Could a Knee Injury Bring an End to a Football Career?

Sports, of almost every type known to man, are physically hard on the human body. Any endeavor requiring short stops, quick turns, landing after a jump, or absorbing mind-numbing tackles will cause damage. Most sports, even one as tame as golf, can cause serious damage to your knees. The damage results from stress placed on the four major ligaments of the knees, and the impact on a professional career can be – but is not necessarily – devastating. Knee injuries are more feared by professional football players than concussions, because they are seen as more immediately career-threatening; this is a misconception, as a severe concussion can take out a pro football career just as fast.

Anatomy of a Knee
Your knees are composed of three bones: the end of the femur (thigh bone), the top of the tibia (major weight-bearing leg bone) and the patella (knee cap). The interior of the joint is lined with synovial tissue, fluid, and cartilage. There are two articular disks in the knee: the medial meniscus and the lateral meniscus. These disks are not cartilage, but made up of connective tissue with cartilage-like fibers. The knee is surrounded by four ligaments: the anterior and posterior cruciate ligaments, the medial collateral ligament and the lateral collateral ligament. The anterior and posterior cruciate ligaments provide stability to the joint as it moves and flexes. The medial collateral ligament runs down the inside of the joint, and the lateral collateral ligament runs down the outside of the joint. These ligaments provide stability in lateral (side-to-side) movements of the joint. The ligaments and menisci are prone to injury; the cartilage is prone to wear and tear on the joint. Cartilage wears away over time, causing bone to begin grating on bone. This leads to the onset of osteoarthritis. Arthritis is not a concern for most pro football players; it usually develops later in life, well after a professional sports career is over. However, a significant injury to a knee can lead to early onset, so a professional football player may experience osteoarthritis at a younger-than-expected age; still, it is most likely to occur after the player’s career is ended.
 
Sports-Related Injuries
The most common knee injury is a torn ACL (anterior cruciate ligament). Short stops, quick turns, improperly planting the foot before turning, or being tackled with the knee improperly placed will all contribute to tearing an ACL. A torn ACL is not necessarily a career-ending injury, but it is a season-ending one. Most athletes take eight to ten months to completely recover from an ACL tear injury. The second ligament injury is one to the medial collateral ligament (MCL) on the inside of the knee. Typically a player will sustain a hit to the outside of the knee, and the force pushes the knee sideways, towards the inside. The MCL cannot sustain the joint’s stability against the force, and it sprains or tears. A sprain is usually mild, and the athlete can return to play within two to three weeks. A more severe sprain is labeled as a partial tear, and the recovery time is longer, but the injury may still not end the player’s season. A tear of the ligament is a season-ending injury. If it occurs with a tear to the ACL as well, it can possibly be a career-ending injury, depending on how well the ligaments heal. Should the injury tear both the ACL and MCL, and the meniscus tear as well, this is most likely a career-ender. This injury is known as the ‘unhappy triad’ due to its severity and the impact on the player’s career. Athletes have successfully come back to play a professional sport after severe knee injuries, but many have had their careers cut short by them as well.

Can a injury bring an end to football? It has before, and it will again. However, a knee injury does not necessarily mean the end of a career, even if it is a severe one. Much depends on the player’s age, his ability to heal, and the rehabilitation program he follows once the injury has healed to the point the joint is usable. Force of will also come into play, but the physical condition of the joint is the determining factor. A player is more likely to lose his career to a knee injury than any other injury he sustains, although the other injuries may prove more serious in the long run. So, the answer is a qualified yes – a knee injury can bring an end to football, but it doesn’t mean it will.

References:

• Agnethe Nilstad,*y PT, MSc, Thor Einar Andersen,y MD, PhD, Roald Bahr,y MD, PhD, Ingar Holme,y PhD, and Kathrin Steffen,y PhD Investigation performed at the Oslo
• Time-Loss and Non-Time-Loss Injuries in Youth Football Players http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1978461/
• Sports Trauma Research Center, Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway