The Terrible Triad


If you ever have had a knee injury, you may be familiar with the Terrible Triad -- Medial Collateral Ligament, Anterior Cruciate Ligament and Meniscus injury. This traumatic injury can consist of full or partial tears of the two ligaments and meniscus. 



Symptoms that occur that would make you very suspicious that you have suffered the Terrible Triad include:

  •           Extreme pain in the knee after the injury
  •           Extreme and sudden swelling of the knee
  •           Hearing a popping or tearing sound at the time of injury
  •           Extreme pain or difficulty moving the knee
  •           An unstable feeling in the knee

Immediate treatment

          Avoid ice if possible. The meniscus and joint space has limited blood supply. Important to accentuate this where you can. 

          Avoid NSAIDS if possible. If tolerated, use Tylenol.

          High dose Curcumin - decreases pain and improves mobility 

          SAMe - 800mg per day; provides the ingredients needed for collagen and cartilage growth


          MRI is needed to confirm diagnosis. X-rays won’t always pick up the degree of soft tissue tears. If the ligaments are found to be ruptured, surgery is needed. 

Platelet Rich Plasma Prolotherapy Treatment

PRP Prolotherapy works at strengthening intact ligaments and tendinous structures. PRP Prolotherapy may also help to regenerate cartilage. If the ACL or MCL is found to have a partial tear, platelet rich plasma prolotherapy treatment is an effective option. Typically between 3 to 4 treatments, spaced 3 weeks apart are required. PRP Prolotherapy provides a long term solution to an injury and can be a viable option for those that have suffered the terrible triad. 



Jurenka, Julie. "Anti-inflammatory Properties of Curcumin, a Major Constituent of Curcuma longa: A Review of Preclinical and Clinical Research." Alternative Medicine Review. no. 02 (2009): 141-154. 

Reeves KD and Hassanein K. Randomized prospective double-blind placebo-controlled study of dextrose prolotherapy for knee osteoarthritis with or without ACL laxity. Alternative Therapies. March 2000. 6(2):68-80.