Unhappy Triad

Generally Speaking…How? Valgus ForceValgus Force to the Knee –Can also have posterior force Foot is fixedFoot is fixed rotational stressPlaces increased valgus and rotational stress to the knee

What Tissues are Damaged? ACLACL Medial MeniscusMedial Meniscus MCLMCL

What is the Mechanism Occurs most often with violent sudden contact in football, rugby, soccer, etc –Even though the ACL & MM can tear without direct contact, you need the valgus force blow to tear the MCL –So not as common in non- contact sports…but…can still happen

Athlete is running / Cutting Blow from the Medial Side (Valgus) and/or posteriorly The ACL Tears because of the rotation and anterior displacement of the tibia

As the knee loses stability, the medial femoral condyle and medial tibial condyle compress against the medial meniscus –Tears the Meniscus The open position of the knee plus the force of the contact and torsion, tear the MCL

What Might the Athlete Complain of? Since the unhappy triad is a combination of a torn ACL, torn MCL, and torn meniscus the symptoms offer mirror symptoms from all three of those injuries. The symptoms also will vary depending on the severity and extent of each tear. There is normally more pain, swelling, and bruising when the tears are complete tears –the pain and swelling may be less when there are partial tears involved in the unhappy triad. With any knee injury it is normally difficult and painful to walk and move the knee. This is especially true for the unhappy triad knee injury.

Unhappy Triad Signs/Symptoms A popping sound at the time of injury Sever swelling of the knee Bruising on or around the knee Pain that ranges from mild to severe The knee feels unstable or that it may give out Stiffness in the knee The knee feels like it is catching or locking Unable to move the knee