Can Knee Injuries Be Permanent? Everything You Need to Know

Have you had injured your knee in an accident? Fortunately, knee injuries that range from minor to moderate have a high chance of recovering fully.

With 1 in 4 Adults suffering from chronic knee pain, and the increasing trend of knee replacements, it's not surprising to be concerned about the long term consequences after suffering from a knee injury.

So can knee injuries be permanent? In short, with adequate care and rehabilitation, nearly all knee injuries of a less serious nature will fully recover. The outlook for major injuries however, are less positive, as these types of wounds usually require surgery and a post rehabilitation programme.

This really just scratches the surface of the problem, as there are many factors that can affect how permanent a knee injury is.

Less severe knee injuries that have been left to fester can evolve into more chronic issues, and repeatedly exposing the knee joint to physical strain can also push an injury from minor to severe. This is often the case for sports professionals or even people that enjoy a very active lifestyle.

Due to the breadth of the topic, it can be difficult to give a fully comprehensive answer. But to give you a good understanding on the long term effects of a knee injury, here is a guide that covers the types of knee injuries, how long knee injuries take to recover, risk factors that can lead to chronic pain and when knee surgery is the only option.

Types of knee injuries

Damage to the knee joints are generally mechanical in nature or developed after the onset of diseases such as osteoarthritis and gout. Here, the focus will be on mechanical issues caused by accidents and general wear and tear.

The knee joint consists of a combination of soft tissues. These tissues govern the different types of motions that the knee is capable of on a daily basis:

• Ligaments
• Cartilage
• Tendons
• Prepatellar Bursitis.

Injuries to the Ligaments

Ligaments are tissues that control the "left and right" and "backwards and forwards" motion of the knees. The ligaments come under to types:

• Collateral ligaments - referred to as the ACL and MCL ligaments, which run down either side of the knee. These ligaments control the side to side movements of the knee. Tears to the ACL and MCL ligament are prevalent in sports, such as tackles that impact the knee and excessive pivoting of the joint.

• Cruciate ligaments, are slightly different and are located across the inside of the knee. The cruciate ligaments control the backwards and forwards motion of the knee joint. Accidents involving these ligaments are extremely serious, and can happen in car collisions or high impact sports.

There are three grades which you will be assessed for by your doctor if you've damaged your ligaments. Understanding which grade the damage to your ligament falls under, will help you determine the gravity of your knee injury.

• Grade 1 - ligament has stretched but not tearing

• Grade 2 - slight tearing of the ligament

• Grade 3 - ligament has completely torn through

Do Torn Ligaments Heal Completely?

Yes and no. Ligaments are one of the most commonly injured parts of the knee, and the level of damage will determine if you can recover completely without the need for extensive treatment.

When it comes to ligaments that are of grade 1 and 2 damage - these types of injuries will generally heal well without the need for surgery.

With grade 3 injured ligaments, due to the ligament being completely torn, ligaments will not be able to heal completely on their own. This is due to the ligament requiring blood supply in order to heal properly. Once the ligament has been torn, blood supply to the tissues will be low or close to being completely severed.

This is when surgery is required to help the ligament heal completely, or in the more serious case of a ruptured ligament - fully replacing it with a donor.

Other Types of Soft Tissue Damage

Ligaments are one type of tissue that can be damaged, however there are other surrounding tissues that can also be damaged such as the cartilage, tendon and bursitis.

Cartilage injuries

A cartilage that's commonly injured is the Meniscus. Shaped like a wedge, the meniscus cartilage can be found located inside of the knee.

• Injuries to the meniscus are normally contracted through sports that involve twisting such as basketball, skiing and tennis.

• General wear and tear with age, will also wear down the cartilage and increase the likelihood of injuring the meniscus whilst doing daily activities

Tendon injuries (Patellar Tendinitis)

• The quadriceps tendon is a tissue that connects from the kneecap (patella) to the thigh muscle, and the patellar tendon form the tissues that surround the kneecap.

• Both types of tendons can easily be irritated and torn, especially in high impact sports that involve a lot of running and jumping

• Injuries to the patellar tendon is commonly known as "jumpers knee"

Prepatellar bursitis (Knee Bursitis)

• Injuries to the bursitis are are sometimes referred to as housemaids knee

• The prepatellar bursitis are sacs that behave like cushions between the tendons and the bone

• Damage to the bursitis can happen after kneeling forwards for a long time from activities such as gardening. The constant pressure to area, can cause fluids to increase in the sac which results in swelling. Although common, this type of injury can be prevented by using protective pads

• Direct hits to the knee through falls or a car accidents are also typical accidents that can cause trauma to the bursitis

Can Soft Tissue Damage Be Permanent?

If your knee injury is mild, with the correct aftercare post diagnosis, such as physical therapy, rest and knee braces to ease the pain - recovery can be swift. Severe damage to the soft tissues however, will never fully heal back to its original form.

