Ligament Injuries: Symptoms, Diagnosis, and Treatment Options

Ligament rupture

Hello, I previously experienced shoulder pain when raising my arms, so I went to see a doctor and had an X-ray.
The doctor said there were no issues with the bones.
I would like to ask about a time when I heard a "pop" sound while excessively stretching both arms behind my back.
Could this indicate a ligament tear or injury? I can still raise my arm, but it hurts.
Is it possible that there is a complete tear? Would surgery be necessary? Thank you.

Ting, 20~29 year old female. Ask Date: 2016/05/24

Dr. Shi Guozheng reply Orthopedics

First, we need to assess how long the pain has been present and the circumstances of the injury.
Is the pain occurring when raising the shoulder or when moving it backward? Have any medications been effective? Additionally, has physical therapy been pursued? If these treatments have been ongoing for more than three months without improvement, it is essential to consult a physician to check for any ligament tears.
A definitive diagnosis can only be made through examination, and we can discuss surgery afterward if necessary.
Typically, young individuals are less likely to experience ligament tears unless subjected to significant external force.

Reply Date: 2016/05/24

More Info

Understanding ligament injuries, particularly in the context of shoulder pain, is crucial for proper diagnosis and treatment. Based on your description, it seems you experienced a significant event where you heard a "pop" sound while overstretching your arms behind your back. This could indicate a potential injury to the ligaments or tendons in your shoulder, particularly the rotator cuff or the ligaments surrounding the shoulder joint.

Symptoms of Ligament Injuries
Common symptoms associated with ligament injuries include:
1. Pain: This is often localized around the joint and can vary in intensity. In your case, the pain when lifting your arm suggests that there may be an underlying issue with the shoulder's soft tissues.

2. Swelling: Although you didn't mention swelling, it is a common response to ligament injuries.

3. Limited Range of Motion: You noted that you can still lift your arm, but it causes pain. This limitation can be indicative of a partial tear or strain rather than a complete rupture.

4. Instability: In more severe cases, you may feel like your shoulder is unstable or may "give way."

Diagnosis
To accurately diagnose a ligament injury, healthcare providers typically use a combination of physical examinations and imaging studies. While X-rays can rule out fractures, they do not provide detailed information about soft tissue injuries. An MRI (Magnetic Resonance Imaging) is often recommended to visualize the soft tissues, including ligaments and tendons, and to assess for any tears or inflammation.

Given your symptoms and the history of the "pop" sound, it is advisable to consult with an orthopedic specialist who can perform a thorough examination and possibly recommend an MRI to assess the condition of your shoulder.

Treatment Options
Treatment for ligament injuries can vary based on the severity of the injury:
1. Conservative Management: For mild to moderate injuries, treatment may include rest, ice application, anti-inflammatory medications, and physical therapy. Physical therapy can help strengthen the muscles around the shoulder and improve flexibility, which may alleviate pain and restore function.

2. Surgical Intervention: If there is a complete tear of the ligament or if conservative treatments do not provide relief, surgery may be necessary. Surgical options can include repairing the torn ligament or reconstructing the damaged area.

3. Rehabilitation: Post-surgery, a structured rehabilitation program is essential for recovery. This typically involves gradual strengthening exercises and a focus on restoring range of motion.

Conclusion
In summary, while your ability to lift your arm suggests that you may not have a complete ligament tear, the pain you are experiencing is a concern that should not be ignored. It is essential to follow up with a healthcare professional who can provide a definitive diagnosis and appropriate treatment plan. Early intervention can significantly improve outcomes and prevent further complications. If you continue to experience pain or if your symptoms worsen, seeking immediate medical attention is advisable.

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