Cruciate Ligament Injury

There are 2 Cruciate ligaments in the knee. These are the Anterior Cruciate Ligament (ACL) and Posterior Cruciate Ligament (PCL). The role of the cruciate ligaments is to provide stability by limiting the amount of bending, strengthening, and rotation within the knee. Therefore an injury to this structure can be very debilitating.

The cruciate ligaments are found within the knee joint and cross each other like an X. The ACL is lateral (outside) and PCL is medial (inside). The ACL keeps the tibia from slipping forward and PCL from the tibia slipping backwards.

Causes:

ACL injury:

👣 Mostly occur during sports, especially collision or contact sports e.g football, or basketball

👣 Landing awkwardly from a jump

👣 Abnormal twisting

👣 Direct blow when foot is firmly planted in the ground

👣 Awkward fall

👣 Stopping suddenly when running

PCL injury:

👣 Less common injury

👣 PCL can tear if shinbone is hit hard just below the knee or if you fall on a bent knee

👣 Motor vehicle accident- Dashboard injury when knee hits the dashboard

👣 Contact sport. Falling on a bent knee or contact on a bent knee

Symptoms:

ACL:

👣  May feel popping sound

👣 Pain

👣 Knee instability

👣 Unable to weightbear

👣 Swelling

👣 Reduced range of movement

PCL:

👣 Severe knee pain

👣 Swelling

👣 Pain on weightbearing

👣 Unable to straighten knee

👣 May feel/ hear grating, cracking, popping noises

Treatment:

👣 Follow the POLICE protocol:

Protection- Rest for the first few days following injury , however, you should then begin gentle motions to maintain movement and avoid a decreased muscle strength and flexibility. You may require assistive devices at this time, for example crutches.

Optimal Loading- Whilst protecting the effected area, gentle movement should be started to help promote optimal healing of the injury and prevent delay in returning to normal activities.

Ice- Apply ice to help manage swelling. Ice can also help decrease some acute pain.

Compression- Compression bandaging will help reduce swelling as a result of the inflammatory process.

Elevation- Elevating the foot above heart level will help reduce swelling by allowing fluid to drain from the area.

👣 Avoid the HARM factors for 2-3 days post injury

Heat- Increases swelling and bleeding. Avoid hot baths, heat packs and saunas

Alcohol- Can delay healing by increasing swelling and bleeding

Running or exercise- This can aggravate the injury and therefore increase pain, swelling and bleeding.

Massage- Massage on the injured area can aggravate the damaged tissues. Massage away from the injury site may be helpful. Seek medical advice before proceeding.

👣 Immobilise knee

👣 Seek Medical attention

👣 Rehab program to strengthen the knee