Physiotherapy rehabilitation exercises following superior tibiofibular joint sprain with possible partial ligament tear

[physiobob]

Hi again Narcissus,

Thanks for the further information and questions. The issue is that you heard a 'pop' that to me would indicate a complete tear of the ligament either within it's structure or at the boney attachment. These typically do not show on an x-ray as that only shows bone damage. An MRI or Ultrasound scan would give more information but then given your current recovery status the treatment approach would not really change. Of course the pop might have been a subluxation of bone too but typically you need to go through the ligament to set to the bone. Bone healing takes a good 12 months to really be stable although in 12 weeks if should be quite stable. Discomfort can however last a good while longer. Everyone is different and every injury is slightly different so we can't really be more specific. As a general rule you should be back to things at 3 months albeit with some discomfort. You'll be able to work out what things aggravate it and can reduce those as required. And have specific treatment to the ligament structure with friction massage and even acupuncture if the pain is persistent.

Continued exercise in the event or a rupture or good strain will indeed lead to a less stable ligament structure and therefore more bone movement and risk of secondary injury down the line. However normal joint movements as I suggested in the earlier email should be OK. Again monitor any discomfort. I would NOT however recommend doing any of the stretches you mentioned in your post as they truly challenge the joint whilst unstable and could lead to some meniscal (knee cartilage) irritation.

And yes normally a ligament that has been over strained does remain lengthened than pre-injury. So unfortunately the joint will be slightly less stable as a result. That said this is all part of life and we cope and continue to perform sport without much of an issue. So personally I would not worry to much about the long term. It will just be one of those little issues to manage as part of your daily life and should not cause you any day to day problems.