Yudu - sportEX dynamics - 1999-2010

COLLATERAL DAMAGE TO KNEE LIGAMENTS Patella

Lateral ligament

Medial collateral ligament - show- ing attachment of the ligament to the joint capsule and meniscus

Meniscus Joint

capsule

Figure 1a: Medial collateral ligament of the knee (anterior aspect)

These ligaments are very important because together they prevent the knee from buckling inwards and outwards and keep it on track for forward-back movement. A person can have a mild sprain of these ligaments, where only a few fibres are damaged; a moder- ately severe sprain, where many fibres are torn; or an extremely severe one, where the ligament tears more extensively or ruptures completely in half.

The medial collateral ligament of the knee is injured more fre- quently than the lateral collateral ligament. The medial ligament runs from the femur to the tibia while the lateral ligament attach- es the femur to the fibula. With either of these ligament sprains, commonly the fibres may have torn either in the middle or near the ends of the ligament at the attachments.

The medial collateral ligament is actually attached to the inner aspect of the joint capsule of the knee and is connected to anoth- er important ligament in the knee, the medial coronary ligament. Medial collateral and coronary ligament tears therefore often accompany each other and are sometimes confused with one another. The lateral collateral ligament is not contiguous with the joint and therefore causes less or no swelling when injured.

PRINCIPLE: PAIN AS A SIGNAL Pain is the signal that something has gone wrong in the body. When the body speaks it is good to listen. If the pain diminishes and disappears within a few days, there is usually nothing to worry about. If the pain persists for more than several days, becomes more frequent or hurts with less and less activity then the body is giving the person an important message: “Pay atten- tion!”

The sooner appropriate healing begins, the better are the person’s chances of full recovery. Early warning signals are too frequently ignored and often result in more severe injuries that may inca- pacitate the person for months or years. Curtailing activities or resting for a few days may be all that is needed. In other circum- stances it may be necessary for the person to be treated by a

Figure 1b: Lateral collateral ligament of the knee physician or hands-on healthcare practitioner.

It is essential to see a doctor if: ■ The pain is very severe ■ There is paralysis ■ There is numbness or constant pins and needles in the arms, hands, legs or feet

■ The area is swollen ■ A snapping sound or tearing sensation accompanied the injury ■ There is weakness of the injured body part ■ There is extreme limitation of movement or inability to use the injured area

■ There is malfunction of the bladder or bowel ■ There is associated nausea, vomiting or blurred vision ■ The person is disorientated, dizzy or cannot perform normal activities because of the injury.

Application: Pain signals at the medial and lateral aspects of the knee In a medial or lateral collateral knee injury, regardless of where along the ligament the lesion is, pain is felt directly on the medi- al or lateral side of the knee.

A collateral ligament sprain generally arrives in one of two ways. Suddenly, as if hit by lightning, a person finds themselves on the ground. They fell or were tackled, and the knee buckled inwards (medial collateral) or outwards (lateral collateral). Perhaps the person heard a snapping sound, but more likely it was missed in the confusion of the fall. The person’s knee hurts everywhere and often the patient hobbles off trying not to bend it. Over the next few hours the knee swells, feels hot to the touch, and continues to ache. With the passing hours, the knee stiffens, making bend- ing and straightening difficult, and by the next day the pain begins to concentrate on the inner or outer side of the knee. Activity automatically becomes limited because walking is painful and anything more strenuous is impossible.

In the second case, a person might start feeling a twinge of pain www.sportex.net