Sprain of the tibial collateral ligament of the knee

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A sprain is the stretching or tearing of a ligament (fig 1).
A ligament is a fibrous structure that maintains the articulation (≠ the tendon which is part of the muscular apparatus).

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Jocelyn-William LOUBRIAT
Francis HELIAS

Definition

A sprain is the stretching or tearing of a ligament (fig 1).
A ligament is a fibrous structure that maintains the articulation (≠ the tendon which is part of the muscular apparatus).

In climbing, the tibial collateral ligament (medial collateral ligament = MCL) of the knee can be stretched too much and become distended or tear.

The sprain is an accident with immediate pain at the inner side of the knee and instant functional inability. The knee may tend to swell.
Depending on the importance of the lesion, after-effects of articular instabilities may occur.

(sprain of the cruciate ligament is no specific pathology of climbers, that is the reason why we do not deal with it here)


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Fig 1: The tibial collateral ligament
by Michel Dufour, Anatomy of the locomotor apparatus


Mechanism of the lesion

The tibial collateral ligament may tend to tear or stretch when they are under much repeated tension or when making one rough movement.

It is under tension during flexion + external rotation + knee valgus.

It is the position which is adopted when using the Lolotte method (fig 2) and which can be found also during a fall when bouldering (fig 3).


lolottem chute bloc
Fig 2: The Lolotte Method
Fig 3: A fall when 
bouldering, 
knee in flexion 
external rotation

Prevention

Technique correction:
Avoid useless Lolotte which would “tire” the ligament.
When bouldering, spotting is essential for a good fall.

Correction of the physical preparation:
The learning all the warm up, muscle training and stretching techniques should be done by strictly respecting the articular physiology.

Searching non-physiological articular amplitude weaken the articular stability and vigilance.


Treatment

Put an ice pack on it as soon as possible.
Immobilise the knee and go to a sport doctor.
Undergo strict physical therapy.
To start climbing again soon is possible a splint should be used but only when the physiotherapist consents to it.

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