The knee (tibiofemoral joint) is composed of four main ligaments:

1. Anterior Cruciate ligament: controls rotation and forward movement of the shin bone of the thigh bone.
2. Posterior Cruciate ligament: controls backward movement of the shin bone on the femur.
3. Lateral collateral ligament: stabilises the outside of the knee.
4. Medial collateral ligament: stabilises the inside of the knee.

Damage to one or more of these ligaments is common during falls, sudden movements and change of direction. The severity of the damage will affect pain levels, restriction in range of movement and function and stability of the knee.

Diagnosis is very important. Knowing exactly which ligament(s) are affected and how badly will significantly effect the path of treatment. Ligaments connect bone to bone and in some circumstances the injury sustained will render the knee joint unstable. Surgical intervention may be needed not only to enable you to return to full function but to also preserve the joint and its condition in the long term.

Management of mild strains is also still very important. We only get one chance for the ligament to heal. The broken bonds will start to form new links and how these are formed as well as the strength of these bonds is dependent on the stresses applied to them. This occurs through a process called ‘mechanotransduction’. If too much load is applied too soon then the bonds will break and if the tissue is not loaded enough the structure will be weaker. Physiotherapy focuses on this process to ensure optimal recovery of the damage ligament and in doing so this will reduce the risk of re injury.