Knee Ligament Problems in Sports Activities

What is Ligament?

A ligament is a tough strip of connective tissue that joins one bone to another bone around a joint.
The knee ligaments help to stabilise and support the knee joint when it is moved into different positions.
They are tight in some positions and slack in others. Some ligaments in your knee can be as wide as a pencil and some as wide as three fingers. The knee has four main ligaments; the medial collateral, lateral collateral, anterior cruciate and posterior cruciate. Each has a different job to do.
The ligaments around the knee are strong. However, sometimes they can become injured.
They may be sprained (stretched), or sometimes ruptured (torn).
How common are knee ligament problems?
Most knee ligament injuries are sprains, not tears and tend to settle down quickly.
There are a number of different things that can cause injury to the ligaments in your
• You may have a direct blow to your knee or knock into something with your knee.
• Your knee may be moved outside of its usual range of movement. For example, this can happen during a fall, if you land awkwardly during sport, or after a sudden movement. •
In sports injuries it is fairly common.
Most people with an acute ligament sprain are under 45 years of age, but it can happen to anyone.
What are the symptoms?
• Pain in your knee. The degree of pain can depend on the severity of the knee injury.
• Pain over the ligament on touch.
• Stiffness after rest especially in the morning.
• A feeling that your knee is unstable or perhaps giving way if you try to stand on it. This may cause you to limp. This depends on how severe the ligament injury is. You may be able to stand if you only have a minor sprain.
• Pain at extremes of movement.
• A popping sound or a popping or snapping feeling at the time of injury can sometimes be heard if a ligament is completely torn
• Swelling in the knee – it can be hugely swollen within a couple of hours of injury if the Anterior Cruciate Ligament (ACL) has ruptured.
What tests may be done?
The main way we diagnose knee ligament damage is through what you tell us and by examining your knee. We will assess your knee and check the different ligaments to see if they have extra “give” in them. Sometimes we may get an x-ray to see if there is
also wear and tear in the joint. An x-ray will not show up ligament tears so sometimes we will order an MRI.
What are my treatment options?
In the first weeks of a ligament injury the most important thing to do is
P rotection – protect the injured area from further i
Rest – stop the activity that caused the injury, and rest the injured joint or muscle.
Avoid activity for the first 48 to 72 hours after injuring yourself.
Ice – apply an ice pack wrapped around a wet cloth to reduce swelling – 10 minutes at
a time, three times a day. Warning you can get an ice burn from direct contact with the ice!
Compression – wearing a bandage to compress the area may help reduce swelling.
Elevation – keep your leg elevated – your foot should be higher that your knee and your knee higher than your hip, if you are sitting down.
Take pain killers, but discuss this with your GP or Pharmacist first.
It is important to keep your knee moving (gently at first) and keep your muscles strong so they don’t weaken because you’re using them less.
Physiotherapy can help with an exercise programme.
If it becomes a chronic problem, a steroid injection to the ligament may help reduce pain.
After a sprain or partial tear, the ligament has completely healed in most people after three months.
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.
Unless there is total rupture, surgery is generally not indicated.
In high performance individuals like athletes operative treatment is usually indicated early to ensure optimum out comes and early return to sports. With modern minimally invasive techniques like arthroscopy outcome has been greatly improved.

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