Definition of Knee Sprains

By definition, a knee sprain is an injury to a knee ligament. The sprain may var
y in severity from a slight stretch to a complete tear of the ligament.
A mild, or grade 1, sprain simply stretches the ligament and causes pain and swe
lling. A moderate, or grade 2, sprain partially tears the ligament and is much m
ore disabling. A severe, or grade 3, sprain is a complete rupture and often need
s surgical repair.

Description of Knee Sprains

Most ligament injuries of the knee involve a tearing of either the medial collat
eral ligament (MCL) on the medial side of the knee (medial means toward the midl
ine of the body, and lateral means away from the midline), the anterior cruciate
ligament (ACL) deep inside the joint, or both ligaments. The posterior cruciate
ligament (PCL) is much less likely to sustain an injury than the ACL.
Text Continues Below
--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

Causes and Risk Factors of Knee Sprains

The most commonly sprained ligament is the medial collateral ligament (MCL). Thi
s ligament can be sprained by a blow to the outside of the knee, particularly if
your foot is planted on the ground when you are hit. The blow causes the knee t
o move toward the inside of the body and stretches the ligament. You will feel t
enderness and pain on the inside of the knee, and the knee will feel like it may
buckle or give way to the inside. Anything more than minimal pain should be tre
ated by a doctor.
A sprain on the outside of the knee, the lateral collateral ligament, is caused
by a blow to the inside of the knee, which forces the knee to the outside. This
is much less common than an MCL sprain because it is hard to get hit on the insi
de of the knee. Usually, your leg gets in the way and takes the blow.

Athletic or occupational trauma is usually the cause of an ACL injury. Sports th

at involve sudden acceleration and deceleration, such as basketball, soccer, fie
ld hockey, football and skiing, are frequently associated with ACL injuries. Nev
ertheless, ACL injuries can occur in any sport if the knee undergoes acceleratio
n-rotation-type movement. Disability may be immediate because of pain and (frequ
ently) swelling, which sometimes appears as soon as 1 to 4 hours after injury. H
owever, immediate disability does not suggest the degree or severity of a partic
ular type of injury. Patients may report that the knee "gave way" or became unst
able; an audible "pop" raises the specter of an ACL tear.

A good rule of thumb for these injuries is: if you receive a blow to the knee an
d the pain is on the same side of the knee that was hit, it is probably just a b
ruise, and the pain will go away rapidly. If the pain is on the opposite side of
the knee, consider this a serious injury that needs careful treatment.

Treatment of Knee Sprains

Surgery is needed for patients who fall into the high or moderate risk category
based on job, recreational, and/or athletic demands. Surgery may be considered f
or patients who are not at high risk but who experience symptoms during everyday
activities, such as walking on uneven surfaces and performing simple twisting m
aneuvers. Before surgery, it is necessary to establish whether there is a full r
ange of motion in the knee; if there is significant atrophy of the quadriceps an
d hamstrings, an intensive retraining period should be instituted before surgery
.
It is not uncommon for patients with ACL-deficient knees to have had multiple pr
ocedures to remove articular or meniscal cartilage fragments. With the loss of t
hese secondary restraints, the knee becomes more unstable, and the patient may b
ecome a surgical candidate based on overall knee instability. Physical therapy m
ay help enhance balance and proprioception.

Rehabilitation
If the MCL sprain is a mild one, an early rehabilitation program using a station
ary bicycle and leg extension and curl exercises is all you need. Begin by ridin
g the bicycle for 20 minutes. Keep the seat high so that the range of motion is
minimal. Do not put any drag on the bike; you are simply interested in moving th
e knee. In the very beginning, you may not be able to pedal all the way around.
Just pedal back and forth until you can come over the top.

Do the leg extension while seated at a bench or a table. Once you lift the weigh
t, hold at full extension for three seconds, and then very slowly lower your leg
. Concentrate on the slow movement down, which is the most important part of the
lift. Muscle contraction against weight while the muscle is lengthened builds t
he most strength. