Knee damage due to repetitive twisting

Types of injury

Twisting and changing direction quickly commonly causes injuries, which may include damage to the ligaments, such as strains, and cartilage tears.

Ligament damage

Ligament damage is common in sports where movement is quick and actions require a combination of speed and changes of direction; examples of these sports include football and hockey. Ligament damage may be mild but many cases can be serious. Ligaments connect bones to each other and control movement around the joint. The knee is primarily supported by the medial collateral ligament, which runs within the knee joint and the lateral collateral ligament, which runs on the outside of the knee. The cruciate ligaments are located inside the knee joint and offer stability during movement. A ligament sprain is usually categorised into 3 different classifications depending on the severity of the injury; a grade 1 injury involves a sprain where the ligaments are not torn. Grade 2 infers a partial tear, while grade 3 implies a complete tear of the ligament.

Symptoms of a ligament sprain

Common symptoms include pain, swelling and restricted movement; often serious sprains will result in a loss of movement and extreme pain.

Treating a ligament sprain

All ligament sprains should initially be treated with ice, rest and medication to control pain and ease swelling. Mild sprains will recover over time but the affected knee should be rested as much as possible. More serious sprains and tears will usually result in the person using crutches to prevent the knee from bearing weight; recovery will take a long time and the patient may have to have physiotherapy to increase strength and movement in the affected knee. Surgery may be required if more than one ligament has been damaged or the injury is complex.

Cartilage tear

Cartilage tears are common in sports where the foot is planted on the ground but the athlete moves quickly and frequently changes direction; these sports include tennis and football. Often, the foot remains planted on the ground and the athlete continues to move meaning the knee twists. Tears commonly occur in the lateral meniscus (outer cartilage) although medial (inner cartilage) meniscus tears do happen.

Symptoms of a cartilage tear

The most common symptoms of cartilage tears are pain and swelling; in most cases, pain will be heightened when the knee is straightened. Movement of the knee joint will be restricted in most cases and people with serious tears will struggle to bear weight and walk.

Treating a tear

Initial treatment will include medication, rest, ice and elevation; this will help to reduce pain and ease swelling. Minor tears will heal over time with rest; this will usually take about 6 weeks. More severe tears may take several weeks to heal. If symptoms persist, a doctor may suggest surgical treatment, which can improve 1 in 4 cases. Surgery may involve repairing the meniscus or removing part or all of the affected cartilage; surgery is usually carried out by means of an arthroscopy (keyhole surgery). Once the healing process is underway, most athletes will have physiotherapy to speed up recovery and build strength in the affected area.

Preventing a knee injury

A thorough warm and cool down are advised for all those taking part in physical activity; this allows the muscles time to get warm, meaning they are less susceptible to injury. It is also advisable to maintain a healthy and stable weight; excess body weight causes increased pressure on the joints. It is also advisable to avoid playing sport in slippery conditions; this can increase the chance of slipping and falling awkwardly significantly.

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