Institute for Sports Medicine Frankfurt Main

1. Risk kinds of sport:

Football, ice hockey, handball, ski driving, basketball, rugby, judo

2. Anatomy:

There is an inside and an exterior to sideband, as well as a front and rear cruciate ligament. The cruciate ligaments connect the thigh bones with the lower leg bones. The internal sideband runs from the thigh bone to the seeming leg head and is directly connected with the knee joint cap and the meniscus. The outside sideband runs from the thigh bone to the little head of the fibula and is not connected with the cap of the knee joint.

3. Function:

The sidebands prevent a deviating from the side with stretched knee and brake the turn outward (external rotation). The cruciate ligament secure the articulated contact of thigh and lower leg bone. They prevent the way sliding of the thigh bone of the joint surface of the lower leg head. The cruciate ligemanet brake both overstretching the knee, and the interior rotation and lead the joint movement.

4. Injury mechanism:

- Stump impact (by footstep, impact or impact) of the exterior against the knee joint or of the inside.
- Impact of the inside against the knee joint or at the foot of the exterior.
- Twist of the knee joint with fixed foot.

5. Symptoms:

- Sudden pain during trauma (accident, spraining), depending upon direction of the impact on the inside or on the exterior of the knee, and/or in the knee
- Arising pain is exercised again and again if stress on the hurt ligament
- local pressure pain sensitivity over the beginnings of the ligaments
- Edemas and/or haematomas visibly. With a rupture of the cruciate ligament it comes usually also to a joint effusion
- Function restriction of the knee joint. This depends on the hurt structure
- It comes to a joint instability, which is only noticed usually later

6. First measures:

- Appropriate loads partly or completely waive
- Cooling concerned the range (with it do not put the ice directly on the skin)
- Compression drssings, with larger Haematomas, joint effusions or edemas the leg high-put

7. Diagnostics:

- Investigation by the physician
- Picture-giving procedure, like Roentgen, Kernspintomographie

8. Therapy:

a) Conservative therapy
- Insert supply
- Orthese for the stabilization of the knee joint in the daily stress
b) Operational therapy
Here there are different possibilities.

9. Physiotherapie/rehablitation:

- Manual therapy
- Electrical therapy
- Lymphdrainage
- Cryotherapy
- Stabilization, stretching and strengthening measures, which are dependant on the painfulness and the stability of the appropriate knee joint
- Mobilization of the knee joint, if also movement restrictions are present
- Course training

10. Prevention:

- Appropriate warming up program before each load
- Stretch of the leg musculature both before and after the stress. With risk kinds of sport stabilizing exercises should be included as reconciliation into training also.

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