One of the more distressing occurrences in soccer, especially in the women’s game, is the sight of a player going down clutching her knee, sometimes after an audible pop. This is a sign typically of an anterior cruciate ligament rupture, which proportionately affects three times as many female as male players. While ACL tears receive the most attention of potential knee injuries, given the required recovery time of six to 12 months, the knee joint also can suffer a range of injuries in soccer.


The knee contains four ligaments — tough connective bands of tissue — to connect bones within this complex joint. The medial and lateral collateral ligaments on each side of the knee prevent inward and outward collapse. Injuries to the MCL and LCL rarely require surgery, states Donald T. Kirkendall of the sports medicine program at the University of North Carolina. The anterior and posterior cruciate ligaments are located within the joint and can be torn when the tibia, the larger of the two bones between the knee and the ankle, over-rotates out of its alignment with the femur, or thighbone. Seventy percent of ACL ruptures do not result from contact with the knee. Rather, landing with the leg extended and immediately cutting is more often the cause.


The meniscus is a thin pair of C-shaped layers of cartilage that cushion the femur where it meets the tibia. The lateral meniscus rests on the outer half of the knee and the inner meniscus on the inner half. As with ligament injuries, rotation of the tibia can cause this injury in sports including soccer, skiing and basketball. The knee may swell but less so than after an ACL tear. Articular or regular joint cartilage also covers the ends of the femur and tibia to protect them during movement. Kirkendall describes how this tissue can protect the area for a lifetime unless damaged by injury or arthritis.


The kneecap, or patella, can become dislocated in soccer as the result of a collision or fall, or due to a sudden twisting motion on a firmly planted foot. The latter results when the quadriceps, or front thigh muscles, contract powerfully against the externally rotated tibia and internal rotated femur, note the authors of “Practical Orthopaedic Sports Medicine and Arthroscopy.” A combination of both a collision and a twisting motion can contribute to a single injury, they write.


The knee tendon connects the quadriceps to the kneecap and the tibia. Overuse of the tendon can lead to jumper’s knee, which can occur in soccer although it is more common in basketball. The tendon may become inflamed and even partially rupture. The condition manifests as pain in the front of the knee around the kneecap, aggravated by extending the lower leg.