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Home > Blog > Physiotherapy & Hand Therapy > Conditions We Treat > Elbow Pain > Elbow Annular Ligament Tear & Strain Physiotherapy
An injury or sprain in the annular ligament of your elbow can lead to complications in the joint function. This particular painful elbow condition is typically characterized by:
Unfortunately, it is the younger adults and children who are generally more prone to annular ligament damage. Although rare, the condition can also occur in adults, especially seniors who have suffered some form of an elbow injury before.
Other names given to this type of injury include:
Here, we provide a detailed overview of what adult annular ligament is, how it can be damaged, and the treatment options available to patients affected by it.
The article also discusses other painful elbow conditions that can be confused with annular ligament tears and how physiotherapy can help you recover from the sprain.
As is the case with virtually all painful hand and elbow conditions, recovering from an annular ligament injury requires you to first understand the basic function and position of the damaged part.
Ligaments, as you might already know, are bands of tough elastic tissue that surround a joint. They serve to connect two bones together, support movement, and protect your joints from forces and impact.
Our elbow joint is primarily stabilized by three ligaments:
The annular ligament wraps around the radial head within the radial notch and attaches it to the ulna. This allows for the rotation of the two bones during the supination and pronation of the forearm.
Simply put, the annular ligament supports the rotation motion of your hand. For instance, every time you turn a key, use a screwdriver, or drink tea in a cup, you do so with the help of this tissue.
Given the way it’s naturally sandwiched between the two main bones of your arm, the annular ligament is highly susceptible to damage. It can be easily injured by elbow overuse or direct trauma to the joint.
This type of soft tissue injury is extremely common in children because in the early stages of bone formation, bones can easily slip out of place or the ligament can be easily injured, especially common is where someone pulls a child by the arm, the child might get an annular ligament sprain - even my best friend's kid had this happened to her, and she was just 1+ years old.
They found out only when their kid stopped moving the painful elbow and kept saying pain and crying, before realizing what had happened and bringing the kid to see an orthopedic doctor. Fortunately these kinds of conditions are very mild with almost no residual issues, and it usually resolves entirely.
In most cases, it can be hard to identify the exact cause of adult annular ligament sprains. This is especially true when the onset of pain is the result of gradual damage over time.
However, generally speaking, there are several factors that physicians identify as the major cause of this ligament sprain. This includes:
The main symptoms of elbow annular ligament sprain or injury include the following:
Note that the symptoms of annular ligament sprain differ from person to person, depending on the extent of tissue damage.
A direct trauma to the ligament is likely to cause more damage than that caused by daily muscle overuse.
Generally, an annular ligament injury can be classified into three grades:
Pain due to annular ligament sprain is most commonly confused with the pain stemming from tennis elbow.
Tennis elbow is a condition of the lateral epicondylar region of the elbow that causes pain around the outside of the joint. It usually occurs due to strenuous overuse of the muscle and tendons in the forearm. While the symptoms of tennis elbow tend to overlap with those of annular ligament sprain, the two conditions are, in fact, very different from each other. As such, they require different treatments as well.
Symptoms of adult annular ligament sprain can also be confused with Golfer’s Elbow.
Golfer’s elbow, also known as medial epicondylitis, is a condition that causes pain, inflammation, and tenderness in the tendons that connect the forearm to the elbow. The most common cause of this injury is an overload of the connecting tissues.
Treatment for annular ligament sprain begins with an acute diagnosis of the injury.
This is vital for identifying the extent of damage to the annular ligament and helps rule out other possibilities as well.
Your doctor and our principal physiotherapists will ask for your full medical history and perform a thorough examination to come to a sound conclusion. Typically, patients are asked to perform different types of elbow movements, along with other resistivity tests.
This often includes what is known as valgus and varus stress tests. The doctor might put gentle pressure on specific trigger points to check the severity of the sprain.
At times, patients might be referred to get an x-ray or an MRI scan done to confirm the diagnosis. However, the need to obtain radiographs of the affected area arises only in rare cases where the symptoms are too severe to be considered a probable fracture. The results of the scan allow your physician to see precisely where the ligaments have been stretched or torn.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are often used for the relief of pain and inflammation. If the pain is too intense, patients might be prescribed a mild narcotic or corticosteroid injection as well.If the injury is not too serious to require surgical treatment, conservative pain management techniques and physiotherapy are usually sufficient to help patients recover.
In fact, even when patients undergo a surgical procedure, physiotherapy is generally required as a follow up plan to restore the normal function of the tissues.
Our elbow and hand physiotherapists have vast experience helping people with different kinds of pain problems successfully get on the road to recovery.
To control pain and ensure the healthy function of the elbow joint, following an annular ligament injury, we generally start with a customized treatment plan.
This includes specific exercises that promote natural healing of the torn ligaments by enhancing blood flow and improving the flexibility of the joint. For example, elbow mobility exercises are effective in increasing the range of motion, whereas strength and resistance exercise will provide greater stability in the joint.
Stretching and loading exercise is of prime importance in treating damaged ligaments as there is an increased risk of atrophying otherwise.
Our expert physiotherapists for elbow and hand conditions will carefully examine the degree of damage to determine which exercises will work best for you. We focus on exercises that not only help repair torn or damaged tissues, but also reduce the chances of re-injury at the same time.
To ensure faster and complete recovery, we might also use ice therapy, hot compresses, deep tissue massage, tapes or braces in conjunction with the physical therapy.
In the end, remember that although painful, annular ligament sprain can be easily treated in as little as a few weeks. The key is to visit our principal physiotherapists and seek medical help as soon as you possibly can.
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At the first session, our specialist physiotherapists will carry out a thorough assessment, helping them to select the most appropriate treatment to help you recover as well as provide treatment in the same session.
Follow up sessions are inline to provide expert treatment for your pain as well as prescribing specific exercises to reduce your risk of re-injury and giving you a long term solution.
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