Muscles, ligaments & amp; Tendons

Cruciate ligament pain - causes and treatment

Cruciate ligament pain - causes and treatment



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Cruciate ligament pain arises from overstretching or straining, a tear (rupture) or tearing of one of the cruciate ligaments. In the rarest of cases, both bands are affected.

Tasks of the cruciate ligaments

A distinction is made between the anterior and posterior cruciate ligaments. As the name suggests, these are crossed on top of each other. Exactly considered, the cruciate ligaments are not in the joint, but outside. Together with other ligaments, they belong to the ligamentous apparatus of the knee and ensure stability.

The most important four ligaments in the knee are the two side ligaments and the cruciate ligaments, with the anterior cruciate ligament being the ligament that is most commonly injured in sports. The cruciate ligaments protect against excessive rotation, they limit the stretching of the shin and stabilize it.

Injuries

Cruciate ligament injuries can take various forms, but are always associated with pain.

Cruciate ligament tear

If the knee is twisted with the lower leg still fixed, the cruciate ligament can tear. This is also possible due to a blow to the knee, a fall or a car accident. The cruciate ligament tear is one of the most common injuries to the knee. The symptoms include knee pain, a feeling of instability, severe swelling, an unsteady gait, buckling of the joint, and tenderness.

Tears in the anterior cruciate ligament are generally more common than those in the posterior. The rupture can be heard by a cracking sound. If an athlete suffers a torn cruciate ligament, this may not be noticed immediately because the existing muscles support the knee joint. However, cruciate ligament pain always occurs afterwards, which must be taken seriously and should lead to a doctor's visit.

If the anterior cruciate ligament is injured, other structures, such as the meniscus and the inner ligament, are also injured (see unhappy triad). The posterior cruciate ligament tears much less often and when this happens, the cause is usually external force.

If a cruciate ligament tear is suspected, a detailed medical history is necessary first:
How, when and how did the injury arise? Was this accompanied by a “pop sound?” Was it possible to move after the injury? What movement causes cruciate ligament pain? Is this the first knee injury?

The knee is then examined, scanned, and various tests are carried out. For example, if the lower leg can be moved forward like a drawer against the thigh, the anterior cruciate ligament is affected. This test is called the front drawer test. In the rear drawer test, the lower leg can be moved backwards - so the posterior cruciate ligament is injured here.

The doctor also checks sensitivity, motor skills, blood circulation and the range of motion. An MRI is used to confirm the diagnosis.

If a cruciate ligament tear is suspected, the sport should be stopped immediately, the knee cooled, a pressure bandage applied and the leg raised (PECH rule: break - ice - compression - high camp). Pain relievers can relieve massive pain.

A cruciate ligament tear is not always operated on. Conservative treatment is also possible. Which therapy is the right one depends on the extent of the injury. Age and fitness are taken into account. If athletes who are very active and want to or need to train again as quickly as possible are affected, surgery is the method of choice. A surgical graft in the form of a tendon is usually used in the operation. Subsequent rehabilitation measures are absolutely necessary.

Important: With all knee injuries there is an increased risk of thrombosis, which is why a thrombosis proplaxe (low molecular weight heparin sc.) Should always be considered.

In the case of conservative therapy, immobilization in a splint comes first. After a break of a few weeks, regular, professional physiotherapy follows. The knee is slowly being loaded, step by step.

Cruciate ligament tear

A cruciate ligament tear is also associated with cruciate ligament pain. These are felt immediately after the injury. A stinging in the knee area, restricted movement, insecurity when walking and swelling are added.

In contrast to the rupture, the crack is often not caused by external force. The reasons here are rather a violent jump, an abrupt change of direction or a sudden strong acceleration or braking, as is the case with squash, for example.

This injury needs to be treated - mostly through conservative therapies. Those affected are given joint supports and crutches to relieve the affected knee. Building muscle under the guidance of an experienced physiotherapist is important to stabilize the knee. Often, everyday life with a cruciate ligament tear is not greatly restricted. However, sporting activities are hardly possible.

