Knee ligament damage can be a frustrating injury. Until you injure them, you don’t realise how much your knee joint relies on its ligaments to function normally. In this article, we provide you with all the information needed about how best to treat a torn knee ligament without surgery.
Anatomy of the knee ligaments
Their role is to connect the bones of the knee together and provide stability to the joint during movement. Ligaments are made up of fibrous connective tissue called collagen. These bands of tissue have a limited blood supply which is why they struggle to heal on their own.
There are four major ligaments in the knee joint, two internal and two external:
Anterior cruciate ligament (ACL) – a ligament inside of the knee that connects the femur bone to the tibia bone. Its role is to control backward and forward movements of the knee, stopping the tibia from moving in front of the femur.
Posterior cruciate ligament (PCL) – a ligament inside of the knee that also attaches the femur to the tibia. Similar to the ACL it helps to control forward and backward movements in the knee.
Medial collateral ligament (MCL) – an external ligament that connects the inside aspect of the femur to the inside aspect of the tibia. Its role is to stabilises the knee against any side-shifting movements. It is attached to the medial meniscus.
Lateral collateral ligament (LCL) – an external ligament that connects the femur to the fibula. Similar to the MCL, it helps to limit the amount of movement from side to side in the knee.
What are the symptoms?
The intensity of the below symptoms is dependent on the severity of the knee ligament damage:
- Knee pain – it can feel internal or external or both.
- Swelling and inflammation – knee ligament damage can often cause bleeding in the joint which leads to it swelling up. Full-thickness tears can cause swelling almost immediately. Whereas mild ligament sprains can take up to 24 hours to appear.
- A popping sound at the time of the injury is an indication that a knee ligament is completely torn.
- Reduced mobility – this is often due to the stiffness caused by the swelling.
- Instability – your knee gives way or feels like it’s going to give way. This symptom is more common in an ACL injury.
- An inability to put weight on the joint
Treatment for knee ligament damage
Knee ligaments have a poor blood supply, which is why they can struggle to heal on their own. It is the oxygen and nutrients in our blood supply that helps to heal these structures.
Prolotherapy involves the injection of a regenerative solution into these structures to provide a direct supply of what is required to heal and repair.
As the treatment is helping to treat the root cause of the problem, it is deemed to be a permanent fix.
Causes of knee ligament damage
Knee ligament damage can occur from either being over-stretched (a sprain) or torn (ruptured). During a ligament sprain, only a few of the fibres are torn. During a rupture, many more fibres are torn and classed as either a partial tear or a complete tear. A partial tear is where the ligament is damaged but still intact. A complete tear is where the ligament tears into two pieces. Sprains are more common than tears.
There are three main causes of knee ligament damage:
- A direct blow to the knee.
- Repetitive strain.
- When the joint has been stretched at an abnormal angle. For example, when someone has twisted their knee or landed on it at an awkward angle.
Anterior cruciate ligament injury
ACL injuries are common sports injuries in activities where a lot of twisting, landing, and unpredictable scenarios are involved such as football tackles. It is estimated that about half of people that injure their ACL also injure another ligament or meniscus in the same knee. If required, an orthopaedic surgeon can repair a meniscal tear and ACL tear during the same procedure.
Posterior cruciate ligament injury
An injury of the PCL is less common than ACL injuries due to the fact it is wider and stronger. One of the most common scenarios to injure this ligament is during a car accident, when the knee hits the dashboard, forcing the shin bone backward against the thigh bone. Another scenario is when the leg is forced backward whilst the leg is extended, which is common in contact sports. With a PCL injury, there may be a delay before you start to experience knee pain.
Lateral collateral ligament injury
The most common incident the LCL is injured is from a direct blow to the inner aspect of the knee, forcing the ligament into a stretched position. This can cause either a tear or a sprain of the LCL.
Medial collateral ligament injury
A direct blow to the outer aspect of the knee joint can force the knee to buckle slightly and cause either a sprain or tear of the MCL. Depending on the severity of the injury, it can also cause a tear of the medial meniscus.
Diagnosis of a torn ligament in the knee
Your practitioner will ask you questions about the cause of the knee ligament damage and what type of symptoms you are experiencing. They will then proceed to perform specific orthopaedic movement tests to confirm whether a scan is needed.
The two scans appropriate for diagnosing ligament tears are an ultrasound scan and an MRI scan. Ultrasound scans are only appropriate for viewing the medial collateral and lateral collateral ligaments. An MRI scan is able to view all four ligaments.
Surgery for knee ligament damage is normally only advised for complete tears where the ligament fibres have detached, although there is still a debate about whether it is suitable for most people. The most common ligament to be operated on is the anterior cruciate ligament. The type of operation performed for an ACL reconstruction is an arthroscopy. A graft is normally taken from the hamstring at the back of the thigh bone, or from the patellar tendon that connects the shin bone to the kneecap.
How can you prevent knee ligament damage
– If you are a keen runner or a sportsman it will be good to see a physiotherapist at a physiotherapy or sports medicine clinic every 6 months to have your running gait assessed. They will also provide strengthening exercises to improve muscle strength, which further prevents ligament damage and other types of knee pain conditions.
– It is important to warm-up and stretch before every sporting activity. A physical therapist can guide you through a stretching regime if you are unsure what the best stretches are. This is particularly important for individuals who have had previous sports injuries. The keys muscles to stretch around the knee are the quadriceps, hamstring, and calf muscles.
– A regular sports massage of the leg muscles can help. Massage can help to prevent knee ligament injuries by keeping the muscles around the knee supple. Supple muscles absorb shock and force more efficiently than tight muscles, which helps to protect the knee from damage. If the quadriceps muscle is tight, then it can affect the function of the quadriceps tendon and knee cap, creating instability in the joint. This instability puts knee ligaments under pressure. Supple muscles also help to protect the menisci which work with the ligaments to stabilise the knee joint.
– Wear a knee brace if you partake in physical activity that involves a lot of twisting, turning and landing.
Frequently asked questions
How long does a knee ligament take to heal?
The following data is the average recovery time after surgery:
- Anterior cruciate ligament – 6 months
- Posterior cruciate ligament – 9-12 months
- Medial collateral ligament – 6-9 months
This data is all dependant on how much physiotherapy is performed after the surgery.
Can you still walk with a torn ligament in your knee?
Most people can still walk with knee ligament damage although it is advised to wear a knee brace or elastic bandage. You can use an ice pack on the outside of the knee after a long walk if the knee is hurting.
What helps ligaments heal faster?
Prolozone therapy can help ligaments heal faster by providing oxygen and nutrients to the tissues. PRP injections can also be considered.
Can you bend your knee with a torn ACL?
When you have an ACL tear, the amount you can bend your knee all depends on the severity of the injury and the amount of inflammation is present. To prevent further damage, it is important not to bend the knee forcefully or through any pain.
How should I sleep with a torn knee ligament?
If you sleep on your side then it is advised to put a pillow between your knees. This can help to take the pressure off the damaged area and keep the knee in good alignment during the night.
Can an x-ray show torn ligaments in the knee?
An x-ray cannot show torn ligaments. Only an MRI scan or ultrasound scan can identify knee ligament damage.