Knee Ligament Injuries

Are you experiencing knee pain, stiffness, or swelling, especially after a sudden impact or unusual bend of your knee? Does your knee feel weak or unstable? You may be suffering from a knee ligament injury.

Knee Ligament Injuries: What are they?

Ligaments are dense connective tissues that help connect and support bones and muscles throughout your body. Your knee contains four important ligaments that together help the knee bend and function properly while avoiding injury. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) wrap around the outside of your knee on both sides of your leg and connect your upper and lower leg bones. These ligaments help ensure your knee is supported to avoid the knee “buckling” to the inside or the outside. The anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) form an “X shape” on the inside of your knee and support the bending and overall strength of your knee function.

During high-impact athletics, and sometimes during everyday activities, these ligaments can become strained, stretched, or torn. A knee ligament injury can destabilize the knee and require treatment or surgery to repair.

Football player with knee ligament injury

Symptoms: What do Knee Ligament Injuries feel like?

The most common symptoms of a knee ligament injury are pain, instability, and/or swelling in or around the knee. The location and severity of these symptoms can vary based on the specific ligament that has been injured and the severity of the injury.

Cruciate ligament injuries can also result in reduced range of motion or function of the knee.

Causes

Knee ligament injuries most commonly occur during high-impact athletic events, but can also occur during general daily activities.

Collateral ligament injuries (MCL and LCL) result when a force or impact pushes the knee sideways to the inside or the outside. This force can strain or tear the ligament on the opposite side of the knee.

ACL injuries are more common in non-contact athletic events, such as changing directions rapidly, stopping suddenly, or landing awkwardly after a jump. Impact injuries can also cause cruciate ligament injuries.

PCL injuries are often caused by direct contact to the front of the knee, such as falling directly on the knee during an athletic event. Car crashes can also cause PCL injuries if the knees of the driver or passenger are impacted by the dashboard or steering wheel.

Knee ligament injuries can happen to multiple ligaments at one time or in connection with an injury to the meniscus. Your evaluation will be an important time to ensure the full extent of your injury is diagnosed.

While sporting events or rare occurrences such as a car accident can cause knee ligament injuries, daily activities that result in knee contact, twisting, or hyper-extending can also cause knee ligament damage.

Evaluation: How are Knee Ligament Injuries diagnosed?

When evaluating your knee, your doctor will use a series of visual, physical, and technology tests to determine the type and severity of your injury.

To start, your doctor will discuss your overall health and medical history, ask about the situation that caused the knee injury, and compare the movement and stability of your healthy knee with the injured knee. This will often give your doctor an accurate idea of the extent of your knee injury.

Depending on the specific ligament you may have injured, your doctor may use additional visual and physical tests to confirm the diagnosis. For example, PCL injuries can often be confirmed through a physical test often called the “posterior drawer test.” In this test, your doctor will move the knee in specific directions to test the strength and support of the ligaments.

In addition to visual and physical tests, doctors may use X-ray and MRI testing to fully examine your knee. These tests will not only be used to verify damage to the knee ligaments, but also to check for underlying damage to the leg bones or other parts of the knee that may need treatment as well.

Treatment

Collateral (MCL and LCL) ligament injuries rarely require surgery to treat. Instead, your doctor will likely advise you on a treatment plan involving rest, ice, knee bracing, and physical therapy to heal your ligaments and return you to full functionality. In some cases, specific types of collateral ligament damage or underlying damage to the bone or joint may require surgical treatment as well.

PCL injuries can often be treated with a similar regimen of rest, ice, bracing, crutches, elevation, and other non-surgical treatments that your doctor will share with you after a full evaluation of your knee. More serious PCL injuries may require surgical treatment to repair and restore your knee. PCL surgery can be challenging due to the location of the ligament in your knee, and your doctor will discuss with you your surgical and non-surgical options during your evaluation.

Unlike other knee ligament injuries, ACL injuries will not fully heal without surgery. For older adults or adults with very low activity levels, non-surgical treatments may be beneficial to stabilize the knee and restore most functionality. Like other knee ligament treatment, ACL treatment may include rest, ice, bracing, and physical therapy after a period of healing.

Surgical Options

ACL surgery to fully repair a torn ACL often requires a grafted piece of ligament tissue to be added to the knee to repair the torn ligament. This ligament graft serves as a framework for healthy ligament tissue to grow within and fully repair the knee ligament after a period of recovery and healing.

Recovery: What Can Be Expected?

Recovery time for knee injuries can vary greatly based on the severity, location, and treatment plan for the injury.

Minor injuries to the MCL, LCL, or PCL that are treated with rest, ice, elevation, and bracing often require 3-4 weeks of healing before the knee feels strong enough for physical activity. Additional therapy may be required to restore the knee to full functionality.

ACL surgery or surgery to other knee ligaments will require 1-3 months of healing before resuming most low-impact daily activities and 6+ months of healing and physical therapy before the knee will be healthy enough to return to sports.

Frequently asked questions about Knee Ligament Injuries

Physicians

The following physicians specialize in the treatment of Knee Ligament Injuries:

Gregory M. Neely, MD

Matthew J. McKenzie, MD

Peter A. Looby, MD

Evan N. Hermanson, MD

Corey P. Rothrock, MD

Timothy L. Walker, MD

Keith M. Baumgarten, MD

Erik D. Peterson, MD

Michael J. Adler, MD

Eric S. Watson, MD

Luke H. Rasmussen, MD

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Testimonials

Dr. Zoellner did an outstanding job on my recent knee surgery. His “bedside Manner” was quite professional and very personal, making it clear I was more than just a patient!! His staff was great also! I would highly recommend Dr. Zoellner and the Orthopedic Institute and Specialty Hospital!!!

What a great doctor. Dr. Looby has seen me through knee and shoulder surgeries, with great skill and care. He always makes sure I am doing ok and answers all my questions and listens to my concerns. It has been an awesome journey to being pain-free and able to function normally. I will be able to dance at my daughter’s wedding. I am so grateful. What a blessing!

Dr. Keith Baumgarten is not only knowledgeable but has a great bedside manner and sense of humor. I would highly recommend him to anyone with knee problems like mine. The steroid injection has been a great relief over the past 3 years.

Dr. Rothrock did my right knee replacement last year and just completed my left knee surgery last week. I have been an RN for over 30 years and worked with many doctors and I know quality when I encounter it! Considerate – is on time, and uses skin closure that makes a beautiful healed incision instead of staples which leave lots of ugly dots. He’s very intuitive. At an office visit he knew I needed some encouragement and told me I was doing “better than most.” When I got home I realized how helpful that was. How am I supposed to know where I’m at on the spectrum? I was working hard but hardly getting anywhere. It takes a lot of time. Thanks for those words Dr. Rothrock! VERY encouraging!

This was my second knee procedure with Dr. Hermanson. As a patient, both procedures have resulted in excellent outcomes. Dr. Hermanson and staff answered any questions I had in a direct manner and I was very satisfied with the whole examination, pre-surgery, and surgery experience. Very thorough process.

Knee Ligament Injuries