Ligaments are strong, dense bands of tissue that connect bones and stabilise the joint they encompass. Virtually all joints are protected this way. However, there is greater strain on the ligaments of some joints than others due to our movements, which makes them more prone to injury with certain motions.

It is obvious that the knee and leg ligaments are subject to added strain due to our weight, and that an awkward movement in this region has more serious consequences than in the arm or shoulder.

Just like ligaments, tendons are made of strong connective tissue, but they attach the muscles to the bones. They vary in lengths and are able to transmit muscular strength over longer distances.

A torn ligament, ligament rupture or ligament injury refers to the partial or complete tearing (rupture) of a joint ligament.

Complaints typically include local pain, characteristic losses of functionality and, depending on their location, typical phenomena such as lift-off of the joint or the drawer phenomenon. Typical ligament injuries:

• Exterior ligament rupture of the upper ankle
• Collateral ligament rupture on the knee
• Cruciate ligament rupture on the knee
• Rupture of the ulnar collateral ligament associated with elbow luxation
• Collateral ligament rupture of the thumb in the thumb basal joint (‘skier’s thumb’)
• Complex ligament rupture in the carpus

A partial rupture refers to tissue that is partly torn. This is also called a partial tear. It means that a ligament or tendon is damaged.

Torn muscle fibres are caused by sports injuries where muscle tissue ruptures due to extreme strain. Unlike a pulled muscle, they involve structural damage, the destruction of muscle cells and internal bleeding. The calf and thigh musculature is most often affected.

Among the various forms of muscle injuries, torn muscles are the most serious – sore muscles, pulled muscles and torn muscle fibres are far less serious compared to the complete rupture of a muscle. Runners who tear a muscle are usually not able to move the affected leg anymore – not to mention being able to continue to run.
Ruptured muscles mainly affect athletes such as short-distance sprinters and tennis and football players, who have to tense their thigh muscles abruptly while the muscle is under maximum load.
The causes, symptoms, diagnosis, therapy and prevention of ruptured muscles are the same as for torn muscle fibres.

Pulled muscles, torn muscle fibres and ruptured muscles are caused by the same mechanisms. The only difference is the extent of muscle damage. In cases of torn muscle fibres, numerous fibres and usually the whole fascicle will be torn. Small tears have no discernible effect on performance and are common with all types of training.

In cases of a ligament rupture (also called a torn ligament), the force acting on the ligament is so great that the taught connective tissue tears.

Since the connective tissue of a ligament is normally very strong, a ligament rupture only occurs when a disproportionate amount of force acts on the ligament. Unfortunately, we are quite able to generate this force with our body weight – by falling onto the hands, or making an awkward movement with the knee or foot.
While any ligament in our body can tear in theory, ligament ruptures on the foot – affecting the upper ankle – or the knee are most common in practice. In recent years, however, a torn ligament on the thumb known as skier’s thumb is becoming more and more common.

Torn muscles while jogging are usually caused by excessive stretching and placing great strain on a muscle that has not been warmed up adequately. Cold weather and a tendency towards muscle stiffness can make torn muscles more likely.

Muscle injuries may also occur if the athlete is inadequately warmed up and if excessive strain is placed on the musculature with insufficient training. Abrupt and uncoordinated movements, jumps, incorrect technique, poor equipment or unfamiliar ground characteristics also increase the risk of torn muscle fibres. Physical limitations such as reduced elasticity, poor circulation or advanced age may also mean that the muscle is unable to withstand over-extension and uneven strain.

You should also bear in mind that muscle fatigue sets in and the body loses a lot of liquid and electrolytes in the course of extended periods of exertion. Failure to compensate for these losses in a timely manner can easily lead to torn muscle fibres. The entire thigh, groin and calf muscles are commonly affected areas.

Furthermore, external injuries (e.g. accidents, knocks, kicks) can cause torn muscle fibres as well.

If a ligament rupture is not identified and the ligament cannot heal back together again, chronic joint instability may result. On the upper ankle, this leads to increased twisting of the foot, on the knee it causes pain and an unstable gait.

If the proper protocol (RICE) is not followed after a muscle injury then bleeding into the muscle tissue from damaged vessels may occur. The resulting haematoma (effusion of blood) within the muscle can induce the formation of scar tissue and therefore impair natural movement and significantly reduce load bearing capacity. It is therefore very important to take a break from sporting activities after suffering torn muscle fibres.

The treatment for a ligament rupture depends on the extent and location of the injury. In young, athletic people, cruciate ligaments are usually operated upon while restraint is exercised in cases of ligament injuries on the upper ankle. In those cases operations are only performed on athletes when all three exterior ligaments are torn.

