A Spring ligament takes 4-6 weeks to heal in mild cases, while in severe cases, it can take 3-6 months for a Spring Ligament to heal. The posterior tibial tendon (PTT) and tibiospring ligament (TS)are also demonstrated. We specialize in ligament tear knee treatment without surgery.This treatment does not need hospitalization, is personalized and boosts natural repair process. Tears in the PCL joint account for a little more than 20% of all knee ligament injuries. (They do not at all guarantee stopping the progression of deformity.). These often occur in high energy ankle injuries such as car accidents, falls, significant sports injuries and ankle dislocations. Physical Therapy is an effective form of treatment for a Spring Ligament injury. During this period, you will likely experience pain in the affected joint, the adjacent muscles, and even in some nearby tissues. This means that only part of the tendon or ligament is . Progressive subluxation at the talonavicular joint eventually can cause enough deformity in the triple joint complex (ie, the talonavicular, calcaneocuboid, and subtalar joints) to result in lateral impingement and pain in the hindfoot, a collapsed foot. The degree of heel valgus is assessed from the posterior standing view. Correction of the foot alignment should be considered a critical part of the procedure. Sprained ankles are the most frequent type of musculoskeletal injury seen by primary care providers. In many instances the patient is left with a stiff foot and is prone to developing arthritis. These may also occur with ankle fractures as well. The ligament complex may have tears or large defects, or it may just be attenuated. Your physical therapist will show you the basics of protecting your injured area and preventing future injuries while you become more active as before. Ligament Injuries and Their Treatment. Reconstruction or augmentation methods for spring ligament tears or laxity include the use of anterior deltoid, peroneal tendon graft, split thickness tibialis anterior tendon graft, posterior tibial tendon stump, or suture repair.3. Joint swelling causes pain. Using crutches and/or wearing a knee brace for 3-6 can help achieve this. With failure of posterior tibial tendon function, the contracting gastrocnemius soleus muscle complex generates forces which act abnormally across the talonavicular joint rather than the metatarsal heads.3 This places an abnormal load on the static stabilizers of the arch, most significantly affecting the calcaneonavicular (spring) ligament complex.4. Spring ligament complex injury can be caused by the following 2: overuse injury and chronic degeneration in the setting of posterior tibial tendon dysfunction. If a flatfoot is present with increased heel valgus or abduction (or both) through the midfoot and there is a full tear of more than 30% of the ligament or severe attenuation, the risk of progression of deformity is high. Vitamin C - also known as ascorbic acid, is a key vitamin for ligament repair and collagen production. Possible epidemiological factors associated with rupture of the posterior tibial tendon. 3. Treatment of a ligament injury varies depending on its location and severity. a ligament, which connects two or more bones to a joint. As in other ligament injuries, imaging features in a plantar calcaneonavicular injury include ligament thickening or thinning, contour irregularities, inhomogeneity, partial or complete discontinuity as well as signal intensity changes especially on fat-suppressed T2-weighted or intermediate weighted sequences of one or more of the three ligamentous components 1-3. Laxity of the spring ligament is frequently observed in association with stretching of fibers or a full-thickness ligamentous defect (10a). Connect with a U.S. board-certified doctor by text or video anytime, anywhere. Some of the best uni-compartment offloaders on the market are made by Orthomen, Breg, and Donjoy. How ligaments tear. When this happens, you may face a recovery time of weeks to months, depending on the grade of the MCL tear. Most partial tears can be treated with precise image-guided injections of platelet-rich plasma (PRP) into the affected area. ADVERTISEMENT: Radiopaedia is free thanks to our supporters and advertisers. The spring ligament, posterior tibial tendon, and deltoid ligament all support the medial foot and ankle. Radsource January 2008. "A torn ligament is considered a severe sprain that will cause pain, inflammation, bruising and result in ankle instability, often making it difficult and painful to walk. knee ligament surgery recovery time is also considerable. Called functional treatment, this strategy usually involves three phases: the RICE regimen in the first 24 hours to reduce pain, swelling, and risk of further injury; range-of-motion and ankle strengthening exercises within 48-72 hours; and training to improve endurance and balance once recovery is well under way. Assessing the strength, flexibility and mobility of the foot and ankle helps a therapist create a rehabilitation protocol for a Spring Ligament injury consisting of balance and strengthening exercises. As the Spring