So, You Have a Knee Ligament Injury. What’s Next?

Summit sports medicine surgeon Mikhail Klimstra, M.D., discusses what’s next when an athlete has a knee ligament injury.

Our knees are held together, in part, by several ligaments, strong bands of tissue that connect the bones and provide stability. For athletes who jump, twist, start and stop, or change directions quickly, those ligaments can be stretched or torn. If you’re experiencing knee pain, and your primary care doctor, or your team’s athletic trainer, has said that a ligament injury is the cause, you may be wondering what the next steps are.

Summit sports medicine surgeon Mikhail Klimstra, M.D., discusses knee ligament injuries: what they are, how to treat them, and how to get back in the game.

“In general, there are a wide variety of injuries that fall under the ‘knee ligament injuries’ umbrella,” Dr. Klimstra said. “The first question is, which ligament is injured? Is more than one ligament injured?”

For athletes who do a lot of cutting and pivoting movements, like those prevalent in soccer, football, and basketball, the most common knee ligament injury is a tear in the anterior cruciate ligament, or ACL. Other knee ligaments include the medial collateral ligament (MCL), the posterior cruciate ligament (PCL), the lateral collateral ligament (LCL), and the posterolateral corner. Additionally, athletes may have multiligament injuries, where more than one ligament is damaged.

Symptoms of a knee ligament injury

When you injure any of these knee ligaments, you may experience some or all of the following symptoms:

Sudden, severe pain, sometimes with an audible “pop” sound
Swelling
Difficulty moving the knee
Feeling of instability or laxity (“looseness”) in the knee
Inability to put weight on the knee

Treatment for a knee ligament injury

Treatment varies widely depending on what ligament was injured and whether it was injured alone or in combination with other ligaments. The diagnosis includes a physical examination, discussion with the patient about the injury, and imaging.

“For patients who want to participate in sports after an ACL tear or multiple ligament injuries, surgery is generally recommended to get them back to their sport,” Dr. Klimstra said. “An injury to the MCL or PCL alone may be able to be treated without surgery, provided that the ligaments are able to heal in a way that the knee is stable and, following therapy, functional.”

The decision on whether to have surgery is a big one, and it ultimately depends on the individual patient’s goals. “Having a frank conversation about the patient’s goals is an important part of the decision-making process,” Dr. Klimstra said. “If the patient chooses surgery, a close partnership with a physical therapist to help the athlete strengthen and rehabilitate the knee so they can return to playing their sport safely is essential.”