Knee Tightness After Basketball Injury: Is It a Ligament Issue?

Knee tightness

Hello, doctor.
About two weeks ago, I sustained an impact to my right knee during a basketball game (I believe I was kicked by an opponent).
At the moment, I felt pain, but after resting briefly, I continued to play two more games.
After the game, I applied ice, which helped reduce the swelling.
I experience pain when fully extending my knee, but there is no pain when pressing on the surface of the knee, and I have no significant issues with bending or other movements.
I stopped all activities for the next week, took anti-inflammatory medication prescribed by the clinic, and applied ice daily.
A week later, I was able to run, but I still feel tightness when fully extending my knee (which is noticeably different from my left knee), although there is no pain now.
I have never injured my knee before.
Could this possibly be a ligament injury?

Amy, 20~29 year old female. Ask Date: 2017/05/02

Dr. Shi Guozheng reply Orthopedics

It may be due to swelling that has not subsided after a contusion, resulting in an inability to fully extend or tightness.

Reply Date: 2017/05/02

More Info

Based on your description of the knee injury sustained during a basketball game, it is indeed possible that you may have injured a ligament or other soft tissue structures in your knee. The symptoms you are experiencing—specifically the tightness when fully extending your knee and the absence of pain upon palpation—suggest that there may be some residual swelling or inflammation affecting the knee's range of motion.

When a knee is subjected to trauma, such as a direct impact from another player, several structures can be affected. The most commonly injured ligaments in basketball injuries are the anterior cruciate ligament (ACL) and the medial collateral ligament (MCL). However, other structures such as the menisci (cartilage) and the patellar tendon can also be involved. The tightness you feel when trying to fully extend your knee could be due to a few factors:
1. Swelling and Inflammation: After an injury, it is common for the body to respond with swelling. This can lead to a feeling of tightness or stiffness in the joint, particularly when trying to extend it fully. Even if the visible swelling has decreased, there may still be some internal swelling that is not immediately apparent.

2. Soft Tissue Injury: If the impact caused a strain or sprain to the ligaments or surrounding soft tissues, this could lead to tightness. Ligament injuries can sometimes heal with residual tightness or stiffness, especially if the knee was not immobilized adequately during the initial healing phase.

3. Scar Tissue Formation: After an injury, scar tissue can form as part of the healing process. This scar tissue can sometimes restrict movement and lead to a sensation of tightness, particularly during certain movements.

4. Joint Mechanics: The knee is a complex joint, and any injury can alter its mechanics. If one part of the knee is injured, it can affect how the entire joint functions, leading to compensatory tightness in other areas.

Given that you have already experienced some improvement and can run without pain, this is a positive sign. However, the persistent tightness when fully extending your knee warrants further evaluation. It is advisable to consult with an orthopedic specialist who can perform a thorough examination and possibly recommend imaging studies, such as an MRI, to assess for any ligamentous injuries or other internal damage.

In terms of treatment, continuing with rest, ice, compression, and elevation (RICE) is essential. Physical therapy can also be beneficial in restoring range of motion, strengthening the muscles around the knee, and improving overall function. A physical therapist can provide you with specific exercises tailored to your condition, focusing on flexibility and strength to help alleviate the tightness you are experiencing.

In conclusion, while it is possible that you have sustained a ligament injury, the tightness you feel could also be attributed to swelling, soft tissue injury, or changes in joint mechanics. A professional evaluation is crucial to determine the exact nature of your injury and to develop an appropriate treatment plan to facilitate your recovery and return to basketball.

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