Ligament is instrumental to the stability of the arch of the foot, if it becomes torn, it can lead to a visible reduction in the medial arch height of the foot, causing a flat foot deformity. J Bone Joint Surg Br 1997;79B:641-643. Physical therapy is required for optimal result, and recovery can take up to 9-12 months. Rupture of the posterior tibial tendon: evaluation of injury of the spring ligament and clinical assessment of tendon transfer and ligament repair. You will notice the strength return to the ligament at around six weeks as the collagen fibers grow back. spring ligament tear recovery time. It sits in the center and back of the knee and prevents the knee from slipping backwards. When you overstretch or tear the ligament of your foot it is called a plantar fascia sprain. In chronic disruption (weeks to months after injury) a ligament reconstruction with either an artificial ligament or tendon graft will be required. Spring ligament injuries have a high association with posterior tibial tendon tears.1 Spring ligament tears, like posterior tibial tendon tears, are most commonly seen in middle-aged women and are most often the result of chronic degeneration.6 Disruption of the spring ligament destabilizes the longitudinal arch, allowing plantar and medial rotation of the head of the talus and valgus alignment of the calcaneus (pes planovalgus). Although spring ligament reconstruction cannot give correction on its own, it can add correction to what is achieved by the bony procedures. (8a) Sequential T1-weighted axial oblique images demonstrate the inferoplantar longitudinal (arrow) and medioplantar oblique (arrowheads) components of the spring ligament complex. Spring ligament injuries are seen in 2 separate patient groups: . Pinto C, Zanetti M, Mengiardi B. The most common type of tear is a slow progressive tear that results from an adult-acquired flat foot, but it is possible to tear a Spring Ligament from running or landing from a fall. With time the athlete may note a slight collapse of their arch. Center for Orthopaedic Surgery and Sports Medicine Strains. Inflammatory Phase: The inflammatory phase follows immediately after the injury. Plain radiographs may show flat foot deformity or evidence of hindfoot valgus. spring ligament tear recovery timespring ligament tear recovery time. There might be also indirect signs such as direct contact of the posterior tibial tendon with the talar head 1. Semin Musculoskelet Radiol. Lisfranc injury can be quite serious and require months to heal. Remember to wear your brace even if you dont feel any pain. The surgery is called a knee ligament repair and it involves stitching the torn ligament. Perform exercises that place gentle pressure on your revised joint. 3m perfect it 3 step system. 3m perfect it 3 step system. Minimal damage with less than 10% of ligament fibres torn. Ankle sprains are common sports injuries but also happen during everyday activities. Conservative treatment is indicated in patients with a low-grade sprain or partial tears with no or minimal foot deformities and a low risk of further progression and consists of boots or orthotic devices with medial longitudinal arch support. Create a schedule for yourself so that you remember to engage in regular therapeutic exercises. In some instances, such as a fall from a height, there may be an acute tear or rupture of the Spring ligament. Sprains. 2020;9(12):205846012098014. Of the two, the MPO-CNL is more susceptible to injury due to its close proximity to the SM-CNL. Axial oblique images of the ankle are also helpful in visualizing the SM-CNL. [100% Recovery] Ligament Injury; April 21, 2019 October 17, 2019; . A magnetic resonance imaging (MRI) scan visualizing the spring ligament complex of the ligament tear and amount of degeneration can indicate the amount of degeneration or tear in the complex and is useful for diagnosis if it is of good quality and if it is read by an experienced examiner (see FIG 2). On the AP view of the foot, abduction at the talonavicular joint can be measured with the talonavicular uncoverage angle (ie, the amount of talar head not covered by the navicular; FIG 3A). Radiographics. Balen P & Helms C. Association of Posterior Tibial Tendon Injury with Spring Ligament Injury, Sinus Tarsi Abnormality, and Plantar Fasciitis on MR Imaging. Spring ligament failure is usually due to the repetitive stresses of a flatfoot causing increased strain on the medial ligaments of the foot. Also noted is abnormal thickening of the anterior talofibular and calcaneofibular ligaments (short arrows) indicating scarring secondary to prior ligament sprains. The posterior fibers of the SM-CNL are torn near the sustentaculum (small arrows). Based on the location of Garoppolo's fracture in initial X-ray imaging, the 49ers thought Garoppolo had suffered that dreaded type of Lisfranc injury a tear of a specific mid-foot ligament . To correctly estimate the time of recovery you first have to classify or grade the MCL tear. It causes a sprain, with the severity ranging from grade 1 to grade 3. Evaluate range of motion. razer blade 15 60hz vs 144hz. Orthop Trans 1992; 16:30. The spring