Grade II Ligament Tears: Recovery and Rehabilitation Tips - Orthopedics

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Ligament second-degree tear due to car accident impact?


Hello Doctor: I was in a car accident on August 12, and the doctor at the hospital diagnosed me with a grade II tear of the ligaments in my heel.
It has been two months since then, and during my follow-up appointment, the doctor mentioned that the ligament recovery is going well.
Recently, I have been diligently rehabilitating in hot and cold water, but my heel still feels very stiff, which seems to be affecting my blood circulation.
When I lower my foot, it turns completely black.
I would like to know if this condition is normal and if it will gradually improve.
The only rehabilitation method provided by the hospital doctor is water therapy, but due to the current blood circulation issues in my foot, I would like to ask if this is sufficient.
Additionally, for the hot and cold water immersion therapy, should I alternate between cold and hot for 15 minutes each, or would it be more beneficial to do hot-cold-hot? Thank you, Doctor :)

Claire, 20~29 year old female. Ask Date: 2016/10/11

Dr. Shi Guozheng reply Orthopedics


The treatment you described should take about three months for gradual recovery; you can continue with rehabilitation.

Reply Date: 2016/10/11

More Info


Understanding and recovering from a Grade II ligament tear can be a challenging process, especially following an injury like a car accident. It’s commendable that you are actively engaging in rehabilitation exercises, as this is crucial for recovery. A Grade II ligament tear indicates a partial tear, which can lead to significant pain, swelling, and instability in the affected area.
Firstly, regarding your concern about the hardness of your heel and the discoloration of your foot, these symptoms can be common in the recovery phase. After a ligament injury, it is not unusual for the affected area to feel stiff or hard due to swelling and scar tissue formation. The discoloration you are experiencing, especially if your foot appears black when placed down, may suggest issues with blood circulation or venous return, which can occur after immobilization or injury. It is essential to monitor these symptoms closely. If the discoloration persists or worsens, or if you experience increased pain, it is advisable to consult your healthcare provider for further evaluation.

As for your rehabilitation routine, alternating between cold and hot water can be beneficial. Cold water immersion can help reduce swelling and numb pain, while hot water can promote blood flow and relax muscles. A common recommendation is to alternate between cold and hot water for about 15 minutes each, but you should listen to your body and adjust the duration based on your comfort level. If you find that one method feels more beneficial than the other, it’s okay to modify your routine accordingly.

In addition to your current rehabilitation methods, consider incorporating other forms of therapy that may enhance your recovery. Here are some additional tips:
1. Physical Therapy: If you haven’t already, consider working with a physical therapist who can provide a tailored rehabilitation program. They can guide you through specific exercises to improve strength, flexibility, and stability in the affected area.

2. Strengthening Exercises: Once the initial pain and swelling have subsided, gradually introduce strengthening exercises for the muscles surrounding the injured ligament. This can help support the healing ligament and prevent future injuries.

3. Range of Motion Exercises: Gentle stretching and range of motion exercises can help maintain flexibility and prevent stiffness. Be cautious not to push through pain; gentle movements are key.

4. Elevation and Compression: Elevating your foot and using compression wraps can help reduce swelling and improve circulation. This can be particularly helpful after rehabilitation exercises.

5. Gradual Return to Activity: As you progress, gradually reintroduce weight-bearing activities. Start with low-impact exercises and slowly increase intensity as tolerated.

6. Nutrition and Hydration: Ensure you are consuming a balanced diet rich in vitamins and minerals that support healing, such as Vitamin C, Vitamin D, and protein. Staying hydrated is also crucial for overall recovery.

7. Patience and Consistency: Recovery from a ligament injury takes time. It’s important to be patient with yourself and remain consistent with your rehabilitation efforts.

In summary, while some of the symptoms you are experiencing may be normal during the recovery process, it is essential to keep an open line of communication with your healthcare provider. They can provide personalized advice and adjust your rehabilitation plan as needed. Remember, recovery is a journey, and with the right approach, you can regain strength and mobility in your heel.

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