The Most Common Knee Injuries in Football

In life, we try our best to avoid injury or putting ourselves in harm’s way on a daily basis. We take every necessary care and precaution to exercise safely in the gym and generally lead a non-extreme, risk-free lifestyle. Despite our best efforts, most of us will suffer some form of injury in our lifetime. That could be caused by nothing more than plain misfortune.

In sports however, and especially football (American football, that is), athletes are taking testing their bodies to the full on a regular basis. Putting this constant strain on the body and encountering powerful collisions on the field will inevitably lead to some injuries.

Those which strike fear into the heart of all professional players are knee injuries. A recent retrospective study showed an extremely high incidence of ACL injuries among NFL players. In a recent article of our own, we discussed why knee injuries are common from a general point of view, but here we will take a look at some of the most commonly sustained knee injuries and the most effective treatments to help overcome these injuries within the context of football.

Anatomy of the Knee

The knee joint is the largest in the body and composed of bones, cartilage, ligaments and tendons. These all present risks in terms of sustaining injuries of different magnitude. Your thighbone, shinbone and kneecap all converge to form the knee joint.

The thighbone, shinbone and back of the kneecap are all surrounded and lubricated by articular cartilage. This helps the bones to interact smoothly with one another when you bend and straighten your leg.

Meniscal cartilage fills the lower space between thigh and shin bones. This acts as a more robust buffer, helping to stabilize the joint. On occasion, damaged or misplaced cartilage can cause a quite painful grinding of the bones during joint movement.

There are four main ligaments in the knee. These are essentially what holds the bones in place and keeps the knee stable. Think of them like cables or ropes. They perform a vital function and can be divided into two sub-groups. Collateral ligaments and cruciate ligaments.

The collateral ligaments can be found on the sides of your knee. The medial collateral ligament (MCL) on the inside of your knee and the lateral collateral ligament in the outside. The function of the collateral ligaments is to control sideways movement of the knee.

Cruciate ligaments are positioned on the inside of the knee joint. The anterior cruciate ligament (ACL) at the front and the posterior cruciate ligament (PCL) at the back. These cruciate ligaments serve to control the forward and backward movement of your knee. They are also the cause of some of the most frequent and serious knee injuries in football.

Tendons connect muscles to the bones in your knee. The quadriceps tendon connects your thigh muscles to your kneecap and the patella tendon further connects muscles downward to your shinbone. A torn patella tendon is quite rare, but we have seen recent examples in Victor Cruz and Jimmy Graham. A Northwestern Medicine study has shown it is one of the most difficult knee injuries to recover from.

Most Frequent Types of Injury

ACL Injuries

Taking a look at the most predominant knee injuries which occur in the NFL, anterior cruciate ligament (ACL) injuries stand ahead of the rest in terms of frequency. Forrest Lamp is one of the most recent to tear his ACL. The Chargers second-round pick is among a flurry of those suffering ACL injuries so far this season.

ACL injuries have been a common source of pain for the NFL in recent years, this season is proving to be more difficult. However, once considered a career-ender, prognosis and recovery time for ACL injuries is improving. Adrian Peterson clearly showed that performance can also be sustained upon return to action, at least while he was still with the Vikings. 

There are many contributing factors in terms of an ACL injury. These are predominantly, sharp directional turns, quick landings and sudden halts from a fast pace. This of course does not favor football players for whom all of these actions are an integral part of the sport.

Other factors discussed in the wake of recent injuries include, a greater number of lower body hits as players heads become increasingly protected by the rulebook and the use of artificial surfaces.

MCL Injuries

Another common injury among football players is a tear of the medial collateral ligament (MCL). Again, this injury is most likely caused by a strong hit to the outside of the knee. This comes with the territory for professional football players as illustrated recently by Detroit Lions punter Kasey Redfern, who tore his MCL while trying to scramble for a first down.

Often in the case of cruciate ligaments and again with Redferns injury, a tear of multiple ligaments is quite common. The ACL and MCL combination being the most frequent.

There is a very long road to recovery from these types of cruciate injury and even in the case of a minor sprain to the MCL, players can see a minimum of a few weeks on the sidelines.

Meniscus Injuries

A meniscus tear, most commonly referred to as a cartilage tear is an extremely common form of knee injury. It can be the result of heavy lifting, sharp directional turns or stops or indeed, blunt force trauma to the knee area.

