Pain occurs when normal tension on a ligament stretches the fibers. In sprain or tearing, the fibers become separated from bone, and tthere is an accumulation of lymphy or blood at the site of injury. Healing occurs through initiation of the wound response cascade mediated by chemotactic agents and inflammatory cells. Fibrin is produced and develops into a permanent strong fibrous tissue attached to bone. The healing process can be interfered with.
Subsequent activity can cause separation, or the repair capacity in the individual can be deficient.
This results in ligament relaxation which is a weakness of the attachment. The healing process can be stimulated by the infiltration of a proliferative solution within the ligament. The rich supply of nerve endings in articular ligaments was first described by Lerich in 1930 and later by Gardner in 1953. Hackett described most joint pain as ligament pain. He was the first to scientifically demonstrate a method of strengthening ligaments by the injection of a proliferative solution.