What Is a Tear or Rupture, and What Are the Symptoms?
A tear or rupture refers to a complete or extensive partial disruption of the continuity of a tendon, ligament or muscle. It is a serious injury that often requires surgical treatment and prolonged rehabilitation. Return-to-sport times may range from several months to more than a year, depending on the location and extent of the injury.
Some of the most common sports-related ruptures include anterior cruciate ligament (ACL) tears of the knee—one of the most frequently treated sports injuries requiring surgery worldwide—Achilles tendon ruptures, ankle ligament tears and rotator cuff tendon tears.
Symptoms may include:
- sudden, severe pain at the time of injury;
- immediate inability to bear weight or use the affected area;
- rapidly developing swelling;
- joint instability.
Treatment and Characteristics of Tears and Ruptures
Even when treated surgically, a rupture presents a particularly demanding biological challenge. The quality of healing depends not only on the technical success of the operation, but also on the condition of the surrounding tissues, including their blood supply, immune response and ability to produce functional collagen.
One of the most important factors is the postoperative environment. Surgery creates a new tissue injury, temporarily increases inflammation and places the tissues surrounding the rupture under considerable biological stress.
The period of immobilization that often follows may also reduce blood flow to the tissues, further slowing the healing process.
In ACL reconstruction, the grafts used, whether autografts or allografts—require several months to become fully incorporated. This process, known as ligamentisation, depends directly on the vascularization and oxygenation of the surrounding tissues.
Scientific Basis
Published studies involving patients with anterior cruciate ligament and Achilles tendon ruptures suggest that postoperative hyperbaric oxygen therapy may improve the conditions required for ligamentisation and support faster graft maturation.
In particular, increased local oxygenation appears to accelerate the formation of type I collagen within the graft and reduce the time required for its incorporation.
Studies have also reported reduced postoperative inflammation, faster resolution of swelling and an earlier start to physiotherapy in patients who received hyperbaric oxygen therapy as part of their postoperative treatment protocol.
The Role of Hyperbaric Oxygen Therapy
In cases of tendon or ligament rupture, hyperbaric oxygen therapy is used primarily during the postoperative phase as an adjunct to rehabilitation. It does not replace surgery or physiotherapy but may support and enhance the effectiveness of both.
During the first two to four weeks after surgery, the main objectives are to reduce postoperative inflammation and swelling and to protect the surgical site from secondary tissue injury. Increased oxygenation may also strengthen the immune response against potential infection and support healing of the surgical incision.
During the subsequent ligamentisation phase, hyperbaric oxygen therapy may support graft vascularization, stimulate type I collagen synthesis and promote the production of growth factors involved in graft incorporation.
This may contribute to the development of a more mature and resilient graft within a shorter period, supporting an earlier and safer return to sporting activity.
A typical treatment course for tendon or ligament ruptures consists of 20 to 40 sessions, depending on the type of rupture, the graft used and the patient’s clinical progress. Treatment is always planned in close collaboration with the surgeon and the rehabilitation physiotherapist.