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This week, we continue our discussion on common knee injuries by going over sprains and tears of the ligaments of the knee. Two weeks ago, we went over the structure and function of the knee, so you can always refer to that for more information.
Spraining or tearing ligaments is another common injury in the knee for dancers and many athletes. The four most commonly affected ligaments are the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament, (MCL), and the lateral collateral ligament (LCL). Since we’ve already referenced their strcture and function, we’ll move on to mechanisms of injury. These ligaments can be injured traumatically via a sudden stop or change in direction, contact (such as tackling in football), landing a jump incorrectly, hyperextding the knee or taking a blow to a straight leg, a simple mis-step, or a blow to the side of the knee. Sprains can also result from twisting injuries (primarily MCL and LCL in this case). Symptoms include pain, swelling, instability, and loss of ROM. Remember from the blog post on ankle injuries that sprains are graded based on the severity of the tear. Beyond special your history, symptoms, and special test, and MRI is often utilized ton confirm what is torn and the severity of the tear. More severe sprains may require immobilization, bracing, and/or surgery for repair. Taping may help in more mild cases, and during rehab.
As with meniscus tears, your doctor will most likely recommend RICE in the acute phase. Once the acute phase has passed and once surgery (if applicable) has taken place, you’ll begin your rehab in much the same was as with meniscus tears by focusing on getting your ROM back. Some surgeries may limit your weight-bearing initially, or how much you’re allowed to straighten and bend your leg. A hinge brace may be utilized to allow for only some movement, and you may be on crutches for a while. Your doctor and physical therapist will help guide you in this process, and some doctor’s will issue a specific rehab protocol for your therapist to follow post-operatively. You’ll also incorporate stretching the quadriceps, hamstrings, gastrocnemius, and other tight muscles that may be limiting your progress. Once you’re cleared to strengthen, you’ll begin to perform exercises lying down and in weight bearing, first without, and then with resistance (via Theraband or ankle weights), to strengthen your affected leg. Keep in mind, you’ll be working to strengthen the entire leg (hip, knee, and ankle), as chances are, the whole leg was essentially affected by the injury (and possibly surgery). You’ll also incorporate gait training and balance activities. With sprained ligaments, stability becomes an important factor during rehab, and incorporating lateral movements and things of the like (especially with MCL and LCL sprains) will be integral.You may even work on balance and stability exercises on a Bosu ball, first with two feet, and then with one foot. Once appropriate, you’ll introduce agility training so that you can get back to your full dancing abilities as soon as you’re able.
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