If possible, conservative therapy is prescribed first. Should this fail to work, an operation will most likely be necessary. Conservative therapy encompasses the following:

In addition to strain relief, rest and bandaging with an ointment to reduce swelling, the joint is stabilised with a splint or by thoroughly wrapping with tape. Physiotherapy exercises are started early on in order to train the muscles tissue and improve proprioception/coordination.

Even though the pain after a muscle injury is severe at first, the symptoms are almost always alleviated after a few days of cooling, rest and a relaxed posture. This may take longer if blood vessels have been injured, leading to haematoma.

Applying the RICE rule as soon as possible after suffering torn muscle fibres is important. RICE stands for:

R: Rest
I: Ice
C: Compression
E: Elevation

The conservative treatment of muscle injuries, including physiotherapy, is preferred where possible.

Torn muscle fibres are normally not operated upon. However, if the rupture should affect more than one third of the muscle cross-section, or if there is heavy internal bleeding, or if muscle function is lost entirely, the muscle is sutured in an operation. With competitive and professional athletes who need to get back in the game quickly, or with patients who expressly demand it, torn muscle fibres are usually also treated surgically.

After a ligament or muscle injury to the lower limbs, it is important to start active proprioception training as soon as acute pain is alleviated and the swelling has gone down in order to improve foot coordination. After a foot injury, foot coordination is always impaired and it is important to correct this quickly in order to prevent subsequent injuries to the feet.

Thanks to the soft, elastic material of the kybun shoe sole and the kybun mat, the impact from hard floors is absorbed. Since this makes kybun training very gentle, you can start with it soon after incurring the injury. The kybun mat is especially well suited in the acute and early sub-acute stage, since the exercises can be specifically adapted.

The foot can move freely and naturally in all directions on the soft, elastic kybun shoe sole/kybun mat. This forces the foot to use its musculature to stabilise itself. Small movements take place in the foot at every step, gradually strengthening the foot. This intensive training significantly improves foot coordination/proprioception, and you feel safer and more stable. You will notice a difference after just a few applications.

Good foot stability forms the basis for an axially aligned loading of the joints that lie above, such as the knee, hip and back. If the feet are in good shape, excessive strain and injuries occur less frequently in the other joints and muscles. You can train the entire foot and leg musculature with kybun.

Foot mobility and circulation are improved thanks to the fine movements on the soft, elastic material. This is very important, especially after a foot injury, in order to prevent agglutination and scar formation and to promote healing.

Please follow your doctor’s advice with regard to placing weight on injured feet. In cases of torn muscles, several weeks of rest are often prescribed so that the muscle can grow back together and regain its function.

• Selecting the right dosage is very important in the beginning – adjusting the length of time you use the kybun shoe/kybun mat to your personal needs. It is better to walk shorter distances on ordinary surfaces at first, so your body can adjust to the challenge of walking with the kybun shoe/standing on the kybun mat.
• Gradually increase the duration of use at your discretion until the strength and coordination of your feet is sufficient for walking in the kybun shoes for several hours. For some people, this is possible after just a few days while others take longer. It is highly individual.
  The kybun shoe is a training device and can, but does not have to, become an everyday shoe later.
• Be sure to maintain a correct foot position on the kybun mat/in the kybun shoe. This means that the foot should stand straight on the soft, elastic material without lateral/medial rolling of the ankle joint. Any lateral/medial rolling of the ankle joint on the kybun mat/in the kybun shoe is usually not the fault of kybun but is caused by foot weakness , which has to be gradually alleviated through training. You will notice immediately when you place one-sided strain on your feet because the sole yields in the corresponding area.
• Try to focus on the foot position and correct lateral/medial rolling of the ankle joint. This strengthens your foot musculature so that, with time, you no longer tip sideways. Make sure that your body does not cramp up. Read more under ‘Lateral/medial rolling of the ankle joint’.
• Be sure not to take steps that are too long at the outset. This makes it easier to stabilise the foot over the kybun shoe sole and the tendency towards lateral/medial rolling of the ankle joint is reduced.
• If you find yourself no longer able to walk upright in the kybun shoe or you notice that you are ‘standing beside the shoe’ and are not able to correct this, it is a sign of body fatigue and means that you should take a short kybun shoe break.
• If your foot musculature is weak, it may make sense to acquire a model with weaker trampoline effect when you first purchase the kybun shoe. This sole is more stable in the midfoot section. (Please consult your kybun dealer for further information.)
• Try various kybun shoes; some of those with a higher cut provide more stability.
• If you still feel too insecure walking in the kybun shoe, the kybun mat is the ideal device to carefully train and develop the foot musculature. Please give your body time, and do not give up too quickly.
  The kybun mat is available in three different thicknesses. This allows you to choose the thickness that is most comfortable for you (the thicker, the more unstable, the more intensive the training).
  You can also hold on to a fixed object if you need additional support when using the kybun mat.