ACL/MCL Injuries

Many athletes experience injuries to their knee ligaments. Of the four major ligaments found in the knee, the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL) are often injured in sports. The posterior cruciate ligament (PCL) may also be injured.

 

ACL Injury

Changing direction rapidly, slowing down when running, and landing from a jump may cause tears in the ACL. Athletes who participate in skiing and basketball, and athletes who wear cleats, such as football players, are susceptible to ACL injuries.

 

PCL Injury

The PCL is often injured when an athlete receives a blow to the front of the knee or makes a simple misstep on the playing field.

 

MCL Injury

Injuries to the MCL are usually caused by a direct blow to the outside of the knee. These types of injuries often occur in contact sports, such as football or soccer.

 

Torn Cartilage

When people talk about torn knee cartilage, they are usually referring to a torn meniscus. The meniscus is tough, rubbery cartilage that is attached to the knee’s ligaments. The meniscus acts as a shock absorber. In athletic activities, tears in the meniscus can occur when twisting, cutting, pivoting, decelerating, or being tackled. Direct contact is often involved.

Meniscus Tears

Like a lot of knee injuries, a meniscus tear can be painful and debilitating. Unfortunately, it’s quite common. In fact, a meniscal tear is one of the most frequently occurring cartilage injuries of the knee.

So what is the meniscus? It’s a piece of cartilage in your knee that cushions and stabilizes the joint. It protects the bones from wear and tear. But all it takes is a good twist of the knee to tear the meniscus. In some cases, a piece of the shredded cartilage breaks loose and catches in the knee joint, causing it to lock up.

Meniscus tears are common in contact sports like football as well as non-contact sports requiring jumping and cutting such as volleyball and soccer. They can happen when a person changes direction suddenly while running, and often occur at the same time as other knee injuries, like an anterior cruciate ligament (ACL) injury. Meniscus tears are a special risk for older athletes since the meniscus weakens with age. More than 40% of people 65 or older have them.

 

What Does a Meniscus Tear Feel Like?

Symptoms of a meniscus tear include:

  • Pain in the knee
  • Swelling
  • A popping sensation during the injury
  • Difficulty bending and straightening the leg
  • A tendency for your knee to get “stuck” or lock up

At first, the pain may not be bad. You might even play through the injury. But once the inflammation sets in, your knee will probably hurt quite a bit.

To diagnose a meniscus tear, your doctor will give you a thorough exam. He or she will want to hear details about how you got your injury. X-rays may be necessary, to rule out broken bones and other problems. You may also need an MRI (Magnetic Resonance Imaging) scan, which allows a more detailed evaluation of knee cartilage.

 

What’s the Treatment for a Meniscus Tear?

Treatment for meniscal tears depends on the size and location of the tear. Other factors which influence treatment include age, activity level, and related injuries. The outer portion of the meniscus often referred to as the “red zone,” has a good blood supply and can sometimes heal on its own if the tear is small. In contrast, the inner two-thirds of the meniscus, known as the “white zone,” does not have a good blood supply. Tears in this region will not heal on their own as this area lacks blood vessels to bring in healing nutrients.

Happily, not all meniscal tears require surgery. If your knee is not locking up, is stable, and symptoms resolve, nonsurgical treatment may suffice. To speed the recovery, you can:

  • Rest the knee. Limit activities to include walking if the knee painful. Use crutches to help relieve pain.
  • Ice your knee to reduce pain and swelling. Do it for 15-20 minutes every 3-4 hours for 2-3 days or until the pain and swelling is gone.
  • Compress your knee. Use an elastic bandage or a neoprene type sleeve on your knee to control swelling.
  • Elevate your knee with a pillow under your heel when you’re sitting or lying down.
  • Take anti-inflammatory medications. Non-steroidal anti-inflammatory drugs (NSAIDs), like Advil, Aleve, or Motrin, will help with pain and swelling. However, these drugs can have side effects, such as an increased risk of bleeding and ulcers. They should be only used occasionally, unless your doctor specifically says otherwise.
  • Use stretching and strengthening exercises to help reduce stress to your knee. Ask your doctor to recommend a physical therapist for guidance.
  • Avoid impact activities such as running and jumping.

These conservative treatments, however, aren’t always enough. If a tear is large, unstable, or causing locking symptoms surgery may be required to either repair or remove unstable edges. The procedure is usually pretty simple, and you can often go home the same day. You may need a brace afterward for protection if a repair is performed.

For 85% to 90% of people who get the surgery for a meniscus tear, the short-term results are good to excellent. But in the long-term, people who have a large meniscal injury that is unrepairable may be at a higher risk of developing knee arthritis.