Ligament Tears

What are knee ligaments?

The knee joint is held tightly together by four main ligaments: the inner and outer “hinge” ligaments (medial and lateral collateral ligaments) and the crossing (cruciate) ligaments, which sit in the middle of the joint (the anterior and posterior cruciate ligaments)

The collateral ligaments are firmly attached to the end of the thigh bone (femur) and the end of the lower leg bones (tibia and fibula). The ligaments hold the two bones together and prevent side to side motion. The anterior cruciate ligament (ACL) prevents forward and backward motion. You can partially or completely tear the ligaments.

How do people damage their ligaments?

Sports, whether contact or ‘non-contact’, including football, rugby, basketball and netball, usually involve rapid twisting movements of the knee. Knee injuries with these sports are extremely common.

With large numbers of people taking part at all levels of ability – from elite professionals through to the occasional ‘weekend warrior’ – they produce the greatest number of knee injuries.

 Non-contact injuries happen when a person is running or jumping and then suddenly slow and changes direction or pivots in a way that involves rotating or bending the knee sideways. Women appear to be at a higher risk of non-contact ACL injuries than men, although the exact reason for this is not fully understood.

Contact-related ligament injuries usually occur from a direct blow causing hyperextension or when the knee is forced inwards towards the other leg. This is often seen in rugby when a player’s foot is planted and an opponent strikes him on the outside or front of that thigh.

Ligament injuries most commonly occur during the following activities:

Noncontact sports, such as downhill skiing, gymnastics, and tennis

Certain contact sports, including rugby, football, and basketball

Motor vehicle accidents

How are ligament tears diagnosed?

My Knee Doc or your physiotherapist should be able to tell if you have a ligament tear from your symptoms and by doing an examination.

You will usually need An X-ray or MRI scan can help to confirm the diagnosis and also rule out any other causes for your symptoms. These special investigations can also help plan your treatment.

How are ligament tears treated?

This depends on which ligament you have torn, how bad the tear is and if there is damage to any of the other structures in your knee. After a full assessment My Knee Doc will advise on the different treatment options so you can decide what is best for you.

The first part of treatment usually involves things you can do on your own to reduce your pain.

 To ease your symptoms, you can:

Rest your knee and avoid activities or movements that make the pain worse.

Put ice on the outside of your knee when it hurts or after activities that cause pain. You can put a cold gel pack, bag of ice, or bag of frozen vegetables on the painful area every 1 to 2 hours, for 15 minutes each time. Put a thin towel between the ice (or other cold object) and your skin.

Take a pain-relieving medicine. Over-the-counter medicines include paracetemol or ibuprofen.

My Knee Doc may recommend you see a physiotherapist to do special exercises after your injury. These exercises are called “rehabilitation,” or “rehab.” They help you strengthen your knee and get back the ability to move it around.

Depending which ligament you tear the treatment may be different the following is a brief summary for the more common ligament tears:

Anterior Cruciate Ligament (ACL) tear

These injuries can be managed with physiotherapy alone or, as is the common practice, by a combination of physiotherapy and ACL reconstruction surgery. Early advice from My Knee Doc is important to help you make the best possible recovery and to avoid further injury.

 Medial Collateral Ligament (MCL) tear

Simple sprains can be managed actively with the help of a physiotherapist. More major tears, however, should be treated with a knee brace (splint), which needs to be provided within a week of injury.

Most MCL injuries heal with bracing, and patients make an excellent recovery. Delays in diagnosis, however, can lead to an unstable knee, which sometimes will need knee ligament surgery, with less predictable results.

Posterior Cruciate Ligament (PCL) tear

These injuries are much less common than ACL tear. It is important that these are diagnosed early. Most PCL injuries heal with bracing, and patients make an excellent recovery. Delays in diagnosis, however, can lead to an unstable knee, which sometimes will need knee ligament surgery, with less predictable results.

Lateral collateral (LCL) and posterolateral corner (PLC) tears

It is important that these are diagnosed early as surgery is often needed to reconstruct these ligaments, although partial tears can usually be managed by physiotherapy and bracing.

Can ligament tears be prevented?

Most ligament tears happen as a result of an injury or accident and therefore can be difficult to fully prevent.

You can reduce your chances of getting a ligament injury by:

Staying active and do exercises that make the muscles that support the knee strong and flexible. As part of your training, work on your balance, for example by standing on one foot.

Learning how to move so there is less stress on the knee during sports. This might involve talking to a sports medicine expert, a fitness trainer or a physiotherapist about how to move and position your body, especially during sports.


Call 0161 4646399  today to arrange a consultation with Mr Gareth Stables.