ligament supports the medial longitudinal arch of the foot. Radiographs are not diagnostic tools but are helpful in assessing deformityas long as the patient is standing, letting the arch sag with weight bearing. On the lateral view, plantar migration of the talar head in relation to the navicular can be checked (FIG 3B). It involves precise, ultrasound-guided injections of a patient's own bone marrow concentrate into the damaged ligaments. (3a) The T2-weighted axial oblique image through the ankle demonstrates a thickened posterior tibial tendon with partial tear along the deep surface (arrow). Moderate knee sprains take from 8 to 12 weeks to heal. . What is the Recovery Time for a Medial Collateral Ligament or MCL Tear? Below is the general timeline and what you can expect during ligament tear recovery. News & Perspective . With the development of subtalar and transverse tarsal osteoarthritis, the patient presents with pain, stiffness, and swelling.7, Acute injuries of the spring ligament are rare but have been described. Most common in: knees, feet, legs, back. 8 Borton D, Saxby T. Tear of the plantar calcaneonavicular (spring) ligament causing flatfoot. More often, the SM-CNL is abnormally thickened with intrinsic signal heterogeneity on T1 and T2 weighted images (9a).4 This appearance is the least specific for identifying a spring ligament tear, but is considered abnormal and should prompt a careful search for additional signs of ligament insufficiency. A medial longitudinal arch support inside the boot is advised. A table explaining the differences between strains and sprains. Surgery is usually the last option. Engage in control and coordination activities as well as resistance training. Ankle injuries are a major cause of time loss from work or other daily activities and constitute up to 25% of all time-loss injuries from running and jumping sp. The expected length of time for a sprained ankle to heal will depend on the severity of the injury. Older adults present with pain in a similar area. This means it hasn't torn completely through. The spring ligament complex forms the medial and plantar margins of the articular cavity of the head of the talus and has 3 components. Physical Therapy is an effective form of treatment for a Spring Ligament injury. Spring ligament injuries can theoretically occur in any of the three ligaments. A sprain can happen to anyone without any age or gender discrimination. If you work, be sure to inform your employer that you might be out for a week or two. The average ACL injury recovery time of this group is between 9-12 months. Lateral collateral ligament (LCL) Recovery from a torn ligament may take several weeks, and should be done under the supervision of a health care provider." Strain: Muscle or tendon injury This in turn allows the surgeon to provide a more complete and functional repair of the longitudinal arch. Mansour R, Teh J, Sharp R, Ostlere S. Ultrasound Assessment of the Spring Ligament Complex. Degeneration or tear of the posterior tibial tendon without spring ligament failure. Moderate damage with more than 10% of ligament fibres torn. MRI of Spring Ligament Tears. The arc of motion may be categorized as follows: full, some inversion present, motion only to neutral, or joint contracted in eversion. A custom insole can support the foots arch alongside a stability-cushioned trainer. (2a) The fat-suppressed proton density-weighted coronal image demonstrates abnormal thickening and increased signal intensity of the distal posterior tibial tendon (arrow). The spring ligament complex, also known as the plantar calcaneonavicular ligament, is a thick connective tissue that supports the foot's inner arch (medial longitudinal). If the PCL is the only one that is damaged, a simple treatment is usually sufficient to treat the condition without surgery. Torn ligament in foot recovery time. Share. If there is a complete tear, recovery may take a little longer but most people are back to their usual activities after 6-9 months. 10 Yao L, Gentili A, Cracchiolo A. MR imaging findings in spring ligament insufficiency. Radiology 2005; 237:242-249. 3 Gazdag AR, Cracchiolo A 3rd. Compare the arc of motion (maximum eversion to maximum inversion) to the other foot. This reduces pressure on either the right or left side of the knee. The Spring Ligament (Plantar Calcaneonavicular ligament) is positioned on the underside of the foot connecting the calcaneus bone to the navicular bone. We offer various noninvasive and minimally invasive treatments, surgical procedures, and physical therapy as spearheaded by our board-certified physicians. Later in the course of the condition, if enough deformity has occurred, pain occurs in the lateral hindfoot from impingement secondary to subluxation in the triple joint complex. The anteroposterior (AP) and lateral foot radiographs should be obtained standing with the patient told to let the arch sag. The differential diagnosis of spring ligament complex injuries consist of the following: posterior tibial tendon injury without spring ligament complex injury, Please Note: You can also scroll through stacks with your mouse wheel or the keyboard arrow keys. Recovery Phase . The posterior tibial tendon (arrow) is clearly discernible as separate from the superomedial spring ligament at this level. 