Which abnormal end-feel indicates a complete ligament rupture?

• A. Movement beyond abnormal limit with pain before end of ROM
• B. Involuntary muscle contraction that prevents motion due to pain
• C. Extreme hypermobility
• D. Rebound at end point

Answer: (A)

When evaluating end-feel, a complete ligament rupture is most often signaled by loss of restraint in the joint, so motion can extend beyond its normal endpoint. The key finding is that the joint moves past the abnormal limit and, crucially, pain appears before the end of the range, so you don’t feel a solid end-stop. This creates an “empty” or absent end-feel in practice because the painful response stops the movement before a true end-feel can be established, yet the joint has moved beyond its normal limit due to the torn ligament.

Involuntary muscle contraction due to pain reflects guarding rather than ligament integrity. Extreme hypermobility points to laxity but not necessarily a complete rupture, and rebound at the end point is more characteristic of intra-articular or cartilage-related pathology rather than ligament rupture.