Therapy
The healing time of ligaments is often very long and ligaments have a limited ability to regenerate because they do not have their own blood supply and are only supplied by diffusion of nutrients from the surrounding tissue. They are therefore very poor in metabolism and therefore take a long time to heal. In the past, the indication for a torn ligament was often generously given, but this is not recommended today.
Torn cruciate ligaments are an exception to this rule and thus an indication for surgery, since without intact cruciate ligaments, incorrect loading on the knee can quickly lead to wear and tear of the joint and thus to arthrosis. In addition, an operation is recommended for competitive athletes or for injuries where several ligaments have been torn. After an operation, the period in which the affected joint must be protected and immobilised is approximately four to six weeks.
Only after this time, when the wound has healed, can gradual and careful loading and movement of the joint be resumed. If there is no need for surgery, the torn ligament is treated conservatively. It is important here to protect and avoid stress on the affected joint.
This can be achieved with the help of a stability splint, a so-called orthosis. This orthosis must be worn consistently day and night for a period of approximately six weeks and, by taking over the stabilizing function of the torn ligament, should stabilize the joint to such an extent that the ligament can heal and grow back together without additional stress. In contrast to a plaster cast, the joint can still be moved with an orthosis, so that everyday life is not greatly restricted.
Sometimes so-called tapes are used, i.e. tapes stuck to the skin, which are intended to fulfil the same function as an orthosis. The acute pain can be relieved by administering painkillers. Cooling of the area combined with elevation of the joint often helps against swelling and bruising.
Decongestant ointments can also be applied, which can shorten the time until the swelling disappears completely. Depending on the type of torn ligament, supportive physiotherapy can be useful to counteract the muscle loss caused by the splinting and the resulting lack of movement. The lack of ligament stabilisation can also be partially compensated by strengthening the muscle apparatus.
Duration and forecast
With early and consistent therapy, a torn ligament usually heals without consequences. However, a complete healing takes time. The stabilizing splint must be worn consistently day and night for about six weeks.
Depending on the affected ligament, the complete fusion of the ligaments and thus the healing can last between six weeks (outer ligament at the ankle) and six months (cruciate ligament at the knee). Only then can the ligaments be slowly reloaded and gradually become accustomed to the strain. The time until the ligaments have completely regained their functional and load-bearing capacity and thus their suitability for everyday use, which is comparable to the conditions before the rupture of the ligament, is therefore much longer than the stated duration of six weeks to six months.
In contrast to complete healing, the pain usually lasts much shorter. Through measures such as cooling and, if necessary, taking painkillers, the pain should disappear within a few days after the torn ligament. On average, swelling and bruising gradually subside one to two weeks after the tear.