Immediately after the injury, the knee is cooled, protected and stored high. As with the tear, pain medication is prescribed for severe cruciate ligament pain. The administration of cortisone may be necessary. If the anterior ligament is affected, surgery is sometimes recommended for athletes.

Cruciate ligament strain (cruciate ligament strain)

If the cruciate ligament is stretched, the affected person complains of severe cruciate ligament pain. These can wear off very quickly, but they can quickly start again under load. In addition, there is a significant swelling of the knee, sensitivity to pressure, bruising and an unstable ligament. In connection with competitive sports, cruciate ligament stretching is common. One wrong turn and it's done. This injury can also affect the side ligaments and the meniscus.

If the cruciate ligament is stretched, the knee is protected, stored high and cooled. To completely relieve the knee, crutches are the order of the day. A splint may be prescribed or the knee taped. Physiotherapy is always the method of choice. A “break” of six months may be necessary: ​​no sport, no long walks and no longer driving - targeted exercises by the physiotherapist are essential.

Unhappy triad

This is a serious knee injury with the following triad: injury to the inner meniscus, tear of the inner ligament and tear of the anterior cruciate ligament. This can happen if the knee is turned outward too much when the foot is fixed, for example in skiing accidents or football players. A rotation, combined with a blow to the leg, can tear the ligament structures and injure the meniscus.

The symptoms of this sports injury are: severe cruciate ligament pain and pain in the knee joint, a severely swollen knee, restricted mobility (stretching and bending), pressure-sensitive joint space, popping noise during the accident, bruising after two to three days, feeling of instability and joint effusion. Diagnostic procedures such as X-rays and MRI are part of the diagnosis. As a rule, this injury is operated on and subsequent rehabilitation measures are essential in order to be able to put a full load on the knee again.

Help from naturopathy

Of course, cruciate ligament pain should be treated by a doctor. Even if there is no surgery, regular physical therapy is essential. However, therapies from naturopathy can support healing and shorten the healing time.

Acupuncture can relieve pain, loosen the initially tense muscles and stimulate healing. A reflexology massage is also a suitable form of therapy for cruciate ligament pain, regardless of the cause.

Furthermore, from homeopathy, for example, the individual agents arnica, ruta, rhus toxicodendron, symphytum, ferrum phosphoricum, calcium phosphoricum and calcium fluoratum can be used. In complex homeopathy, the various individual remedies are combined in complex preparations so that they mutually support each other in their effects and, as a whole, achieve a wide spectrum of effects. Certain Schüßler salts can also be used for the supportive treatment of cruciate ligament pain. These are the No. 1 Calcium fluoratum, No. 2 Calcium phosphoricum, No. 3 Ferrum phosphoricum and No. 11 Silicea.

Ointments containing, for example, arnica, hypericum and / or rhus toxicodendron are used for external use. Home remedies such as envelopes with medicinal clay, curd cheese or Retterspitz can also certainly help.

Summary

In summary, it can be said that cruciate ligament pain must be taken seriously. A visit to the doctor is essential so that further injuries can be avoided and complete healing can be achieved. As a rule, an MRI examination is performed to diagnose cruciate ligament pain. Naturopathic treatment at the same time as conventional therapy is recommended, as this can have a positive effect on the healing process and shorten the duration of convalescence. (sw)

Author and source information

This text corresponds to the requirements of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Susanne Waschke, Barbara Schindewolf-Lensch

Swell:

  • German Society for Trauma Surgery: Anterior cruciate ligament rupture, (accessed September 5, 2019), DGU
  • W. Petersen, T. Zantop: The anterior cruciate ligament, Deutscher Ärzteverlag, 1st edition, 2009
  • Andrea Ferretti et al .: The unhappy triad of the knee re-revisited, International Orthopedics, edition 1/2019, (accessed September 5, 2019), Springer medicine
  • Jörn Lange: Injuries to the knee, Clinic for Trauma and Reconstructive Surgery at the Ernst Moritz Arndt University in Greifswald, (accessed September 5, 2019), Uni-greifswald
  • Carl Joachim Wirth, Wolf Mutschler, Dieter Kohn, Tim Pohlemann: Practice of Orthopedics and Trauma Surgery, Thieme Verlag, 3rd edition, 2013


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