Sprained Knee - Symptoms, Treatment, Exercises & How Long Does it Last? | Pain Care

Sprained Knee – Symptoms, Treatment, Exercises & Recovery Tips

Let me tell you, sprained knee is not a pleasant experience!

Pain, restrictions in movement, inflammation of joint can lead to longer recovery time.

Complexity of knee joint:

The knee is a large and very complex joint of the human body. This joint connects the femur or the thigh bone, to the tibia or the shin bone.

Other bone parts of the knee joint include patella or the kneecap and tibia or fibula.

The leg muscles are connected with the help of the tendons to the knee joint, while four ligaments that join these knee bones provide the stability of the joint.

In the knee joint, there are also two cartilage pieces which work as shock absorbents between the femur and the tibia, known as medial menisci and lateral menisci.

Also, there are many fluid - filled sacks, commonly called bursae, which help the knee move smoothly.

As you can see from the knee joint anatomy, this joint is one of the most complex joints in the human body.

As mentioned there are four ligaments in total:

  • Anterior cruciate ligament ACL,
  • Posterior cruciate ligament PCL,
  • Medial collateral ligament MCL,
  • Lateral collateral ligament LCL.
Knee Joint Anatomy

The ACL ligament prevents the tibia from sliding forward on the femur, while it prevents the femur from sliding backward on the tibia.

The PCL is in charge for the opposite of ACL. On the other hand, the LCL and MCL prevent side to side sliding of the femur, as these two ligaments cross each other over the kneecap.

Knee ligaments are soft tissue pliable bands which provide stability, balance, and mobility of the knee joint structures. If one of these ligaments gets damaged than the knee joint can’t function normally.

A sprained knee is one of the problems that can affect the knee joint. This condition occurs when one of the ligaments gets damaged due to overstretching.

Ligament overstretching can cause a total or partial tear of one or more knee ligaments. The severity of the damage depends on the number of fibers damaged. The more ligament fiber damaged, the worse the situation will be.

Signs and symptoms of knee sprain will be more severe, while the knee stability will be affected as well. The more ligament fibers damaged, the harder the treatment is.

Usually, the MCL and the ACL ligaments are the most damaged ones. PCL is the least damaged ligament in the knee.

Knee Sprain Symptoms

Depending on the cause of the knee sprain, the signs and symptoms can develop immediately or after a certain period of time.

In cases of a knee injury, the signs and symptoms of knee sprain usually start immediately. However, sometimes these signs and symptoms appear only a couple of days later.

The most common Sign & symptoms of sprained knee:

  • Knee Pain
  • Bruising
  • Swelling
  • check-circle
    Knee instability
  • Buckling of the knee
  • Inability  to hold body weight
  • Limited knee mobility

The location of the knee pain often serves as an indicator to determine which of the four ligaments is damaged.

Knee pain located on the inner side of the knee usually indicates a damage of the MCL, while knee pain located on the outer side of the knee usually indicates a damage of the LCL.

If the knee pain is widespread and especially if knee pain is accompanied by knee instability as well, then this usually indicates a tear of the PCL or ACL.

When there is also a popping noise present then this is a sure sign of ACL damage.

In cases of a partial ligament tear, the knee pain will be dull and throbbing, while in cases of a total ligament tear, the knee pain will be sharp and constant.

The knee pain due to ligament damage tends to get worse with movement and improves while resting the affected leg.

Swelling of the knee is another common symptom of a knee sprain. The severity of knee swelling depends greatly on the severity of the ligament damage.

Knee bruising usually occurs in cases when the ACL gets torn. However, knee bruising can occur with an injury to any of the four knee ligaments. Around the kneecap and on the kneecap there will be skin discoloration present.

Knee instability is also possible, especially when the two crucial ligaments are damaged, or when the ligament tear is total and severe.

Buckling of the knee is mostly noticed when putting weight on the affected knee, such as when standing up, walking, and running. The direction in which the knee buckles is an indicator of which of the four knee ligaments has been damaged.

