Treatment Options for Ligament, Tendon, and Muscle Injuries
Medically reviewed by Leann Poston, M.D. on 9/18/20
Ligaments, tendons, and muscles do the lion’s share of the work of moving our bodies, day in and day out. They absorb the strains that we throw at them, help us get from point A to point B, and provide a core element of our body’s strength. Yet, they are often not well-understood by the average person. All too often, the people who become most familiar with ligaments, tendons, and muscles, aside from medical professionals, are athletes. That’s because of devastating ligament, tendon, and muscle injuries that can occur, ending their professional careers in some cases.
For average people, a soft-tissue injury of this type is unlikely to end your career, but it can cause serious pain, health issues, and be extremely disruptive, to say the least. Over time, untreated or recurring muscle injuries can have lasting effects on mobility, flexibility, strength, and physical and mental health. But what are the treatment options for these kinds of injuries? How do they compare to one another, and when might one be warranted over another? We’ll answer those questions below in our quick guide to treatment options for ligament, tendon, and muscle injuries!
Understanding Ligament, Tendon, and Muscle Anatomy
First, it’s useful to understand the basics of ligament, tendon, and muscle anatomy. People often confuse the three or are unsure of how they work together in the body. All three are distinctly different, though made of similar soft tissues and materials. Muscles, the most familiar, extend and contract to exert force and motion within the body. Tendons link muscles to bones, the primary hard tissues that make up our skeletal system. They can also link muscles to some other structures in the body, such as the eyes. On the other hand, ligaments link bones to bones and help to stabilize the joints of the body.
Ligaments and tendons are more fibrous than muscles and tend to be tighter and more compact. On the one hand, ligaments are less about flexing and motion than holding bones, joints, and structures together and offering stability. In terms of flex or give, ligaments have the least, tendons a bit more, and muscles by far the most. Tendons also act as shock absorbers, cushioning the forces you experience when your muscles and skeleton move. Ligaments don’t have those same properties or functions in the body.
Who Gets Soft-Tissue Injuries?
The most high-profile cases of ligament, tendon, and muscle injuries are among athletes, as we mentioned at the top of this article. There is no doubt that they are more prone to certain types of soft-tissue injuries. This is the result of the unique stresses their soft tissues undergo during training and games or matches. Some pathologies (like tears of the anterior cruciate ligament or ACL, which helps control knee motion) are far more common among players of certain sports (football, basketball) than others.
However, it’s important to stress that anyone, at any age, and any fitness level, can suffer a ligament, tendon, or muscle injury at any time. Stress, overworking the soft tissue, traumatic injury, and other factors can lead to soft-tissue injury. It doesn’t matter if you are a child, teen, adult, or elderly – though the risk factors and impacts, of course, do vary across this spectrum. Likewise, those who are not very active and not very physically fit generally have different risk factors and profiles than, say, professional athletes.
Additionally, from a biological standpoint, soft-tissue injuries tend to impact men and women equally, with no particular gender disparities. You may see more news stories about injuries among men due to most professional athletes being men. But, among the general public, women, and men both receive ligament, tendon, and/or muscle injuries at about equal rates.
Typical Ligament, Tendon, and Muscle Injuries
Ligament, tendon, and muscle injuries occur in similar ways or types, but generally have different names, causes, and outcomes for patients. Overstretching, tearing, rupture, or bruising are the most typical physical injuries that can occur.
- Ligaments that become overstretched or torn are technically “sprained.” They can be called tears and by other names, because that is accurate, but medically, they are known as sprains. These are common in the ankle, knee, and wrist, especially, typically as the result of falls or sudden, awkward movements.
- Tendons that become overstretched or torn are technically “strained.” This is common, especially in athletes, due to repetitive movements or overwork. Sufficient time for rest and repair is needed between training or use sessions or tendons become overworked and more prone to strain. Leg, feet, and back-related tendons are the most common to become strained.
- Tendons can suffer from inflammation without a strain, a condition known as tendonitis. Typically, this happens from overuse, aging, or sudden use without adequate stretching or warm-up.
- Muscles can suffer strains, like tendons, typically from overuse or a traumatic event. These are effectively tears or ruptures of the muscle as well.
- Muscles can also suffer bruises, known as contusions, typically due to impact trauma.
- Cramps, swelling/inflammation, pain, and soreness are common among all soft tissues suffering from an injury of any kind.
The severity of these injuries varies considerably, with formal grading scales of mild (1), moderate (2), or severe (3) serving to rate the injuries in a clinical context. This rating often forms the basis for a treatment decision. Naturally, the most serious treatments, such as surgical treatments, are most typical of the most severe types of ligament, tendon, and muscle injuries.
Surgery is typically warranted for patients suffering a ligament or tendon injury that is severe and/or where they intend to resume vigorous physical activity in the near term. This is one reason why, again, you hear about these surgeries most often in the context of professional athletes. Surgical methods are used to repair and stabilize the affected tendon or ligament, restore range of motion, provide stability to the relevant joints, and allow for a speedy return to an active lifestyle. Muscle injuries typically do not require surgical treatment absent a complete tearing of the muscle, hematomas inside the muscle, or significant scarring that causes persistent pain or decreased range of motion months after the injury occurs.
