What are ligament injuries?
Ligaments are tough, fibre-like bands of tissue that connect one bone to another. They provide stability and support to your joints, limiting excess movement. They can stretch to some extent; however, over-stretching can tear and damage the ligaments, making your joints weak and unstable.
The hands and wrists are particularly susceptible to injury due to the small moving bones and ligaments in these areas. When the ligaments of the hands become torn or stretched, you can acquire a strain.
Signs and symptoms of ligament injuries
Injuries to the ligaments of the hands and wrist can vary in severity and symptoms
- First degree injury – this usually involves mild pain and sometimes bruising, It can interfere with your ability to perform normal activities, but not seriously.
- Second-degree injury – with this type of injury you may experience prolonged pain, inflammation and weakness. You may even notice a change in your ability to move a nearby joint (i.e. the wrist if your hand is affected).
- Third-degree injury – this is classified as when a tendon or ligament has completely torn or ruptured. In this case, you may hear an audible pop at the time of injury.
Common causes of ligament injuries
A hand or wrist sprain usually occurs due to:
- A fall on an outstretched hand.
- A twist encountered during a sporting activity
- Occupations that put a regular strain on the hands and wrists (such as typing)
- Certain sports activities that involve stress on the hands and wrists (such as gymnastics)
A common site of hand ligament injury is the scapholunate ligament that connects two small bones of your wrist joint.
Diagnosing ligament injuries
After a physical examination, your doctor may refer you for additional tests to help diagnose a ligament injury:
- X-rays – to check for a fracture, bone deformity or dislocation of a joint
- MRI Scans – to look at the muscles, bones, and tissues in further detail. This type of scan can help to identify whether a ligament has torn partially or completely, as well as rule out other possible issues such as small fractures
- Ultrasound – this allows the soft tissues to be viewed whilst the hand and wrist is moved. It can also help to diagnose stress fractures
- CT Scans – your doctor may suggest this if they suspect you have a fracture of the scaphoid bone in the wrist. X-rays cannot usually detect these
The treatment of a ligament injury depends on the intensity of the torn ligament(s) and whether there are any additional issues, such as a fracture.
Hand and wrist ligament injuries most often respond to conservative measures such as the use of a splint to keep the joint straight while allowing the injured ligament to heal.
Over the counter medications such as non-steroidal anti-inflammatory drugs (NSAIDs) such as Brufen and paracetamol such as Panadol can help to manage pain and inflammation, as well as applying ice to the area.
Physiotherapy may also be suggested to help you to regain movement and strength in your hands and wrists.
Injections may be offered containing a corticosteroid and pain-killer called lidocaine. This combination can help to reduce pain and swelling. Long term use of these injections is not advisable as steroids can cause damage to surrounding tissues.
In the unusual case that surgery becomes necessary, it is ideally done via arthroscopy. During the procedure, the surgeon passes a small camera attached to a tube through a small cut in the skin at the back of your wrist. Arthroscopic surgery causes less trauma to the tissue than the conventional approach, and enables a faster recovery. During the procedure, your surgeon will work to repair the ligaments by cleaning the damaged tissue. Doing this allows new tissue to grow and the ligament to heal.
After treatment of hand and wrist ligament injuries, it is advisable to modify everyday activities to help avoid the injury recurring. This may be through reducing certain sports activities, wearing wrist and hand supports during high stress activities, or looking at ergonomic improvements, such as changing the angle of your keyboard.
Physiotherapy or occupational therapy will usually be recommended after surgery to help regain full movement and strength.