Inability to hold body weight is another common problem that accompanies knee sprains. This is more likely to occur in severe ligament damages, usually those of grade 2 and grade 3. In grade 1 knee ligament damages, this problem does not occur.

Limited knee mobility develops due to swelling of the affected knee.

Grade I

A minor tear of the ligament usually no more than 10% of the ligament fibers are affected.

The recovery period is short and the pain, swelling, and bruising are only mild.

A person can put weight on the affected leg with this type of injury.

Grade II

A more severe damage compared to the grade 1, where the severity of the damage varies from 10 % to 90 % of the ligament fibers.

The affected ligament is only partially torn and the knee feels unstable. The symptoms of grade 2 knee sprain are more severe compared to those of grade 1 knee sprain.

 The recovery period lasts longer as well.

Grade III

A complete rupture of the ligament, normally the most severe type of damage.

The affected ligament is completely torn, and a person is not able to put the weight on the affected leg. Pain, swelling, and knee bruising are severe.

The recovery period is normally longer, and treating this kind of injury often requires surgery.

What Causes Sprained Knee?

Risk factors for knee sprain include:

  • Playing contact sports such as rugby, football, soccer, hockey, basketball, skiing, etc.
  • Previous injuries to the knee,
  • Wearing improper shoes,
  • Unexpected exertion, etc.

Knee sprain, as mentioned is an injury or the damage of one or more of the four ligaments that support the knee joint. 

Knee sprain usually results due to twisting movements or side to side movements, when the knee ligaments overstretch.

It is also possible to damage the knee ligaments due to an impact with other players in contact sports, such as rugby, football, soccer, hockey, etc. Knee sprain due to a fall is also common in non – athlete persons.

The medial ligament damage results from an impact on the outer side of the knee, while the lateral ligament damage results from an impact on the inner side of the knee.

MCL damages can also result from continuous stress for a prolonged period of time.

The anterior cruciate ligament damage results from twisting the leg or due to an impact on the front of the knee, while the posterior cruciate ligament damages result when the knee is forced to move backward in the wrong way.

How to Treat a Sprained Knee?

Knee sprain treatment depends on the severity of the ligament tear, as well as from the ligament affected.

In general, the treatment for grade 1 and grade 2 knee sprains is the same, while grade 3 knee sprains are harder to treat and often require a surgical repair, especially when caused from a knee injury.

Dr. Sachin

Bed rest, ice packs, leg elevation, as well as, compression, are important parts of the knee sprain treatment, regardless of its severity.

All these actions will help relieve the pain, bruising & swelling around the knee. 

Dr. Sachin  //  Our Health Expert

Bed rest will prevent any further damage to the affected ligament, while it will give your knee the necessary time to fully recover.

Ice packs should be applied to the affected knee for about 15 minutes a couple of times a day in order to reduce the swelling and relieve the pain and discomfort this way.

Elastic bandages around the injured knee will help reduce the inflammation. However, you should be very careful not to bandage the knee too tight, as blood circulation will be impaired. By elevating the affected knee, the pooling of the blood will be prevented, reducing the knee swelling as well.

Anti – inflammatory medications such as Ibuprofen are often prescribed in order to relieve the pain that accompanies a knee sprain.

The use of crutches is also often necessary to let the knee rest and fully recover, as it reduces the body weight that the knee needs to support.

Mobility exercises are important as well. You should start with mobility exercises once you feel ready. Start with gentle knee bending, without stretching yourself too much, but only as far as you feel comfortable.

Besides all the above - mentioned measurements, you should also consult a physical therapist. With the help of ultrasound and massage techniques, physical therapists can help you recover faster and get back to the track as soon as possible.

How long you will need physical therapy will depend on the severity of the injury, your age, previous knee injuries, medical history, level of athletic competition, etc.

Strengthening exercises are also very important as these exercises will strengthen the leg muscles, especially the hamstring and the quad muscles.

