Partial ACL Tear and MCL Tear

[oggy76]

Hi All,

I am new here and was just after some advise if possible.

Back in early November I damaged my knee playing football (soccer). After several visits to the hospital I saw a knee specialist who referred me for an MRI scan on the 5th Jan 09.

The results are below and the specialist said I would recover just as quickly without surgery which I was really pleased about.

I have seen a sports injury specialist at my local football club who has given me quite a few differant exercises which I have been doing over the past month or two.

Most times during the day my knee does not hurt and I am able to run in a straight line with no problems. I do sometimes still get pain in my knee if I catch it at the wrong angle for example or when crouched down for a long time.

The reason for the post is that I really want to get back playing football again and just wondered in your opinion if the time scale of 4 months would be about right to start participating in contact sports again if I wore a knee support?

I also wondered if anyone is able to suggest a good knee support they have used in the past?

Many Thanks

Oggy

Scan Results

Three plane PD fat images obtained.

The ACL has a disorganised appearance especially
posteriorly. Some fibres are however seen intact and the
findings are likely to represent a partial tear. The PCL
appears intact. The medial meniscus appears intact. There is
a high signal vertical line seen through the middle third of
the lateral meniscus. This is only seen on one solitary
image and on balance probably does not represent a radial
tear.

The tibial collateral ligament appears abnormal and swollen
with high signal seen distally in keeping with a grade 2/3
type injury. There appears to be complete disruption of the
deep components of the medial collateral ligament. In
addition there is high signal in the region of the postero
medial capsule/corner with likely injury of the posterior
oblique ligament. There is high signal seen in the postero-
lateral femoral condyle evening with an impaction type
injury. The rest of the postero- lateral corner appears
intact. There is a small knee effusion.

The extensor mechanism appears intact with 33 mm of the
quadriceps tendon imaged. Normal signal from the cartilage.

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[physiobob]

Hi Oggy,

Thanks for your post. Looks like you just survived the brink of a total MCL, ACL and even cartilage tear. Lucky man.

Your MCL itself would take 6-8 weeks to begin feeling OK to run on so about now it should be looking good in the straight direction. The extent of the ACL tear however can only be seen as your physio puts you through more exercises that challenge your change of direction. It it then we will see the extent of the damage to the ligament as it tries to send information to the brain about that the knee is doing and at what speed it is doing it at.

Once can't give a time frame I am afraid suffice to say that the above is essential part of the rehab process and must be explored and tested before a return to sport.

Best of luck

[Jason_1983]

hello!! i am also new here and i have the same problem as my friend above.
The problem is that i can't live without football.I damaged my knee while playing football last April.till then i am just doing some excercise at my home. I am wondering if i will be able to play again competitive football or just friendly games.and when i will be ready for this? i am thinking of starting jokking.is that a good idea?
please i answer me about the football question.i am very sad without football in my life.
Thats the results of the MRI:
The fibulocollateralligament is completely torn with presence of high signal intensity in the
adjacent soft tissue
Additionally, ίncreased signal intensity of the ACL is seen with moderate thickening of its
femoral segment but keepίng its normal course, compatible with acute incomplete tear
The PCL, MCL and iliotibial band are intact
The patellar and quadriceps tendons appear normal
The anterior and posterior horns of the medial and lateral menisci appear normal in
morphology and signaI
The knee joint and patella cartilage is normal in signaI and thickness
MinimaI joint fluid effusion is noted
Νο bone fracture ΟΓcontusion is detected
ConcIusion: Imaging findings of compIeteIy torn fibuIocoIIateraI Iigament and acute
incompIete (partial) tear of the ACL
Correlation with the findings of clίnicaI examίnation is advisable


thank you very very much...
Looking forward to your answer.

[Canuck Physio]

hello!! i am also new here and i have the same problem as my friend above.
The problem is that i can't live without football.I damaged my knee while playing football last April.till then i am just doing some excercise at my home. I am wondering if i will be able to play again competitive football or just friendly games.and when i will be ready for this? i am thinking of starting jokking.is that a good idea?
please i answer me about the football question.i am very sad without football in my life.
Thats the results of the MRI:
The fibulocollateralligament is completely torn with presence of high signal intensity in the
adjacent soft tissue
Additionally, ίncreased signal intensity of the ACL is seen with moderate thickening of its
femoral segment but keepίng its normal course, compatible with acute incomplete tear
The PCL, MCL and iliotibial band are intact
The patellar and quadriceps tendons appear normal
The anterior and posterior horns of the medial and lateral menisci appear normal in
morphology and signaI
The knee joint and patella cartilage is normal in signaI and thickness
MinimaI joint fluid effusion is noted
Νο bone fracture ΟΓcontusion is detected
ConcIusion: Imaging findings of compIeteIy torn fibuIocoIIateraI Iigament and acute
incompIete (partial) tear of the ACL
Correlation with the findings of clίnicaI examίnation is advisable


thank you very very much...
Looking forward to your answer.

Hi there,

April is not a great deal of time since injury. However, some form of early intervention should have been underway by now.

