Knee Sprain

GENERAL INFORMATION:

What is it? A knee sprain occurs when one or more ligaments in your knee are suddenly stretched or torn. Ligaments are tissues that hold bones together. Ligaments support the knee and keep the joint and bones lined up. They help you to be able to walk, twist and turn. There are four ligaments that help support the knee. Ask your caregiver which of these ligaments was sprained in your knee. Ligaments are often sprained because of an exercise or sports-related injury. Treatment and recovery time depend on the type and cause of the knee sprain.

What causes a knee sprain?

• Movements that cause stress on the knee: Sprains may be caused by using movements that are not normal for the knee. These movements include doing sports that cause you to plant your foot and quickly turn at the knee. They include running and stopping or changing direction suddenly, and jumping and landing. They include any activities that cause quick or sudden twisting at the knees. Doing activities that cause hyperextension (hi-per-ek-STEN-shun) of your knee (making your leg straighter than it normally goes) can cause a sprain. Sprains commonly occur in sports such as football, basketball, hockey and skiing.
  
  
• Direct hits to the knee: Sprains may be caused by knocks or hits to the front, sides, or back of the knees. Sprains may be caused by tripping and falling down onto your knees while they are bent. You can get a sprain from being forcefully knocked to the ground, such as during a football tackle.

What are the signs and symptoms of a knee sprain?

• Decreased movement. Your knee may feel stiff or unable to move as well as it usually does.
  
  
• Pain or tenderness in your knee.
  
  
• Painful "pop" that you can hear or feel.
  
  
• Swelling or bruising. This happens within the first few hours after your sprain. It is caused by the ligament bleeding into the knee joint.
  
  
• Unstable knee. Your knee may feel like it buckles or "gives out" when you try to walk.

How is a knee sprain diagnosed? A caregiver will examine your knee and ask you questions about your activities. You may need x-rays or magnetic resonance (REZ-oh-nans) imaging (MRI). These tests will show a picture of the bones and tissues inside your knee. Caregivers can do these tests to learn if you have a fractured (FRAK-churd) (cracked or broken) bone or soft tissue damage.

How is a knee sprain treated? Treatment includes controlling your pain and swelling first, then beginning rehabilitation (re-hah-bil-ih-TAY-shun). Rehabilitation includes physical (FIZ-i-kal) therapy (THER-ah-pee) exercises. These may be done over a number of weeks or months to help you return to your regular sports and activities. Your treatment plan may include one or more of the following:

• R.I.C.E.: R.I.C.E. is a four-step treatment plan that you can follow. R est, I ce, C ompress, and E levate your knee to decrease swelling and help it heal.
  
  
  • Rest. The most important part of treating a knee injury is resting your knee. You may be told to keep weight off your knee (do not use it to walk). Rest helps decrease swelling and allows the injury to heal. When the pain decreases, begin normal, slow movements. Caregivers may tell you to remain pain-free as you use your knee more.
    
    
  • Ice. Ice causes blood vessels to constrict (get small) which helps decrease inflammation (swelling, pain, and redness). Put crushed ice in a plastic bag or use a bag of frozen corn or peas. Cover it with a towel. Put this on your knee for 15 to 20 minutes, three to four times each day. Do this for two to three days or until the pain goes away. Do not sleep on the ice pack because you can get frostbite.
    
    
  • Compress. You may need to wear an elastic bandage. This helps keep your injured knee from moving too much while it heals. You can loosen or tighten the elastic bandage to make it comfortable. It should be tight enough for you to feel support. It should not be so tight that it causes your toes to be numb or tingly. If you are wearing an elastic bandage, take it off and rewrap it once a day.
    
    
  • Elevate. Lie down and elevate (raise) your knee to a level above your heart to help decrease the swelling.
  
  
• Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling). Some NSAIDs may also be used to decrease a high body temperature (fever). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.
  
  
• Brace: You may need to wear a brace to keep your injured knee from moving too much while it heals. There are many different types of braces. Use your brace as directed by your caregiver. You may remove your brace each day to bathe. Put your brace back on as soon as possible after bathing. Move your toes and foot several times an hour to prevent joint stiffness while wearing a brace.
  
  
• Crutches: You may be given crutches to use until you can put weight on your knee (stand using that leg) without pain.
  
  
• Heat: After two or three days, you may try using heat to decrease knee pain and stiffness. Use a hot water bottle, heating pad, whirlpool, or warm, moist compress. To make a compress, dip a clean washcloth in warm water. Wring out the extra water and put it on your knee for 15 to 20 minutes, three to four times each day.
  
  
• Rehabilitation exercises:
  
  
  • Your caregiver may want you to go to physical therapy. A physical therapist can do special treatments and exercises to help your knees heal and move better. Your caregiver or a physical therapist may teach you special exercises to do at home. You may be told to start doing these exercises once your pain and swelling have decreased. Exercises are important for preventing stiffness, decreasing swelling, and helping your normal knee movement to return. You may be told to do these exercises two or three times each day.
    
    
  • As your knee continues to heal, you will learn new exercises to help strengthen and stretch your knee. You may use equipment including weights, exercise bikes and treadmills to help make the muscles around your knee stronger. The muscles around your knee are the calf, thigh, and ankle muscles. Making these muscles strong can help support your knee and protect your knee from more injury. Following your rehabilitation plan as directed by your caregivers will help you return to your usual activities sooner.
  
  
• Remove extra fluid from your knee: Caregivers may use a needle to drain fluid from your knee. Removing the extra fluid may help your knee heal faster. The fluid may be sent to a lab and checked for infection (in-FEK-shun).
  
  
• Surgery: If a knee ligament is torn, you may need surgery. During surgery, caregivers can use a graft (piece of tissue from a donor or your body) to replace a torn ligament.

How can I take care of my knees and help prevent another knee sprain? Knee sprains often cannot be prevented, but doing the following may help protect your knee from injury:

• Always ask your caregiver before you start exercising. Do not start exercising until your caregiver says it is OK. If you start exercising too soon after your knee sprain, you may damage your knee more. Damaging your knee more can lead to long-term knee problems.
  
  
• Slowly start your exercise or sports training program as directed by your caregiver. Gradually (slowly) increase time, distance and training. Sudden increases in training may cause you to injure your knee again.
  
  
• Ask your caregiver if you should wear a brace to support and protect your knee during training.
  
  
• Warm up and stretch before exercising. Warm up by walking or using an exercise bike before starting your regular exercise. Do gentle stretches after warming up. This helps to loosen your muscles and decrease stress on your knee. Cool down and stretch after exercising.
  
  
• Keep your leg muscles strong by doing special exercises. Having strong calf, thigh and ankle muscles can help support your knee. Your caregiver can help you plan an exercise program to build your leg muscles and keep them strong.
  
  
• Wear shoes that fit correctly and support your feet. Replace your running or exercise shoes before the padding or shock absorption is worn out. Ask you caregiver which exercise shoes are best for you. Ask if you should wear special shoe inserts. Shoe inserts can help support your heels, arches, or keep your foot lined up correctly in your shoes. Exercise on even (flat) surfaces.
  
  
• Wear protective equipment. If you are playing a sport, wear the right type of protective gear. For example, wear pads and a helmet for football or hockey. Keep yourself in good physical shape to decrease the chance of injury while playing your sport.
  
  
• Stay at a normal weight. Ask your caregiver what weight is right for you. Ask for information about eating a healthy diet to help stay at the best weight for you.

CARE AGREEMENT:

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.

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