Knee injuries are common in football. They can result from direct trauma as well as without the presence of contact. We will focus on soft tissue injuries as fortunately fractures are relatively rare. Soccer poses a high risk of significant knee injuries, such as ligament damage (lateral or cruciate) or meniscus tear, which very often results in a forced end to the season for a given player.
The meniscus is a small cartilaginous sickle-shaped structure that increases congruency (conformity between joint surfaces), stability and acts as a shock absorber in the knee joint. Each knee joint has two menisci, one on the outside (lateral meniscus) and one on the inside (medial meniscus). The inner meniscus is much more commonly damaged, and in more than 50% of cases the damage is not isolated but associated with damage to the articular cartilage and ligaments of the knee.
Depending on the extent of the damage, there may be a partial or complete tear, crushing or detachment of small parts ("articular strands") of the meniscus.
The most common mechanisms of meniscal injury are internal or external twisting of the hip with the foot fixed, abrupt extension of the lower extremity at the knee joint in the squat starting position and landing from a great height on hard ground. Damage to the menisci can also occur under the influence of microtraumatic injuries at high sports loads, which reduce their mechanical endurance and may result in rupture with much less future loading.
Meniscal damage is characterised by constant and vague pain, increasing with forced movements and with prolonged forced flexion of the knee joint (when sitting). Specific is also the pain on palpatory pressure in the articular cleft on the side of the injured meniscus. In case of meniscus damage, there is oedema of the joint and there may be synovial effusion inside the joint localising in the area of the articular cleft (medial or lateral). A sure sign of a damaged meniscus is a joint blockage that occurs suddenly when walking and is associated with severe pain and inability to extend the lower limb half flexed at the knee joint.
Meniscus damage is most accurately diagnosed by arthroscopic examination or imaging.
Also common in football. There are four main ligaments in the knee - the anterior cruciate ligament (ACL), the posterior cruciate ligament (PCL), the medial collateral ligament (MCL) and the lateral collateral ligament (LCL).
The mechanism of obtaining damage to the cruciate ligaments is associated with a sudden stop, twisting, a change in the axis or direction of the joint, extreme knee overflexion, or a direct blow from the front, back, or outside of the lower leg. Damage to the cruciate ligaments of the knee, and especially their rupture, is in many cases associated with concomitant injury to the articular cartilage, damage or tear of the meniscus, which further aggravates the injury. They are common in sports involving frequent changes of direction, sudden stopping, jumping and landing or direct collision, such as football, basketball, wrestling, rugby and skiing. Most athletes report "snapping" at the time of injury with an inability to continue playing. In most cases, radiographs are taken to rule out fractures and an MRI can serve as a more accurate diagnosis.
Once diagnosed, the goal of the medical staff is to ensure the athlete's treatment and return to the field in the planned timeframe. In most cases, surgical intervention is resorted to, after which the means of physiotherapy and rehabilitation are included as early as possible (first, second day) after surgery in order to shorten the recovery period and prevent complications. Sometimes conservative treatment of injuries is resorted to, but it carries the risk of recurrence of the injury and prolonged absence from the field of the given player.
At Okto, we have top-of-the-range physiotherapy equipment that is extremely suitable for both post-operative conditions and conservative treatment.
