Is there a way to tell if you have loose knee ligaments, and if one of your ligaments is loose, do you really need to do anything about it? Yes and yes. We often see patients with loose knee ligaments, and many times they don’t even realize it. Or perhaps they are aware of it, but a doctor has told them it’s nothing to be concerned about—it’s not damaged enough to need surgical intervention. While it’s a good thing no surgical steps have been taken, loose knee ligaments are a red flag that something must be done now to correct the resulting knee joint instability…before it leads to knee arthritis. Performing a knee tibial rotation test can help you prevent arthritis by allowing you to address loose ligaments now before they cause bigger problems.
Before I explain the test, let’s look at the ligaments in the knee.
The Four Knee Ligaments and How They Work
Each joint from your spine to your foot rotates. Your pelvis rotates, your thigh rotates, your knee rotates, and your ankle rotates. The long upper-leg bone is the femur. The femur connects at the hip joint on the top and the knee joint on the bottom. There are two lower-leg bones that connect at the knee joint on the top and the ankle joint on the bottom—the fibula (the smaller one) and the tibia (the larger one). When you rotate your leg, all of these structures work together along with your ligaments, which connect your upper-leg bone to your lower-leg bones.
The four ligaments of the knee are the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL) the lateral collateral ligament (LCL). The ACL and PCL live in the middle of the knee joint and provide front and back stability to the knee. The MCL and LCL live on either side of the knee joint and provide side-to-side stability to the knee. Ligament injuries can occur, and torn ACLs, for example, are common in athletes. Just last month, I blogged about ACL tears and how reconstructive surgery doesn’t prevent arthritis. Today, however, we just want to look at knee ligament laxity (or looseness) and emphasize the importance of addressing it before it leads to arthritis.
So how can you tell if you have a loose knee ligament? The knee tibial rotation test, and, yes, you can do this at home.
The Knee Tibial Rotation Test
First, watch the video at the top of this post for a demonstration of how to do the test. You will need a short stool that rotates. Your focus is going to be on tibial rotation, or how your tibia (larger lower-leg bone) rotates on your femur (your upper-leg bone) at the knee joint where those ligaments live.
- Sit with your right foot planted firmly on the rotating stool (your left foot is on the ground).
- Make sure your right knee is flexed at 90 degrees. Adjust your setup accordingly.
- Rotate your right foot inward (using the natural rotation of the stool) and note the distance of the rotation.
- Follow steps 1–3, now using your left foot, and note the distance of the rotation.
Is there a difference in how far each foot is able to rotate, or are they pretty equal? If you aren’t sure, you may need to video each and compare, like I did in the video above. If one rotates farther than the other, what’s causing that? For example, in the video, my left foot rotates more than my right foot, meaning my left tibia is rotating farther than my right tibia at my knee joints. Well, the cause is really the laxity in the ligaments in my left knee.
Should I Be Concerned with My Loose Knee Ligaments?
I’m not really feeling any major pain, but what will happen if I leave it this way? I can get knee arthritis. So whether I’m already feeling knee pain due to that loose ligament or not, I should certainly be concerned and address it ASAP. These loose ligaments will also impact my hip and ankle. In my case, to get this fixed, I’m going to have my partners do precise guided injections of my own platelets into the ligaments to help tighten them up and restabilize the knee.
The upshot? Knee joint instability, even in small amounts, can lead to arthritis. When this instability is caused by loose knee ligaments, you can prevent knee arthritis before it sets in by having those ligaments tightened. You may not even know you have a loose knee ligament, but a simple knee tibial rotation test can help you find out. Get out a rotating stool, and measure your tibial rotation. If your test shows one tibia rotates more than the other, it’s a good idea to follow up with an exam to have your knee stability checked and then look into precise injections to tighten those ligaments and prevent knee arthritis down the road.