Ligaments attach bone to bone and provide stability to the knee joint. There are four main ligaments; the lateral ligament on the outside, the medial ligament on the inside, the anterior cruciate ligament and the posterior cruciate ligament within the knee joint.
Ligament injuries are usually acute injuries caused by a sudden impact or twisting of the knee. Medial ligament sprain is usually caused by impact to the outside of the knee. Lateral ligament injury is less common but occurs from an impact on the inside of the knee.
The anterior cruciate ligament is commonly injured in contact sports where the foot is fixed and the leg is twisted. Posterior cruciate ligament is injured if the shin bone is forcibly pushed backwards on the femur.
Ligament tears can be graded as follows:
Grade 1 tear: a small number of fibres are torn resulting in some pain but allowing full function
Grade 2 tear: a significant number of fibres are torn with moderate loss of function.
Grade 3 tear: all fibres are ruptured resulting in knee instability and major loss of function. Often other structures are also injured such as the menisci.
Anterior cruciate ligament injury may require surgery however, most of the other ligament are treated conservatively with physiotherapy and rehabilitation. Post operative physiotherapy is very important to promote a full recovery.
Treatment for Ligament Sprains
Physiotherapy treatment for patients with this condition is vital to hasten the healing process, ensure an optimal outcome and decrease the likelihood of injury recurrence. Treatment may comprise:
- Exercise programs to stretch, self treat and improve proprioception, balance, strength and core stability
- Biomechanical Assessment
- Joint mobilisation
- Dry needling /acupuncture
- Deep tissue massage/myofascial release
- Education / training advice
- Activity modification advice
- Orthotic/Insole advixe
- Ice or heat treatment
- Clinical Pilates
- Injection advice
- Surgical advice