Coronary ligament sprain has similar symptoms to cartilage meniscus injury and often occur at the same time as lateral knee ligament injuries (at the side of the knee). A sharp pain is felt on twisting and turning but it is often not bad enough to require complete rest.
Symptoms of a coronary ligament sprain
A coronary ligament sprain has very similar symptoms to that of a torn meniscus. It is often difficult to differentiate between the more common cartilage meniscus injury and hence it can often be incorrectly diagnosed. Symptoms include a sharp pain on twisting movements with tenderness along the joint line of the knee.
The knee joint itself will not be swollen and there is unlikely to be much localized swelling along the joint line (at the side of the knee where the thigh bone meets the tibia), however, it may be painful or tender when pressing in along the joint line. There may be a positive result when performing McMurray's test and range of motion is not usually limited although the end of the range may be uncomfortable.
An MRI scan may give a diagnosis although if it is still not obvious then arthroscopic surgery may be required to differentiate a coronary ligament sprain from a medial meniscus injury.
Coronary ligament injury explained
There are two coronary ligaments in the knee (sometimes also called the meniscotibial ligaments) which form part of the fibrous joint capsule surrounding the knee joint. They are located on the inside (medial) and outside (lateral) of the joint and attach to both the edge of the cartilage meniscus, and the tibia. Their purpose is to fix the cartilage meniscus to the bone and limit rotation of the knee.
Coronary ligament injuries are usually acute, sudden onset injuries which occur when twisting the knee. For example in football or any team sport when the foot is planted firmly on the floor and the player suddenly changes direction and ends up twisting the knee in the process. They can however also occur as a result of overuse or repetitive strain, especially in sports which involve twisting at the knee, such as soccer, martial arts, and dancing.
Coronary ligament sprain treatment
Treatment will vary depending on how bad the injury is and whether other structures in the knee joint are also injured.
Rest for aggravating activities. Complete rest may not be necessary depending on how bad the injury is but avoiding any activities that trigger pain is important. In many cases this may just mean modifying training to avoid any sideways or lateral movements, twisting and turning. A straight line running may be possible but switch to cycling or running in a swimming pool until pain-free if necessary.
Apply cold therapy to ease pain, inflammation, bleeding and swelling if there is any. Wear a knee support which is either hinged or stabilized to protect the joint from sideways stresses whilst the injury is healing.
A doctor may prescribe the use of anti-inflammatory medications such as ibuprofen and use electrotherapy treatment such as ultrasound. A rehabilitation program to promote full strength and flexibility at the knee is required as soon as pain allows. If this fails, an arthroscopy or keyhole surgery may be performed to diagnose and repair the injury.
When pain allows a full rehabilitation program of mobility and strengthening exercises can begin. The heel slide is a good mobility exercise, to begin with. Lying on the back, one knee is bent upwards whilst sliding the foot along the ground. Slide the heel up as far as possible towards the buttocks. Repeat 10 to 20 times daily, aiming to increase the range of movement as pain allows. Play heel slides video
Isometric exercise can often begin immediately as there is no movement of the knee joint. For a mild Coronary ligament sprain, it may be possible to move quickly past these and move onto more dynamic exercises such as squats and lunges and eventually other more sports specific exercises.
Proprioception and balance exercises are also important. Read more about knee rehabilitation exercises for medial meniscus injuries.