Ligament injuries in the knee such as an anterior cruciate ligament () are dreaded by professional and amateur athletes alike. They are painful and debilitating. They might even change your lifestyle permanently.
While an ACL injury or other ligament damage once ended the career of many athletes, treatment is much more successful now.
Ligaments are tough bands of tissue that connect the bones in your body. Two important ligaments in the knee, the ACL and posterior cruciate ligament (PCL), connect the femur or thighbone with the tibia, which is one of the bones in the lower leg. Too much stress on these ligaments can cause them to over stretch or even snap.
ACL injury and other ligament injuries can be caused by:
- Twisting your knee with the foot planted.
- Getting hit on the knee.
- Extending the knee too far.
- Jumping and landing on a flexed knee.
- Stopping suddenly when running.
- Suddenly shifting weight from one leg to the other.
These injuries are common in soccer players, basketball players, skiers, gymnasts, and other vigorous sport athletes.
There are four ligaments in the knee that are prone to injury:
- As mentioned above, the anterior cruciate ligament (ACL) is one of the two major ligaments in the knee. It connects the thighbone to the shinbone in the knee. ACL injuries are a common cause of disability to the knee.
- The posterior cruciate ligament (PCL) is the second major ligament in the knee connecting the thighbone to the shinbone in the knee.
- The lateral collateral ligament (LCL) connects the thighbone to the fibula, the smaller bone of the lower leg, which is found on the lateral or outer side of the knee.
- The medial collateral ligament (MCL) also connects the thighbone to the shinbone on the medial or inner side of the knee.
What Does a Knee Ligament Injury Feel Like?
An ACL injury or other ligament injury is sometimes hard to diagnose. Symptoms of a knee ligament injury are:
- Pain, often sudden and severe
- A loud pop or snap during the injury
- A feeling of looseness in the joint
- Inability to put weight on the point without pain
If they’re not treated at the time, ACL injuries and other types of ligament injuries may act up months or years later. They can make your knee give out when you twist or pivot.
To diagnose an ACL or other ligament injury, your doctor will give you a thorough exam. If your knee is swollen with blood, your doctor may use a needle to drain it. You may need X-rays, MRI (Magnetic Resonance Imaging) scans, or other tests.
What’s the Treatment for a Knee Ligament Injury?
A mild to moderate knee ligament injury may heal on its own given time. To speed the healing, you can:
- Rest the knee. Avoid putting excess weight on your knee. You may need to use crutches for a time.
- Ice your knee to reduce pain and swelling. Do it for 20-30 minutes every 3-4 hours for 2-3 days, or until the pain and swelling is gone.
- Compress your knee. Use an elastic bandage, straps, or sleeves on your knee to control swelling.
- Elevate your knee on a pillow when you’re sitting or lying down.
- Wear a knee brace to stabilize the knee and protect it from further injury.
- Take anti-inflammatory painkillers. Non-steroidal anti-inflammatory drugs (NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling.
However, these drugs can have side effects and they should be used only occasionally, unless your doctor specifically says otherwise.
- Practice stretching and strengthening exercises if your doctor recommends them.
For severe collateral ligament tears, you may need surgery to attach the ligament back to the bone if it was pulled away or to the other part of the ligament if it was torn in the middle.
Unfortunately, the cruciate ligaments, ACL and PCL, cannot be repaired. Once they are completely torn or stretched beyond their limits, it cannot be reversed. The only option is a reconstruction. In this procedure, tendons are taken from other parts of your leg or a cadaver to replace the torn ligament.
A ligament reconstruction for an ACL or PCL injury is complicated and involved. It’s not the right choice for everyone. Some people who have pain or severe instability in their knees may choose to have it, or so might professional athletes or devoted amateurs who really want to return to their previous level of activity.
But if the pain is not a problem, you may choose to skip the surgery and accept the risk of some permanent weakness and instability in your leg. You may also opt for a custom-made brace. Talk over the treatment options with your doctor.
When Will I Feel Better After a Knee Ligament Injury?
Recovery time depends on how severe your knee ligament injury is. People also heal at different rates. While you recover, and if your doctor agrees, you could take up a new activity that won’t hurt your knee. For instance, runners could try swimming.
Whatever you do, don’t rush things. Don’t try to return to your old level of physical activity until:
- You feel no pain when you bend or straighten your knee.
- You feel no pain in your knee when you walk, jog, sprint, or jump.
- Your knee is no longer swollen.
- Your knee feels as strong as your uninjured knee.
If you start using your knee before it’s healed, you could cause permanent damage.