Soft-Tissue Surgery in Athletes: tendons, ligaments and muscles

What soft tissues are

Soft tissues are the structures that move and stabilize the skeleton: tendons (connect muscle to bone), ligaments (connect bone to bone), muscles, joint capsules and menisci. In athletes they are exposed to extreme efforts and to acute injuries, such as ruptures, and chronic ones, such as persistent tendinopathies.

Injuries that may need surgery

• anterior cruciate ligament injury and other knee ligaments;
• repairable meniscus tears;
• distal biceps rupture and other tendon ruptures;
• tendinopathies unresponsive to non-surgical care, such as refractory tendinitis and tennis elbow;
• muscle injuries with large retraction or complete rupture.

Not every injury needs surgery. In many cases rehabilitation and complementary therapies, such as biologic ones, solve the problem.

How treatment works

Repair can be done by arthroscopy (small incisions and a camera) or open technique, with suturing of the tendon or ligament, reattachment to bone or reconstruction with a graft. Planning takes into account the sport, the athlete's position, the calendar and return goals.

Rehabilitation and return to sport

Recovery is part of treatment. It follows well-defined phases: protection of the repair, recovery of mobility, strengthening, sport-specific training and functional testing before clearance. Returning too early raises the risk of re-injury.

Dr. Daniel Ramallo coordinated the medical department of the Deborah Colker Dance Company and works in sports medicine.