Is It a Sprain or a Tear? Understanding Ligament Injuries

You’ve rolled your ankle, twisted your knee, or felt a sudden ‘pop’ during sport—and now you're in pain. But is it just a sprain? Or something more serious, like a tear?

Ligament injuries are among the most common musculoskeletal injuries we see at MSK Doctors, affecting joints such as the ankle, knee, wrist, and shoulder. Yet, many patients are left unsure whether they’ve suffered a mild strain or a complete rupture—and uncertainty can lead to the wrong treatment, prolonged pain, or even long-term joint instability.

In this blog, we explain the difference between sprains and tears, how to recognise the signs, and why accurate diagnosis and early intervention are essential for proper healing and joint preservation.

What Are Ligaments?

Ligaments are strong bands of connective tissue that link bone to bone, providing stability and guiding joint movement. They’re not elastic like muscles or tendons—they’re designed to limit excess movement and protect your joints from dislocation or overload.

When a ligament is injured, it’s typically due to:

• Overstretching (e.g. rolling the ankle)

• Sudden trauma (e.g. a tackle or awkward landing)

• Repetitive microtrauma (e.g. chronic instability)

Sprain vs. Tear: What’s the Difference?

🔹 Sprain = Overstretched ligament fibres

A sprain occurs when the ligament is stretched beyond its normal limit, but not completely ruptured. Sprains can range from mild to severe.

🔹 Tear = Partial or complete rupture of ligament fibres

A tear means that some or all of the ligament fibres have been torn, potentially compromising joint stability.

Grading Ligament Injuries

Clinicians classify ligament injuries into three grades:

Common Ligament Injuries by Joint

🦶 Ankle – Lateral ligament sprain

Often occurs when the foot rolls inward. Common in running or court sports.

🦵 Knee – ACL, MCL, or LCL tears

The anterior cruciate ligament (ACL) is especially prone to tearing in pivoting sports. Collateral ligaments (MCL/LCL) can tear with direct blows.

💪 Wrist – Scapholunate or TFCC sprains

Desk workers and gym-goers are prone to wrist ligament injuries during weightbearing activities.

🦴 Shoulder – AC joint or capsule tears

Common in contact sports or falls, especially when landing on an outstretched arm.

How to Tell if It’s a Tear

Some signs suggest a more serious tear rather than a minor sprain:

• You heard or felt a “pop” at the time of injury

• Immediate swelling or bruising

• Inability to weight-bear or use the joint normally

• Instability or “giving way” sensation

• Pain that worsens despite rest

• Recurrent injury to the same joint

If any of these are present, it’s vital to get a clinical assessment and imaging.

Diagnosis: Don’t Rely on Guesswork

At MSK Doctors, we combine expert clinical examination with advanced imaging to accurately diagnose ligament injuries.

MR

MRI detects subtle tears and inflammation, even when standard scans miss them.

High-resolution Ultrasound

Visualises soft tissue in real time—ideal for dynamic testing of tendon and ligament integrity.

Treatment Options: Tailored to the Grade

🟢 Grade I (Mild Sprain)

• RICE (Rest, Ice, Compression, Elevation)

• Bracing or taping

• Physiotherapy to restore proprioception

• Return to sport: 1–2 weeks

🟡 Grade II (Partial Tear)

• Functional rehab programme

• Cryo-ultrasound or shockwave to reduce inflammation

• Consider PRP injection for healing

• Return to sport: 4–6 weeks

🔴 Grade III (Complete Tear)

• May require surgical repair or reconstruction

• Regenerative options (e.g. mFAT) may support healing

• Intensive rehab with motion analysis

• Return to sport: 3–6+ months depending on the joint

Why Early Intervention Matters

Delaying treatment of ligament injuries increases the risk of:

• Chronic joint instability

• Early arthritis

• Recurrent sprains or compensatory injuries

• Muscle weakness or altered biomechanics

With early intervention and modern treatment, most patients can avoid surgery and return to full function.

Frequently Asked Questions (FAQs)

1. How do I know if I’ve torn a ligament?
A sudden pop, swelling, and instability are signs of a tear. A scan and clinical exam will confirm it.

2. Can a torn ligament heal without surgery?
Partial tears often heal well with rehab and regenerative support. Full tears may need surgical repair, depending on the location and activity level.

3. Is MRI necessary for all sprains?
Not always, but if symptoms persist or you suspect a tear, an MRI or ultrasound provides valuable insight.

4. What’s the role of PRP in ligament injuries?
PRP promotes healing by enhancing collagen repair in partial tears. It’s especially effective when combined with rehab.

5. Can I still exercise with a sprain?
Yes—with modifications. A guided rehab plan ensures safe activity and prevents further damage.

6. How long does it take to recover?
Mild sprains: 1–2 weeks. Moderate injuries: 4–6 weeks. Severe tears: 3+ months, depending on treatment.

Conclusion: Know Your Injury, Know Your Options

Not all ligament injuries are created equal. Whether you’ve had a mild sprain or a full tear, the right diagnosis makes all the difference in recovery time and long-term joint health.

At MSK Doctors, we offer same-day assessment, advanced imaging, and access to regenerative therapies that help you heal better, not just faster.

Injured a joint? Don’t guess—get the facts. Book your personalised ligament injury assessment today.