A rupture of the cruciate ligament is one of the most common sports injuries. There are 2 cruciate ligaments in the knee, the anterior and the posterior cruciate ligament. The anterior cruciate ligament pulls from the outer surface of the medial condyle to the inner surface of the lateral condyle and inhibits hyperextension of the knee joint.
The posterior cruciate ligament pulls from the outer surface of the lateral condyle to the inner surface of the medial condyle and inhibits hyperextension of the knee joint. Both cruciate ligaments together provide for proprioception in the joint itself, i.e. for the feeling of the joint position and stabilize the knee joint during movement. Immediately after the injury, it is important to immobilize the leg and have a direct examination in hospital. In most cases, surgery is necessary because the muscles surrounding the knee are not strong enough to compensate for the lack of stability.
Physiotherapy after surgery
In the early phase after surgery, the tendency of the knee joint to swell should be taken into account. Since it is a very sensitive joint, there is often a lot of swelling, which prevents mobility and increases pain. Lymph drainage or certain decongestant grips can be used to treat this swelling.
In addition, the patient himself should put his leg up and cool it down a lot. Initial tension exercises can be actively performed by pressing the back of the knee and pulling the kneecap (patella) towards the trunk. In order to prevent the niches in the knee joint from sticking together, the patella should be mobilized directly in all directions.
This is done passively by the patient or actively by pushing down the hollow of the knee. The movement is prescribed by the surgeon. Learning to walk with crutches is just as important for the early phase.
The patient should pay attention to a proper rolling over the big toe and to the existing partial load. In the later phase of wound healing, the load can be increased and mobility can be developed to the maximum possible extent. Manual therapeutic techniques, such as sliding the shinbone back and forth in relation to the thigh bone, can improve movement.
The achievement of a final extension is extremely important for a physiological gait pattern. Mobility is particularly important for competitive athletes, as they need to be able to exert optimum strain on the body. If the muscles are shortened, they are stretched carefully.
If there is pain directly at the knee, an ice treatment can be used and traction to reduce the pressure in the knee. If there is pain in the area of the tendon attachments or muscles, this can be alleviated by soft tissue techniques and transverse friction. In general, heat applications and treatments in the area of the thoracic spine are suitable to achieve a damping of the sympathetic nervous system (= part of the autonomic nervous system).
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