Question - The Unhappy Triad

This happened to my daughter last Tuesday in a volleyball game, she was not hit it just happened, her knee locked. She has a complete tear of her ACL, a partial tear of the MCL and meniscus tear and bad bone bruise that is causing a lot of pain.

My Q is... she is a star on the team and we are in the playoffs and the coach still wants her to play, said they need her. She said it can be fixed where she can play this Tuesday. What does she mean? Is it possible to give her a shot in the knee or brace it? Would it be a risk to her health or damage it were it can't be fixed?? She's only in 10th grade and basketball is her best sport. I want her to be able to play the next 2 years.

Please help!!
Thanks Beverly

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Question - The Unhappy Triad

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Nov 04, 2007
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Better Safe Than Sorry...
by: Bart - SII

The unhappy triad is a pretty extensive injury. The ACL tear alone is serious enough to end a season, let alone the meniscus and MCL tear. The chances of creating more problems and further injury if she continues to play are fairly high.

The ACL is completely torn, so that cannot be injured further. But the instability that is created without the ACL intact can further injure the meniscus if she continues to play. I have seen many athletes who play after an ACL injury to finish the season, and they end up with larger meniscus tears afterwards.

The MCL heals best with rest, not with surgery. The more activity you participate in without letting it rest increases the chances that she could have increased laxity or looseness in that ligament. Surgery for the MCL is not usually done, as again, it heals better without surgery.

Is she even able to play right now? Most of the time with this injury there is a significant amount of pain and swelling and it usually takes at least 2-3 weeks to calm that down enough to be able to even try to play. A functional brace may provide some support, but not enough to completely prevent further injury. As for shots, I would avoid them at all costs. There is no good shot for this injury that will not cause more problems in the long run.

If she was a senior, and she was dead set on playing, maybe you could consider a functional brace and let her play. As a sophomore, with two more years of high school ball, and possibly college ball, I would lean towards the conservative side and protect her knee for the future. There is no guarantee she will cause more damage, but is it worth the risk?

These are all very hard decisions to make. I would talk to your orthopedist and get their opinion and advice.

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Nov 04, 2007
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Submitted by: Bart - SII

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The unhappy triad is a pretty extensive injury. The ACL tear alone is serious enough to end a season, let alone the meniscus and MCL tear. The chances of creating more problems and further injury if she continues to play are fairly high. The ACL is completely torn, so that cannot be injured further. But the instability that is created without the ACL intact can further injure the meniscus if she continues to play. I have seen many athletes who play after an ACL injury to finish the season, and they end up with larger meniscus tears afterwards. The MCL heals best with rest, not with surgery. The more activity you participate in without letting it rest increases the chances that she could have increased laxity or looseness in that ligament. Surgery for the MCL is not usually done, as again, it heals better without surgery. Is she even able to play right now? Most of the time with this injury there is a significant amount of pain and swelling and it usually takes at least 2-3 weeks to calm that down enough to be able to even try to play. A functional brace may provide some support, but not enough to completely prevent further injury. As for shots, I would avoid them at all costs. There is no good shot for this injury that will not cause more problems in the long run. If she was a senior, and she was dead set on playing, maybe you could consider a functional brace and let her play. As a sophomore, with two more years of high school ball, and possibly college ball, I would lean towards the conservative side and protect her knee for the future. There is no guarantee she will cause more damage, but is it worth the risk? These are all very hard decisions to make. I would talk to your orthopedist and get their opinion and advice.

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