2008;18(11):2670-5. As a result, orthopaedic surgeons have more recently focused efforts on evaluating and correcting associated spring ligament complex injuries, resulting in a more anatomic repair. forms a sling, suspending/articulating against the head of the talus. James offers Online Physiotherapy Appointments for 45. (11a) A T2-weighted axial image demonstrates a large tear of the SM-CNL (arrowheads) at the navicular, resulting in a large ligament gap (small arrows). The procedure is called a Percutaneous Ankle Ligamentoplasty (PAL). Note that the posterior tibial tendon (arrow) contacts the medial head of the talus within the the ligament defect. The SM-CNL is the most important spring ligament component for providing functional stability of the arch and is also the most frequently injured spring ligament component.9 Efforts at evaluating the integrity of the spring ligament complex should focus on the SM-CNL.4 Published reports give a mean thickness for the SM-CNL ranging from 2.5 mm to 4.7mm, suggesting significant interobserver variability and possible inconsistent methods of assessing thickness.5,10 In pathologic states the SM-CNL frequently thickens. Posterior tibial tendon tears are a frequent cause of flatfoot deformity. This allows good access to both sides of the foot. A measurement of 4 mm has been suggested as the threshold beyond which the spring ligament is abnormal.1 Our experience suggests this value may be frequently exceeded in the normal population. This is not medical advice and we recommend a consultation with a medical professional such as James McCormack before trying any of these exercises. The radiological report should include a description of the following features: type of calcaneonavicular ligament injury (sprain, partial tear, complete tear, avulsion), affected components (superomedial, medioplantar oblique, inferoplantar longitudinal), posterior tibial tendon abnormalities (tenosynovitis, tendinopathy, longitudinal tear), associated injuries (deltoid ligament injury, midtarsal sprain, flat foot). The Posterior cruciate ligament (PCL) is found at the center of the knee, where the thigh bone and shin bone intersect. MRI findings present in surgically proven spring ligament tears include an abnormal spring ligament caliber, signal intensity, waviness, a full-thickness gap, and posterior tibial tendonopathy. However, recent anatomic dissections have identified the MPO-CNL as a separate ligament.5 The MPO-CNL originates at the coronoid fossa of the calcaneus just anterior to the IPL-CNL and has a medial oblique course attaching at the medioplantar navicular, just plantar to the navicular tuberosity (8a). razer blade 15 60hz vs 144hz. 95-111. 5 Taniguchi A, Tanaka Y, Takakura Y, Kadono K, Maeda M, Yamamoto H. Anatomy of the spring ligament. The Recovery Process Since spring ligament repair is often combined with a flatfoot reconstruction, recovery involves typically six weeks of non weightbearing then a walking boot. Eur Radiol. A short, articulated anklefoot orthosis is less cumbersome and allows ankle motion with a customized arch support. Rockville, Md: Aspen Publication; 1985. Yes, you can tear the spring ligament. Related Article: Posterior Tibial Tendonitis. A spring ligament injury refers to stretching, partial or complete tear of the spring ligament complex that acts as a static stabilizer of the medial longitudinal arch 1. (9a) Sequential T2-weighted axial images demonstrate partial tears of the distal posterior tibial tendon (arrows). The first two weeks will be the most critical time in your recovery process, since this is when your body is beginning to heal and is, therefore, most vulnerable. 2016;20(01):104-15. With more severe flatfoot deformities, lateral column lengthening procedures or fusions are being incorporated. You will likely undergo rehabilitation for about six months, but the length of time will depend on the severity of your injury. A removable boot is helpful for initial management. Nonoperative management is particularly appropriate for those patients for whom the tear and alignment are thought to have a low probability of progression. Spring ligament complex injuries or calcaneonavicular ligament injuries refer to stretching sprains, tears, or ruptures of the plantar calcaneonavicular ligament complex and can affect one or more of the three portions. Differentiation of the SM-CNL and PTT is often difficult at their point of contact; however the SM-CNL is readily differentiated proximal to this level. Spring Ligament Tear. A custom orthotic with a medial longitudinal arch support and medial heel wedge is the least cumbersome but also provides the least support. Sprain is a common condition that occurs when you overstretch or tear a ligament. There are many factors that influence recovery times that we will discuss later. The joint must be mobile into inversion for tendon repair or reconstruction. plantar calcaneonavicular ligament complex, Inferoplantar longitudinal