People usually seek out my services for chronic symptoms after trying other treatment approaches, often with limited success. For many of these clients with chronic symptoms I began to see a reoccurring pattern: muscle weakness/pain, poor joint control/stability, poor proprioception (balance, coordination, “muscle awareness” ) as well as muscle tightness and/or excessive joint mobility. Coincidentally, I have also experienced similar deficits with my own injury history. Through my research, experience and observation I’ve concluded that injuries to ligaments often produce multiple, functional deficits and symptoms, and if left untreated can lead to chronic pain, disability and poor athletic performance.
Anatomy of a Ligament
Basic anatomy teaches that ligaments are tough, dense fibrous structures that bind bones together, yet allow for joint translation. When ligaments are injured – stretched primarily, they do not return to their original length – they lose their structural integrity. Since they are so dense, blood supply necessary for healing isn’t always adequate. This means a joint that was once stable and mobile now has excessive movement and this excessive movement leads to multiple symptoms.
To understand this in simple terms think of any moving, mechanical component like hinges on a door or the steering mechanism in your car. Proper functioning of these components is dependant on exact fitting tolerances that allow good mobility between the pieces (joint). If there is excessive joint movement (poor fitting tolerances) the forces acting on the joint will not be properly dissipated or transferred, instead the joint will eventually break down from excessive movement between the parts. In other words the door will no longer open or shut properly and your car won’t travel in a straight line.
Unlike a car your body has a complex communication network in your nervous system. With the injured ligaments and excessive joint forces your nervous system responds by sending pain signals from the injured ligaments and joint stresses, triggering muscle tightness which can be a compensatory response for the lack of joint integrity. The most significant issue I see is muscle function is inhibited (arthrokinematic inhibition) leading to weakness, atrophy and poor joint control. This process unfortuantely reinforces the vicious cycle of continued ligament stress and joint degeneration. This makes sense from a practical standpoint however. It would not be safe for you to drive your car fast or on a twisting road if your steering mechanism was damaged and loose. The body shuts down muscle function as a way of preserving and protecting itself from future injury by limiting how much force your muscles can generate. This is why ligament injuries are so devastating to athletes who require maximal exertion, joint control and endurance.