Knee Ligament Injury: Anatomy, Symptoms & The Best Rehabilitation Advice

Ligaments are responsible for providing structural stability and strength to your joints. If joints are stretched beyond there normal range of motion this contributes to stress and strain placed upon ligaments and therefore the development of ligament injury. Anatomically, ligaments are bundles of collagen connective tissue that originate at one aspect of a bone or joint and insert into another. Ligaments are deceptively strong and flexible making them a very important structure within the human body. Here we will specifically address knee ligament injury as it is a common clinical presentation within our clinic with many people seeking assessment, treatment and general advice.


Interestingly the knee is the largest joint in the body and unfortunately one of the most easily injured. The human knee joint consists of bone, cartilage, ligament and tendons:

  • Bones
    • Three bones form an articulation to create the knee joint including the femur, tibia and patella
  • Articular cartilage
    • At the end of both the femur and tibia as well as the posterior aspect of the patella is a thin coverage referred to as articular cartilage. This substances allows your knee to glide smoothly during movement
  • Meniscus
    • There is a medial and lateral meniscus which act as shock absorbers to distribute stress and strain which is placed upon the knee during activity
  • Ligaments
    • Collateral Ligaments
      • Found on both the inside and outside of the knee joint to control unnecessary sideways motion of your knee. Includes both the medial collateral and lateral collateral ligaments
    • Cruciate ligaments
      • Situated within the knee joint and form a cross like structure to effectively position the knee from unnecessary forward and backward motion of the knee. Common causes of knee ligament injury during sports related activity. Includes both the anterior cruciate and posterior cruciate ligaments
  • Tendons
    • Provide an attachment of muscle to bone


The severity or intensity of your symptoms depending upon the degree of knee ligament injury as well as which structure has become damaged. Knee ligament injuries are graded depending upon there severity:

  • Grade 1: Overstretching of the ligament is noted however the ligament fibres remain intact
  • Grade 2: Partial ligament fibre tearing is noted, pain is moderately more intense then a Grade 1 injury
  • Grade 3: Complete tear of ligament is noted, significant pain, unstable joint laxity is typically noted upon examination

Typical signs and symptoms of knee ligament injury include:

  • Often sudden onset of pain during activity
  • A “pop” or snapping type sound may be heard
  • Knee joint swelling following injury is sustained
  • Joint laxity or abnormal knee movement may be noted
  • Inability to appropriately weight bear or walk


Conservative management is fantastic for assisting individuals recover from knee ligament injury. Treatment that may be provided includes:

  • Strategies to assist with reducing swelling such as heat/ice advice and ultrasound therapy
  • Mobilisation of the knee joint to ensure proper movement and joint alignment
  • Exercises designed to restore muscular strength, proprioception, agility and power


  • There is little doubt that pre‐operative conservative rehabilitation strategies has a significant positive effect on motor function in individuals suffering from anterior cruciate ligament injury and should therefore be routinely recommended to maximize muscle stabilization prior to surgical intervention. Keays, S. (2006). The effectiveness of a pre-operative home based Physiotherapy programme for chronic anterior cruciate ligament deficiency. Physiotherapy Research International, 11(4); 204 – 218
  • Quadriceps strength, functional knee score, activity level and functional performance all demonstrated clinically significant improvements following intervention. Friden, T. (1991). Anterior cruciate insufficient knees treatment with Physiotherapy. A three year follow up study of patient with late diagnosis. Clinical Orthopaedics & Related Research, 263; 190 – 199


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