms
A capsular tear is characterized by a sharp pain at the moment of injury, which later takes on a pulsating character. Another typical symptom is severe swelling of the affected joint: the swelling is caused by synovial fluid flowing out of the injured capsule. Often, a bruise (hematoma) also forms in the case of a capsular tear, which is caused by the injury to smaller vessels. The bruise can cause the joint to have limited mobility. In rare cases, another symptom that occurs is a cracking sound when moving the joint.
Diagnosis of capsular injuries often difficult
Diagnosing a capsular tear is not always easy. This is because if the joint is overstretched, other injuries, such as a torn ligament or stretched ligament, can also occur. An X-ray usually does not clarify exactly whether ligaments or capsule are injured. However, an ultrasound examination can be used to rule out a ligament injury. If there is still uncertainty about the nature of the injury after ultrasound, the doctor may perform magnetic resonance imaging (MRI).
Treating a torn capsule: The PECH rule
An acute capsular tear should first be treated according to the PECH rule:
- Rest: the affected joint should be spared as much as possible in the next days and weeks.
- Ice: To relieve pain and avoid excessive swelling of the joint, acute injuries should be cooled for about 20 minutes.
- Compression: a compression bandage can also help prevent the affected joint from swelling too much.
- Elevation: To prevent too much blood flow to the injured tissue, the affected body part should be elevated as often as possible.
If the capsule tear causes severe pain, a painkiller can be taken. Blood-thinning agents such as acetylsalicylic acid should be avoided, however, as they promote blood flow to the tissue.
Healing process takes several weeks
If there is a suspicion that a capsular tear has occurred, a doctor should always be consulted who can diagnose the injury with certainty. To ensure that the injury heals quickly, the joint is usually immobilized by the doctor. If it is moved again too soon, this can result in a permanent restriction of the range of motion. In some cases, however, targeted movement of the joint is recommended today in order to reduce the bruise more quickly. However, movement training should then only be carried out under the guidance of a physiotherapist. In the case of a torn capsule, it usually takes at least six weeks for the injury to heal completely. Cooling and decongestant medication can have a positive effect on the healing process. Sometimes, however, the mobility of the joint remains limited after the capsular tear has healed. Especially in the fingers, it is not uncommon for the capsule to remain thickened. In the long term, a torn capsule can also lead to joint arthrosis.
