Cruciate Ligament Injuries
Bournemouth’s East Cliff Physiotherapy team are sports therapy experts, with over 40 years of combined experience in the treatment of Cruciate Ligament Injuries. Ligaments are strong fibrous bands that help to connect two bones together at a joint. There are four primary ligaments in your knee, which act like strong ropes to hold the bones together and keep your knee stable by preventing any unwanted movement.
The Cruciate Ligaments are located inside the knee joint. They cross each other to form an “X” with the Anterior Cruciate Ligament (ACL) nearer the front, and the Posterior Cruciate Ligament (PCL) nearer the back. These ligaments control against any excessive forward or backward translation of the knee joint, or any excessive twisting. Injured ligaments are termed “sprains” and are graded as follows:
The ligament has been slightly overstretched, with minimal damage. There is likely to be a short period of pain, swelling and stiffness, with full recovery within 6 weeks.
The ligament has been significantly overstretched to the point where it has become loose. This is also known as a partial tear. Pain, swelling and stiffness may last a lot longer, and full recovery may take 12-24 weeks.
The ligament has torn into two pieces and is no longer able to support the joint. This is also known as a complete rupture. These injuries can still be managed with a course of specific physiotherapy, with return to activity at 6 months. However, if the knee remains unstable and gives way, referral to an Orthopaedic Surgeon may be required to reconstruct the ligament.
Mechanisms of Injury
Anterior Cruciate Ligament (ACL)
These injuries most commonly occur during sports such as football, netball, skiing and tennis. The injury often happens when your knee is forced to twist inwards whilst your foot is planted on the floor. A sudden ‘pop’ may be felt, and the knee may swell quickly over the following few hours. ACL injuries are often accompanied by injuries to the Meniscus and MCL.
Posterior Cruciate Ligament (PCL)
This ligament is wider and stronger than the ACL, and as such, is not as commonly injured. It may become injured when the shin bone (tibia) is forced backwards whilst the knee is bent, in examples such as hitting the dashboard during a car accident, or falling onto a bent knee. It may also become injured when the knee is forced backwards whilst it is straight (hyperextension) with the foot on the ground, for example, during rugby or football. As with the ACL, the injury may be accompanied by a ‘pop’ and swelling is also common.
The following symptoms may accompany a knee ligament injury:
- A popping sound at the time of injury
- Swelling of your knee, which may be accompanied by some bruising
- Pain in your knee
- Not being able to use your knee normally
- A feeling that your knee is unstable, or gives way if you try to stand on it
If you have any of the symptoms above, you should seek to have your knee assessed as soon as possible. If you have sustained a small tear to a ligament, these are usually best managed by a course of physiotherapy. This may include:
- Activity modification – to reduce the amount of strain on the knee whilst the ligament is recovering
- Manual therapy – to maintain flexibility and desensitise any painful, shortened structures as a result of the injury
- Specific Exercise – to gradually re-strengthen the knee, whilst minimising aggravation
- Taping/Strapping – to provide pain relief and support to the knee during recovery.
- Bracing – is an effective way of managing a complete ligament rupture without needing an operation. See our Ossur Knee Braces page.
If you have been diagnosed with a complete rupture, we may need to refer you to your GP or a Knee Consultant for further investigation, such as an MRI scan, to confirm our findings. We are fortunate to have good links with all local GP practices and Orthopaedic Consultants. This may result in having a repair of the ligament which all the East Cliff Physiotherapists have vast experience in treating post operation.
If you require any further information then please contact us.