Several non-surgical treatment options are available, all of which are aimed at speeding healing time and restoring the full functionality of the ligament, tendon, or muscle. Their efficacy and the time involved will, of course, vary based on the nature and extent of the ligament, tendon, or muscle injury in question.
Braces and Support
Using a brace or other forms of support, particularly when working the affected soft tissue in question, helps relieve some of the stress placed on the ligament, tendon, or muscle. This can also be used pro-actively to reduce the likelihood of strain or injury in the first place. Traditional elbow, wrist, or knee braces are common examples. Kinesthesiology (KT) tape has also gained a popular following among athletes.
Over-the-counter painkillers, typically NSAIDs (non-steroidal anti-inflammatory drugs), can help reduce the pain associated with ligament, tendon, and muscle injuries, and decrease swelling. They may be insufficient for more serious grades of ruptures or tears but are a good first-line treatment to eliminate pain.
Healing supplements and injections may provide a valuable boost to the body’s own healing powers and speed injury recovery. Taking a multivitamin that contains vitamin C and zinc is critical for cellular regeneration. Special healing-oriented supplements like BPC-157 have been shown to increase blood vessel growth, wound healing, and cellular proliferation, meaning soft tissue can be repaired and regrown faster.
RICE or POLICE
RICE, or the updated POLICE, are acronyms for a rehabilitative or treatment protocol that is commonly recommended for muscle injuries and all soft-tissue injuries. The first, RICE, stands for rest, ice, compression, and elevation – the prescribed course of treatment. POLICE, an updated version, has become more popular among practitioners in recent years. It stands for protection (which can include the aforementioned braces or support, or immobilization for a period of time); optimal loading, a kind of physical therapy to ensure the right amount of activity and stress is put on the tissue to reduce swelling and speed healing; and ice, compression, and elevation, the same as the “ice” part of RICE.
For more serious injuries, active individuals/athletes, and/or those recovering from surgical treatment, professional physical therapy is often recommended. This is combined with a gradual return to physical activity levels consistent with your normal so that you do not have a reoccurrence of the ligament, tendon, or muscle injury.
Prevention of Soft-Tissue Injuries
As they say, an ounce of prevention is worth a pound of cure. While the above treatments for soft-tissue injuries are definitely all effective, it’s better to avoid injury in the first place. Taking some preventative steps when you exercise or compete, along with some basic lifestyle changes or considerations, can go a long way towards reducing the likelihood of an injury, or reducing the severity should one occur. Accidents and trauma are always possible, but with a little work, you can improve your odds when it comes to exercise or competition-induced soft-tissue injury.
Expert prevention tips include:
- Always stretch properly before any workout or physical exertion. This serves to warm up the soft tissues, as well as stretch out their range of motion and prime them for action.
- Exercise regularly. A single session of exercise once a week can overwork your muscles. Try breaking it up into smaller chunks of time spread throughout the week.
- Stay hydrated. Muscles, like most of the structures in your body, are largely water. You also want to ensure you don’t get dehydrated, as that can increase the likelihood of heat exhaustion or heat stroke during workouts or exertion.
- Schedule rest days in between hard workouts, competitions, or other physical exertion. Your muscles, ligaments, and tendons need time to break down and repair.
- Maintain good nutrition. A balanced diet, with sufficient protein and a blend of vitamins and minerals, is essential for soft-tissue health.
- Don’t forget to cool down after a workout. Gradually reduce the intensity of your workout over the course of several minutes, don’t just stop abruptly. This can help you to avoid ligament, tendon, and muscle injuries.
- Maintain a healthy weight. Carrying more bodyweight than your muscles and skeleton were designed for increases the risk of injury.
- Practice balanced fitness. Don’t over train a particular set of muscles, or focus on strength training to the exclusion of cardio or flexibility.
- Use proper equipment and proper technique. If you don’t know how to use a particular piece of equipment, ask an expert, don’t just wing it. That’s one of the most common ways to sustain a soft-tissue injury. Likewise, invest in quality products like good athletic wear, shoes, and so on.
Perhaps the best piece of prevention advice is to listen to what your body is telling you. If you feel pain, soreness, or swelling, respect that. Don’t push your ligaments, tendons, or muscles to feel macho or because you think pushing is what will make you stronger. Pain and fatigue happen for a reason, and respecting them can help you to avoid ligament, tendon, and muscle injuries.
Sustaining soft-tissue injuries isn’t fun for anyone, but is an inevitable part of being a human. Everyone will experience a strain, sprain, or another similar injury at some point in their lives. While athletes and those who are extremely physically active, demanding a lot from their bodies, are more likely to sustain certain soft-tissue injuries, they can affect anyone, at any age, and any activity level. Depending on the severity level, treatments may include surgery, physical therapy, medications, supplements, rest/ice/compression/elevation of the affected tissue, or some combination of those treatments. Taking preventative steps to avoid ligament, tendon, or muscle injury in the first place is often the best strategy.