As per the results, one should be optimistic. I doubt you will be having surgery?

As the Ligaments are the only structures significantly damaged, there is no reason why you should not be able to play again.

However, one must understand that low level rehabilitation is necessary at this stage. Regular activity to induce healing, with specific rehabilitative exercise. This may be enhanced by physiotherapeutic modalities.

Jogging may not be a good idea at this point. Without the joint feedback of the LCL/FCL and ACL the damage further possible by this activity can set you back far more than a slow progressive plan that begins today.

If you begin rehabilitation now, you should be able to begin playing low level within 3-6 months. Is the injured leg the Kicking leg? How did you injure the leg? ( I am assuming a tackle to the inside of your leg, pushing it outward with a planted foot)>

Regards

[Jason_1983]

Hi there,

April is not a great deal of time since injury. However, some form of early intervention should have been underway by now.

As per the results, one should be optimistic. I doubt you will be having surgery?

As the Ligaments are the only structures significantly damaged, there is no reason why you should not be able to play again.

However, one must understand that low level rehabilitation is necessary at this stage. Regular activity to induce healing, with specific rehabilitative exercise. This may be enhanced by physiotherapeutic modalities.

Jogging may not be a good idea at this point. Without the joint feedback of the LCL/FCL and ACL the damage further possible by this activity can set you back far more than a slow progressive plan that begins today.

If you begin rehabilitation now, you should be able to begin playing low level within 3-6 months. Is the injured leg the Kicking leg? How did you injure the leg? ( I am assuming a tackle to the inside of your leg, pushing it outward with a planted foot)>

Regards

thank you very much for answering so quickly.
No,i dont need a surgery.and the injured leg is not the kicking leg.(at least the strong one).i heard that legaments injuries never heal 100%.is that true? after 6 months when i will be ready for football again my leg will be 100% as it was before the injury or i have to be still carefull with my moves?
pretty much that was the injury reason.not exactly a tackle but yes it was pushed outward.
thanks again

[Canuck Physio]

Hi,

yes re-injury is possible, however, with proper training there is no reason you should not be able to play full contact again. If someone says otherwise, then ask yourself why persons with broken bones can get back playing american football again. They have sports/rehabilitative specialists who know what it takes to overcome injury.

Although ligaments to a certain extent may not be 100%, they can repair, and do so spontaneously so long as they are not over-stretched repetitively during the healing phase, and the joint remains in a good position and alignment.

Regards

[physiofixme]

Hi

I think anyone who is serious about playing football again after the injuries mentioned needs to focus on a comprehensive rehab programme that involves graduated strengthening as the knee improves and builds strength, leading to agility drills which mimic the actions undertaken during football (ie dribbling the ball, changing direction etc) and ultimately doing plyometrics to increase strength and power. This needs to be under the supervision of a physio so that the appropriate exercises are given at the appropriate stage of recovery.

Good luck

[CallumT17]

Hi.
Im a 17 year old, and play football at semi pro level.
In april his year i sustained a partial acl tear, and i was diagnosed wrong straight away. I was told i had a medial ligament injury, or possibly a tear in my meniscus. They told me i could wait 8 months for an MRI scan, or have surgery next week. I chose surgery as i felt the wait for an MRI was far too long. In surgery, they found that i had torn 75% of my ACL. As soon as i had recovered, i was sent to physio, and started training at the gym, 2 or 3 times a week. After my initial couple of physio appointments, improving the core strength in my leg muscles, i was referred to a hospital to try and improve the dynamic strength in my muscles, which i was told would help me play football again. By this time, my knee had stopped "giving out", and i felt no pain. But after carrying out the hospital class for a couple of weeks, i started to get pain again. It has puzzled me as what i did in the dynamic strength class, is reasonably similar to what i was doing at the gym. Im unsure as to what to do now. I know that i need to improve the strength of my hamstrings, or at least this is what i have been told by a number of different physios since my operation. I have also had suggestions that i should get an ultrasound on my knee to see if anything has happened since surgery, or something about a TENS machine(i am unsure what this would do). I am desperate to get back to playing football, and i am willing to do whatever it takes to get back to the level i was playing at.Any replys, help, suggestions or information would be very much appreciated.
Thankyou.

[sharakumar]

Hello,

I need some advise on what should i do for my injured knee.

My MRI report says:

1. Cleavage tear in posterior horn of lateral meniscus.
2. Interstitial tear of ACL
3. Tear in MCL at femoral attachment with posterior subluxation of femur.

There is no pain in my knee, but i cannot walk. I am using the knee brace.

My doc has advised me to take rest for 10 days from now. Its already 15 days since i am on a bed rest.

Is surgery needed for this?? I am not a sports person. At times i will need to run for short distance unknowingly duing my daily activities.

Thanks for your help.

[Vanc_WA_PT]

sharakumar - is there pain when you walk but no pain at rest? if there is no pain trying to walk then what do you feel is preventing walking? There are people walking around with similar injury who have not had surgery, so it is not essential; all depends on what is limiting walking