The knee joint is one of the largest in the human body. In connection with the erect walk, this joint accounts for the greatest load. Any anatomical features, excess weight, engaging in traumatic sports, and even wearing high-heeled shoes can damage the structures of the joint.
Ligamentous apparatus of the knee joint
The knee joint is formed by the femoral and tibial bones, as well as the patella. They are held together by special bundles:
- Anterior cruciate ligament.
- Posterior cruciate ligament.
- Internal lateral ligament.
- Outer lateral ligament.
The most common fracture of the anterior cruciate ligament. This usually happens during sports (for example, football, basketball, downhill skiing) when a person sharply turns the body and hips, and the feet and legs remain fixed on the ground or do not keep up with the rest of the body. Other reasons for the break include strikes to the knees and lower legs, falls and unsuccessful landings after jumps.
If an athlete stops and unfolds abruptly (for example, a basketball player is blocked by a defender and tries to deceive him), then a very serious injury can happen – “an explosion of the knee joint”. With such damage, not only the anterior cruciate ligament is broken, but also one of the menisci, as well as the internal lateral ligament.
Prerequisites for rupture of the knee ligaments
- The angle between the lower leg and thigh. In women it is more, so the risk of rupture is higher.
- Exercise, muscle strength. The stronger the muscular corset surrounding the joint, the lower the chance of injury. That is, an ordinary person, playing football and turning sharply on the field, is more likely to be injured than a professional athlete.
- Hormonal status. It is believed that female hormones (estrogens) reduce the elasticity of ligaments, and this increases the risk of injury.
The classification of the rupture of the knee ligaments
- Degree 1 – stretching and micro-breaking of the bundle fibers. The patient feels pain in the knee, it may swell up and turn red. The functionality of the joint is slightly reduced.
- Grade 2 – a large number of broken fibers. The function of the joint is partially preserved. Symptoms are more pronounced.
- Grade 3 – complete rupture of the ligament. Severe pain, hematoma, possible hemarthrosis (accumulation of blood in the joint), swelling, instability of the joint, the inability to stand up on the injured leg.
If any injury is suspected, a tight bandage should be applied from the lower third of the thigh to the middle of the tibia and the patient should be taken to a specialized hospital.
Diagnosis of rupture of the knee ligaments
- Examination by a traumatologist. A survey of the patient, palpation of the knee can determine the injury and suggest its degree of severity.
- Radiology diagnosis. X-rays in front and side projections. If necessary, CT and MRI. On a CT scan, the bones are better visualized, and on magnetic resonance imaging – soft tissues. After analyzing the images, you can accurately set the degree of damage.
- Tests for joint stability. Lachman test and front drawer test.
Treatment and recovery after rupture of the knee ligaments
Already from the moment the patient arrives at the hospital or in the emergency room, his rehabilitation begins. Properly chosen treatment will allow you to restore the functionality of the joint as early as possible.
- Surgical intervention. If the patient has a complete rupture of the ligament with instability of the knee joint, with other injuries in the joint or surrounding tissues, then the traumatologist prescribes an operation. In other cases, it is most likely not required.
- Anesthesia. The patient is prescribed analgesics intramuscularly (Ketorolac) or orally in pills. You can use ointments, creams and gels with an anesthetic component. It is better that the active substance in tablets and cream be the same, for example, Diclofenac.
- Cold and immobilization. Cold compresses or cryotherapy, splinting or wearing an orthosis. Do not load the leg.
- Puncture of the joint. If a vessel is damaged during an injury, then blood may accumulate in the joint cavity. To do this, under local anesthesia, a needle is inserted into the side of the knee, through which the doctor removes all the accumulated fluid and, if necessary, injects healing solutions into the joint. If the blood is not removed, it fester, which in turn can lead to sepsis.
Stage 1: 1-7 days after injury
All exercises are done with both legs, 3-4 times a day, 10 approaches each. Engaging through pain is prohibited.
- Flexion and extension of the leg at the knee joint. With a slight injury, you can perform exercises with little resistance, but you can’t hurry with the complication of exercises either, as excessive load will only aggravate the situation.
- Static muscle tension on the front of the thigh (quadriceps). It stimulates blood circulation and improves skin tone.
- Rolling the foot back and forth, to the sides helps to maintain the strength of the muscles of the leg, and also stimulates blood circulation.
- Walking. As soon as the attending physician allows you to walk, you should immediately begin to exercise. In this case, it is impossible to fully rely on the injured leg. It is necessary to use crutches, a cane or an orthosis. You can walk at a comfortable pace until the first pain.
Stage 2: up to 14 days after injury
The scheme of therapeutic gymnastics of the first stage continues. Several exercises are added to it for training the muscles of the lower limbs and preparing for independent walking without crutches and an orthosis.
- Semi-squats. Performed against the wall, knees should not go beyond the foot, the loin remains straight.
- Lifting socks.
Stage 3: up to 1 month after injury
The patient performs all the previous exercises. To these are added:
- Leg abduction and adduction. Starting position – lying on your back.
- Lift up straight leg. Starting position – lying on its side.
- Classes on the elliptical trainer. It is a cross between cycling and skiing.
- Independent walking. Complete abandonment of crutches, canes, orthosis.
Stage 4: 1.5 months after injury
A revision of the scheme of occupations. The simplest exercises are excluded, some are complicated.
- Pricing with burdening. Weight is selected individually. It is very important to carefully follow the safety guidelines when performing this exercise.
- Foot press. The weight of the load is selected individually.
- Step on the platform.
- Exercise bike and elliptical trainer.
Stage 5: up to six months from the moment of injury
The patient regularly performs physical exercises at a comfortable pace for him with selected weights.
Professional athletes in six months can gradually return to their usual training. All the rest should be regularly engaged in physical therapy to maintain muscle strength, the development of dexterity and balance. This will avoid injury in the future.