Knee injuries in footballers are very common with evidence from the UK Premier League that they are increasing in incidence and severity. In the 2016/17 season 28 premier league players sustained serious ligament injuries with 17 of those injuring their anterior cruciate ligament (ACL) (Data from BBC Sport, July 2017).
Sports injuries in elite athletes can ruin careers and require an exceptional team of surgeons, physiotherapists and support staff to restore them to full sporting ability.
Ligament injuries : The most common seriously damaged ligament in football is the anterior cruciate ligament, but it may be associated with sprains and tears of the other ligaments of the knee such as the medial or lateral collateral ligaments(MCL or LCL), or less commonly the posterior cruciate ligament (PCL). Interestingly whilst collateral ligament injuries and posterior cruciate injuries will often heal without the need to intervene with surgery, ACL injuries rarely heal and commonly lead to knee instability and the knee giving way. Under these circumstances it may be necessary to consider anterior cruciate ligament reconstruction (ACL reconstruction).
Meniscal Injuries : Due to the necessity to change direction at speed in elite sports such as football, rugby, squash or tennis, excessive shearing forces are applied to the structures of the knee. The menisci are two highly specialised structures that act as shock absorbers and have a secondary role in improving knee stability, but unfortunately are susceptible to injury through exposure to excessive shear. This most commonly results in a meniscal tear or root avulsion and can lead to pain, swelling and instability of the knee.
In keeping with elite footballers, modern day rugby players put a tremendous amount of strain through their knees. Whilst pre-conditioning and in-season training can afford some protection against injury there is no doubt that elite rugby players exert exceptional forces through the knee through scrummaging, rucking, mauling or taking heavy impacts.
Ligament Injuries : Can be life changing for a professional rugby player. I’ve seen all 4 major knee ligaments damaged through heavy impacts in rugby which have sometimes necessitated multi-ligament reconstructive surgery. The most common and significant injuries tend to affect the anterior cruciate ligament and usually mandate reconstruction in competitive athletes.
In addition to the ACL, both the medial collateral and lateral collateral ligaments are vulnerable to injury, but often respond better to conservative management with bracing and supervised rehabilitation.
Meniscal injury : In common with footballers, rugby playing athletes exert significant shear forces on the knee predisposing to injury to the menisci, the specialised shock absorbing cartilageof the knee. This can lead to meniscal tears and due to the unique structure of menisci these have very little ability to heal spontaneously.