Muscle strengthening exercises should be regularly performed during the recovery period as they will help to prevent muscle loss due to prolonged bed rest or inability to use the injured leg.

Once you can correctly land your leg on the ground, without having any knee pain, this means you can fully bear your body weight. In this period balance exercises are very important.

Surgical Treatment: In severe and total ligament tears, surgical treatment is often necessary. The surgical procedure is performed arthroscopically.

An arthroscope is a small surgical instrument which has a shape of a tube with a camera in the end, which is inserted through some incisions into the knee joint.

With the help of an arthroscope, your healthcare provider will reattach the torn ligament by stitching it or by using a tendon graft.

Common tendon grafts used are the patellar tendon, the hamstring tendon, and even autografts. There is always the possibility of using allografts, which are tendon grafts than come from a donor.

Once the tendon grafts are placed where they should be they can be attached using screws or surgical staples. After the ligaments are completely repaired, the incisions are closed with surgical staples.

 It will take a few weeks after the surgery until you can return to your daily activities. However, be patient as a full recovery and rehabilitation after a knee sprain surgery may last for several months.

Possible risks of a surgical repair of the knee ligaments include:

  • Infections,
  • Bleeding,
  • Blood clot formation in the leg and even pulmonary embolism,
  • Side effects due to general anesthesia, etc.

Some patients have reported a limited range of motion, occasional swelling and pain even after a surgical repair of the damaged knee joint.

How Long Does a Sprained Knee Last?

It all depend on the severity of knee injury, grade of knee sprain, type of the sports you play and most importantly the line of treatment & rehabilitation program your doctor chose. Usually, Grade I & Grade II sprains are termed as milder and heal within 2 to 4 weeks while the sever sprain with Grade III may take 4 to 12 months to recover.

Please note that, it takes time to recover from knee sprain. Because it all depend on the reduction of inflammation & maturation of collagen fibers, 

How to Prevent Knee Sprain?

The following tips can help you prevent knee sprain:

  1. Wear comfortable and supportive shoes that best fit your feet.
  2. Wear proper shoe cleats that might help reduce the risk of a knee injury when playing sports like football.
  3. Perform regular strengthening exercises which will make the muscles stronger.
  4. Warm up and stretch regularly before playing any sports.

Don’t increase the intensity of your training program suddenly. Instead, increase the exercise intensity gradually and exercise regularly based on your own schedule. Listen to your body in order to prevent any knee injury. 

Knee Sprain Exercises

Useful exercises for knee sprain include straight leg raise, knee bending, sitting kicks, side - lying straight leg raises, clamshells, etc.

Straight Leg Raise Exercise

  • Lie on the ground on your back while keeping your legs straight out,
  • Bend the knee of your healthy leg to a 90 - degree angle, while keeping the foot flat on the floor,
  • Tighten the muscles on the leg that is still straightened out,
  • Keep the muscles tight while lifting the leg slowly off the floor,
  • Hold it lifted for a couple of seconds,
  • Slowly get your leg back on the floor,
  • Relax for a couple of seconds and repeat this exercise about 10 times.

Knee Bending

  • Sit on a chair,
  • Bend your knee back as much as possible,
  • Hold for a couple of seconds in that position,
  • Slowly return the knee to the starting position,
  • Relax and repeat this exercise about 10 times.

Sitting Kicks

  • Sit on a chair,
  • Lift your foot while keeping your knee straightened forward as much as you can,
  • Hold for a couple of seconds in that position,
  • Slowly return the leg to the starting position,
  • Relax and repeat this exercise about 10 times.

Side-Lying Straight Leg Raises

  • Lie on the floor on your side,
  • Lift your affected leg slowly toward the ceiling,
  • Lower your leg carefully,
  • Relax and repeat this exercise for about 10 times.

Clamshells

  • Lie on the floor on your side,
  • The affected knee should be pointed toward the ceiling,
  • Open and close the legs just like clamshells, while keeping your heels close together,
  • Relax and repeat this exercise for about 10 times.
Dr. Sachin
 

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