calcaneonavicular ligament injury, Medioplantar oblique calcaneonavicular ligament injury, Superomedial calcaneonavicular ligament injury, Plantar calcaneonavicular ligament complex injury, Calcaneonavicular ligament complex injury, Plantar calcaneonavicular ligament injury. The remaining 4-7 weeks focus on restoring your joint's strength and range of motion. Posted On 7, 2022. The posterior tibial tendon is the most important dynamic stabilizer, serving to invert the hindfoot and lock the transverse tarsal joint through the middle and late phase of gait. An MRI is the best scan to identify a Spring Ligament injury. Turn into (differentiate) ligament cells Recruit other repair cells in the body to come and assist. It is recommended to increase your intake of vitamin C immediately after an injury to help support the healing process as it directly assists in wound healing and tissue repair. These are patients with no or minimal flatfoot deformity and not a large tear. Acta Radiologica Open. The intersegmental system includes the anterior and posterior longitudinal ligaments and the supraspinous ligaments. Foot and ankle 1992;13:70-79. There might be associated signs of posterior tibial tendinopathy 6. Elevate the affected joint three to six times a day in order to help reduce swelling. 7 Pomeroy GC, Pike RH, Beals TC, Maoli A 2nd. [1] Function The spring ligament functions as static restraint of the medial longitudinal arch, it supports the head of the talus from planter and medial subaxation against the body weight during standing. What are the findings What is your diagnosis? If untreated spring ligament injuries can result in the following 1-3: A spring ligament injury refers to stretching, partial or complete tear of the spring ligament complex that acts as a static stabilizer of the medial longitudinal arch 1. These injuries occur when an individuals joint is stretched out beyond the normal range, causing the ligament to partially or fully tear. [1] A sprain is usually caused by the joint being forced suddenly outside its usual range . Although spring ligament failure is associated with a preexisting flatfoot, once spring ligament failure occurs, it frequently results in progressive deformity of the foot at the talonavicular joint and hindfoot. The plantar calcaneonavicular ligament (also known as the spring ligament) . Pain is worse when weight-bearing at it places the spring ligament under a stretch, while activities such as walking, running or jumping can further exacerbate pain levels. Exercise the affected joint periodically throughout the day as directed by your physical therapist. The medial collateral ligament (MCL) on the inner side of the knee is most often torn when there is a force that strikes the outside of the knee. Pre-Surgery Checklist for Joint Replacement, Center for Orthopaedic Surgery and Sports Medicine, What Do You Mean by RICE for Tendonitis Treatment, 5 Things to Expect When Visiting an Orthopedic Clinic, How Your Sports Medicine Doctor Can Help You Recover From Injury, Nonsurgical Options for Meniscal Tear Treatment, Broken Shoulder And Elbow Treatment Near Me, The Center for Orthopaedic Surgery and Sports Medicine. Clinical symptoms are vague and similar to posterior tibial tendon insufficiency 1. Clinical alignment should be checked for midfoot abduction and height of the arch as noted on the frontal standing view. 9 Toye LR, Helms CA, Hoffman BD, Easley M, Nunley JA. The symptoms of a Spring Ligament injury include pain, bruising and swelling on the underside of the foot. We hypothesize that a large size spring ligament tear (>1.5 cm) results in medial ankle and TN joint instability, represented by a decreased TT and TN JRF. You will likely undergo rehabilitation for about six months, but the length of time will depend on the severity of your injury. It is best for those patients with considerable deformity and limited function. Although spring ligament reconstruction cannot give correction on its own, it can add correction to what is achieved by the bony procedures. In severe cases, a patient may be advised to spend a period in a walker boot to help offload the foot. Insufficiency of the posterior tibial tendon has been recognized as the primary cause of acquired flatfoot deformity in adults.1 More recently, the importance of the static stabilizers of the foot in maintaining the medial longitudinal arch has been emphasized. Since spring ligament repair is often combined with a flatfoot reconstruction, recovery involves typically six weeks of non weightbearing then a walking boot. Previously the MPO-CNL and IPL-CNL were considered a single plantar calcaneonavicular ligament. As with any injury, following your doctor's recommendations is an essential part of the recovery process. But, it also depends on the injured ligament and what your doctor considers best. Signal heterogeneity due to fat interposed between the IPL-CNL and MPO-CNL components is normal and should not be confused with a ligament tear (6a,8a). Skeletal Radiol 1997;26:310-312. Resting from painful activity, icing the injury, and some anti-inflammatory medications are useful. Here, we have to