Tearing or damaging the meniscus is certainly not limited to professional athletes. You can damage it simply by standing up too quickly from your chair. However, given the exposure to such physicality and strenuous movement, it is a common cause of injury for NFL players.

Most recently, top NFL prospect Connor Williams of the Texas Longhorns has been sidelined with a torn meniscus for which he will undergo surgery.

Dependent upon the severity of the meniscus tear, the recovery time can range from just a few weeks to three months if arthroscopic surgery is required as in the case above.

Available Treatment Options

In terms of knee injuries, the vast majority can heal in time with a non-surgical option. This is certainly true of MCL and Meniscus injuries on the lower to middle range of the scale. This will also depend on whether other parts of the knee have been injured. You will rely on the other areas of your knee to pick up the slack while you recover, therefore if they have also been injured it is likely to further hamper your recovery.

In the case of a serious tear or injury to multiple areas of the knee, it may be necessary to consider reconstructive knee surgery. In terms of the ACL, the torn ligament is most often replaced with a tendon graft taken from the patellar or quadriceps tendon. Recovery time including rehab to rebuild your knee strength can take up to six months. It has been noted in football and other sports that performance is often reduced and in some cases never reaches previous levels after return from ACL surgery.

A meniscus tear may require arthroscopic surgery if it is a particularly bad injury. The resulting lay-off can be up to three months. However, meniscus tears and MCL injuries respond very well to non-surgical treatments such as physical therapy and the use of a knee brace.

For the best non-surgical results it is recommended to take a thorough and considered approach. It is important to reduce swelling in the area by applying ice and elevating the knee. Pain relief medications such as ibuprofen and aspirin can also be helpful in this regard. Keeping your knee immobilized or with limited back and forth movement is also highly recommended.

Once the swelling and pain begin to reduce, rehabilitation begins. This is a slow process designed to gradually build up the strength of the knee again. Rushing this rehabilitation can cause instability in the knee and a high instance of recurring injury.

Knee Braces Can Assist With Recovery

After sustaining a knee injury, it is highly likely that a rehabilitative brace will be your first port of call. These braces are designed with the primary objective of limiting knee movement. Commonly used post-surgery, a rehabilitative brace can serve to protect injured ligaments by controlling knee movement.

These braces are typically used for a number of weeks after surgery and often a patient will also be using crutches during this time. They offer a range of motion to the patient and allow for some swelling to take place. Rehabilitative braces are also removable. This can help when examining recovery progress.

Often, these braces are foam lined and stretch from the lower thigh to the upper-shin bone. Secured using several straps at key points and a metal bar which stretched from top to bottom and is hinged to allow for movement. The Breg T-Scope knee brace is a great starting point if you are searching for a top quality rehabilitative brace.

Functional Knee Braces

Similar to rehabilitative knee braces, functional braces seek to aid the recovery process. They allow for a certain amount of movement as well as rotational movement while reducing the strain on the knee. We recently reviewed the best knee braces for football players, but we will briefly expand on the different types of applicable knee braces in the section below.

Functional braces as the name suggests, allow for a certain amount of activity to be performed. On occasion, they may be offered to patients with moderate ligament damage in an effort to circumvent surgery. During this period, they effectively perform some of the tasks of the damaged ligament while allowing the ligament itself to recover.

Alternatively, functional braces are often offered post-surgery to ACL patients and help to protect the tendon graft that will have been placed during surgery. The DonJoy Armor is an excellent choice for a functional brace allowing you excellent flexibility and a durable design.

Prophylactic Knee Braces

Prophylactic braces offer great support for athletes and individuals who may be concerned about knee injuries or hoping to prevent a recurrence of an old injury. These braces are very much operating on the premise that prevention is better than cure.

Statistics show that prophylactic braces do reduce stress on the knee ligaments greatly and thus help to prevent injury. They are very common among most professional athletes for this reason, especially when suffering from any minor strains or stiffness in the knee.

These type of braces offer a comfortable and protected covering for the knee area during sport or other activities. Check out our review of the all-around good value Tech Ware Pro

Final Thoughts

As we can see, there are many perils when it comes to professional sports. Over recent years, the NFL has become synonymous with knee injuries. The statistics are worrying, but as technology continues to advance treatments, the prognosis is improving.

Together with the assistance of some excellent non-surgical accessories that we have taken a look at, hopefully the future for knee injuries continues to get brighter. As always, remember to take care when performing any activities, especially contact sports. Check out our other pages and keep up to date with the latest advances and some helpful educational information.

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