Sometimes when you injure an ankle, wrist, knee, finger or other joint, the pain doesn’t go away entirely. A nagging soreness remains, months and even years later, and your joint is not at 100% capacity.
A ligament connects one bone to another; whereas a tendon connects a muscle to a bone.
A sprain refers to an injured ligament; a strain refers to an injured tendon. When you injure a joint, ligaments and tendons are usually injured together; thus the common term used by doctors for this injury: “sprain-strain.”
The main reason why ligaments and tendons take a long time to heal compared to muscle and skin is that they don’t have a direct blood supply. They rely on absorption of extracellular fluids, much like spinal discs.
Ligaments and tendons, a class of connective tissue are mostly comprised of a collagenous matrix secreted by special cells called fibroblasts and chondroblasts, and it takes considerable time to make this matrix. That is why when a pro athlete significantly injures a ligament, it is usually a “season ending” injury due to the long time it takes to heal.
Sprains and strains are graded I-IV. Grade I is a minor sprain-strain, where just a few fibers are torn. Grade II sprains and strains are partial tears, where the tear doesn’t go all the way through the ligament or tendon. Grade III is a complete tear, where it separates, and Grade IV is when it comes off a bone.
Possible Causes of Chronic Ligament Pain
If you injured a joint and it is still painful after a month, and you notice instability (the joint moves more than it should) then you probably sustained a Grade III or IV sprain-strain. It is the instability that stresses the rest of the joints ligaments and tendons and prevents complete healing. Most people get the ligament/tendon reattached surgically; some leave it alone which is not a good idea because the instability will accelerate joint degeneration resulting in more pain and more loss of function down the road.
If you sustained a Grade I or II strain but still feel pain, it could be that you are continually aggravating it, or on the opposite side, keeping it too immobile causing it to atrophy and delay healing.
Another possibility of chronic ligament and tendon pain is scar tissue adhesions. When ligaments, tendons, fascia and muscle are injured, the body lays down collagen scar tissue, which is less organized than normal collagen fibers and tends to bunch up and calcify. It can also stick to adjacent tendons and interfere with their movement, causing pain.
How to Treat a Recent Sprain Strain so It Doesn’t Become Chronic
Unless you have a Grade III or IV sprain-strain, which warrants a visit to the orthopedic doctor, the protocol upon injuring your joint is to rest it, ice it (20 minutes every 2 waking hours for a few days), compress/support it with tape or a brace, and try to keep it elevated to reduce edema.
- Apply a comfrey root-based ointment to your ligament daily, such as Kytta Salbe, Dr. Christopher’s Formula or Burt’s Bees Res-Q. Comfrey is a plant that has been used for a variety of ailments for centuries, especially injuries and pain. It contains allantoin, a cell proliferant that speeds up the natural replacement of body cells.
- Apply red-light therapy to your ligament three times a day. Red light is known to increase cellular ATP (energy) production, which enhances healing.
- Do myofascial therapy using a myobar or Edge tool. Using long strokes along the length of the tendon, press down firmly but not too hard. When you feel the small bumps of scar tissue, use shorter, firmer strokes to soften them up.
- Do resistance exercises to put a controlled load on the affected tendon. A 5 lb. dumbbell is good for wrist and shoulder problems; if it’s your knee or ankle ligament, use an ankle weight. Move your joint in all directions with the weight. This stimulates the fibroblast and chondroblast cells to make more collagen matrix in the ligament.
Watch this video to see how I use Red Light therapy to accelerate tissue healing:
Lifestyle Modification for Stronger Joint Ligaments
- Avoid smoking (if you do). Smoking interferes with healing of any kind.
- Eat bone broth soup weekly, made with animal joints and bones, and eat all the cartilage and tendons as well. This provides building blocks for connective tissue. Pork and beef joints, chicken and turkey carcasses, and fish (salmon spine and heads) work well.
- Make sure to include onions, garlic and shallots in your diet. Alliums are high in sulfur, which is needed for protein (collagen) synthesis.
- Take supplements for joint health such as MSM, collagen and NEM- natural egg membrane, as well as anti-oxidant supplements such as astaxanthin, cherry juice and Vitamin C.
- Lift weights regularly. When you put loads on your ligaments and tendons, the cells sense the load and automatically secrete more collagen, making them thicker and stronger. Use 5-10 pound dumbells to strengthen your wrists by holding the weight in front of you, palm facing down, then extending just your wrist to lift the weight. This strengthens the tendons at your elbows (protects agains epicondylitis/ tennis elbow). Read this post on how to strengthent your joints, which goes into more detail.