It's important to remember that although minor injuries might appear insignificant, it's best to get the opinion of a trained medical professional. There's nothing worse than re-injuring the knee after returning back to your usual activities, which is often the case if the tissue hasn't fully healed.

Keep in mind that even after reversing soft tissue damage, the long term effects of repeated trauma to the same area, can increase your chances of sustaining another injury to the same area.

Are Knee Injuries Reversible?

For the average person, the odd knee injury should be easy to manage without the need for any drastic measures. Although reversible, the knee joint will naturally wear down over time, which does unfortunately up your chances of another injury. Therefore, the best that you can do is to take preventative measures that help to prolong knee health.

In the case of most major trauma to the knees, recovery time will often be much longer. Treatments can range from long term medication and physical therapy to injections and major knee surgery.

Sports professionals may not have a choice but to retire from their sport, since repeated tearing of the tissues in the knee joint, will result in damage that's irreversible.

Risk Factors for Recurring Knee Injuries

After recovering from a knee injury, it makes sense to go back to a daily routine. However, depending on the nature of your injury, lifestyle changes are often required in order to prevent a relapse. Here are some examples of risk factors to be aware of

Playing Sports

Regularly playing sports such as skiing, running, basketball etc. which can lead to recurring stress on the knees. You may need to compromise by cutting down on the amount of time playing these types of sports and using knee supports to reduce further damage.

Once you have experienced damage to the knee joint, this unfortunately puts you at higher risk of getting injured in the same area again.

Sedentary Lifestyles

Increasingly sedentary lifestyles can also cause weak muscles, which often exacerbate knee injuries.

The best way to counteract this is through strengthening your leg muscles with exercises such as leg raises and hamstring curls. This helps to protect your bones and joints, which have the added bonus of increasing your stability and balance.

Being Overweight

Carrying some extra weight could be to the detriment of your knee joints, as this puts extra pressure on the bones supporting your weight.

Being extremely overweight will increase the general wear and tear of the tissues around the knee joint, and you might find yourself experiencing knee problems frequently.

Why Do Knee Injuries Take so Long to Heal?

As the knee is formed of various soft tissues, the limited blood supply to these tissues affect the speed of recovery. In more detail, the "type" of soft tissue damage will also dictate how long your body will need to fully rebuild the tissue.

For example, ligaments tend to take much longer to heal due to less blood supply compared to other soft tissue injuries such as the tendons.

All injuries will go through several stages of recovery, and understanding these stages should give you more insight as to how long it takes to completely recover from a knee accident.

There are 3 stages of healing which the damaged tissue goes through:

Inflammation

Swelling occurs within a couple of hours after an injury. Generally, the swelling is at its worse in the first few days, but can last up to a couple of weeks for severe injuries. It's the first phase of the healing process and is completely normal, as it allows the tissues to start recovery.

Scarring

After the swelling has gone down, the body will begin to form collagen fibres in the form of scar tissue. The new scar tissue is weaker and less flexible, which is why this phase can be prone to re-injury. There's less pain during this period, however, avoid putting too much strain on the area during this period, otherwise this could impact your recovery time.

Remodelling

During this final phase, the collagen fibres begin to strengthen and improve in quality. As the scar tissue fibres begin going through a period of realignment, it is also a stage when the tissue "learns". Therefore, adding stress to the tissues through physiotherapy in this period is an important part of the healing process.

The remodelling of the scar tissue can continue to develop from a couple of months up to a few years, and over time - the knee joint will regain full motion and strength.

How Do I Know if My Knee Injury is Serious?

If you experience any of the following symptoms, make sure you speak to a doctor as soon as possible:

• Persistent swelling that does not go away after a few days.

• Intense pain and difficulty walking

• When you have trouble bending or straightening the knee

• If your knee feels weak and gives way when trying to walk

• Your knee appears visibly deformed

• Any loud sounds such as popping or cracking at the time of injury

• If your joint feels "loose" or seemingly unstable

What Knee Injuries Require Surgery?

Typically, if a knee injury has caused you to lose the majority of normal movement after a period of recovery and rehabilitation, then there is a good chance that you will need to go through surgery.

What type of normal movement does this mean?

• A stiff knee, such as the inability to bend or straighten the joint
• Your knee has trouble holding your body weight when standing
• If you hear or feel a pop when twisting

More serious injuries that often end in surgical intervention include:

• The meniscus tear - cartilage that cushions the bones in the joint
• Grade 3 ACL and MCL ligament tears

What Can I Do to Recover As Soon As Possible From A Knee Injury?

Can knee injuries be permanent? Hopefully this article has shed some light into the many outcomes that can result from a knee injury. If you are recovering from an accident, try to give your body enough time to heal and seek help from a medical professional, no matter how big or small the issue. Knee injuries can become permanent if left untreated.

Visit the knee bible blog for more helpful articles and to learn how you can support the recovery of your knee injury.