reduce the load on the joint to allow the injury to heal. The lateral talometatarsal angle, although a useful measurement, includes deformity at the naviculocuneiform and metatarsaltarsal joints. Weight-bearing x-rays of the foot can be used to assess the lateral talo-first metatarsal angle to assess for flat foot deformity 3. You can typically still stand on it. Proper knowledge of anatomy and pathology of the spring ligament complex enables the careful MR reader to diagnose spring ligament tears. If subluxation is already present, progression of the subluxation is highly likely.4. (10a) Sequential T2-weighted axial images in a patient with a partial tear of the distal posterior tibial tendon (arrow), demonstrate an abnormally lax and thickened SM-CNL along its anterior fibers (arrowheads). This strength makes it less likely to strain or tear. The short answer: recovery time for a shoulder sprain varies according to the severity of the injury, with more serious sprains requiring more time to heal. [1] [2] Coming back to competition a year after suffering an ACL injury was high (85.8%); however, only 65% (60 out of 93 players) were capable of competing at the highest level three years later. Mild knee sprains usually take around 3 to 6 weeks to heal with therapy. Posted On 7, 2022. Physical therapy is required for optimal result, and recovery can take up to 9-12 months. ed. The most specific finding of a ligament tear is a fluid-signal filled discontinuity of the ligament on T2-weighted sequences, representing a tear through the full thickness of the spring ligament. It is commonly fasciculated and may be divided into two distinct bands. Medial and plantar 3D representations of the midfoot demonstrate the 3 major components of the spring ligament complex, the superomedial (SM-CNL), medioplantar oblique (MPO-CNL), and inferoplantar longitudinal (IPL-CNL) calcaneonavicular ligaments. A shoulder sprain is a tear of shoulder ligaments, the tough bands of fibrous tissue that connect bones to one another inside or around the shoulder joint. Assessing the strength, flexibility and mobility of the foot and ankle helps a therapist create a rehabilitation protocol for a Spring Ligament injury consisting of balance and strengthening exercises. Physical examination should evaluate the posterior tibial tendon and alignment of the foot with the patient letting the arch sag fully when standing. Injury to the SMCN ligament component of the spring ligament complex can result from an acute eversion ankle sprain or from chronic compression of the talus against the fibrocartilaginous portion. The superomedial portion of the calcaneonavicular (spring) ligament is diffusely thinned and attenuated (arrowheads). The medial ligament is stronger than the lateral ligaments. The superomedial portion of the calcaneonavicular (spring) ligament is diffusely thinned (arrowheads) and torn distally at the navicular insertion (small arrow). If one meniscus is torn, shifting pressure towards the healthy meniscus on the other side of the knee may reduce pain and limit strain on the injured side. Spring ligament tears usually involve the superomedial calcaneonavicular ligament portion of the ligament, which is the most important static stabilizer of the longitudinal arch. Torn labrum in shoulder recovery time. For those experiencing strains or sprains, recovery could take six to eight weeks. Here are the details: Grade I - Grade I will take a few weeks to fully heal. If you have had an ankle ligament repair, you may be able return to high impact sports after 4 to 6 months. The internal bleeding and fluid from damaged cells together produce swelling within the joint. Evaluate inversion strength. The patient is placed in the supine position with a bolster under the greater trochanter so that the lower leg is neither internally or externally rotated. The ACL is one of the ligaments that help to keep the knee in place. If you are looking for orthopedic care in the San Antonio area, then visit us at the Center for Orthopaedic Surgery and Sports Medicine. Posted On 7, 2022. It can affect one or more of the following ligamentous portions 1-3: superomedial calcaneonavicular ligament (clinically most relevant), medioplantar oblique calcaneonavicular ligament, inferoplantar longitudinal calcaneonavicular ligament. If the ligament is only partially torn, you will likely be told by your doctor to follow the RICE method: rest, ice, compression, and elevation of your joint that was affected. A gliding zone is present between the PTT and the SM-CNL composed of fibrocartilage elements in both the deep layer of the PTT and the superficial layers of the SM-CNL. The posterior tibial tendon (PTT) lies immediately superficial to the SM-CNL and is separated by a layer of loose connective tissue. The function of the Spring Ligament is to provide stability to the underside of the foot and the foots medial arch. The PCL, or posterior cruciate ligament, is the strongest ligament in the whole knee. 2 Michelson J, Conti S, Jahss MH. The ligament can be repaired, or reconstructed using a tendon transfer. 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