Medial Ligament Injury
Anatomy

Medial Knee LigamentThe Medial Knee Ligament is a flat, thick band of fibrous tissue on the inside aspect of the Knee joint. It provides stability and contact between the Femur (thigh bone) and Tibia (shin bone). It also helps to support the Medial Meniscus inside the Knee joint.

Mechanism Of Injury

Rapid/violent overloading of the Medial Ligament by twisting or valgus (knock-knee) movements cause a breakdown of the connective tissue fibres. There are 3 different categories of ligament damage:

Grade I - Microscopic tearing or stretching of the fibres.
Grade II - Partial tearing of the fibres which cause slight laxity of the joint.
Grade III - Total rupture of the ligament fibres causing marked laxity of the joint.

Incidence

Occurs mainly in males aged 20-50.
Increased risk during wet or muddy conditions when spikes or studs get stuck in the mud.
Increased risk when wearing unsupporting shoes, uncorrected foot biomechanics (alignment) or if overweight.

Signs and Symptoms

  • Localised pain around the Knee joint that radiates down the shin or up the thigh
  • Tender to touch around the inside of the Knee joint
  • Increasing discomfort during twisting or knock-knee movements
  • Swelling and or bruising on the inside aspect of the Knee (Common in Grade II or III injuries)
  • A feeling of laxity on the inside of the Knee joint (Common in Grade II or III injuries)

Investigations

X-Rays will usually detect an increase in the medial joint space
MRI scans are useful for determining the extent of ligament tearing in more serious cases and excluding additional internal Knee damage

Therapy

  • Initial reduction of activity and decreased weight bearing with crutches
  • Ice packs or ice massage to the localised area every 2 hours for the first 48 hours
  • Taping/Strapping to reduce the swelling and strain on the tissues
  • Ultrasound or laser therapy
  • Deep Frictions of the ligament fibres
  • Strengthening exercises for the quadriceps, hamstrings and calf muscles
  • Balance exercises
  • Purchase of Orthotics (arch supports)

Medical

  • Non steroidal anti inflammatory drugs (NSAID'S)
  • Corticosteroid Injections
  • Surgery to repair or attach damaged ligament tissue (Grade II-III injuries)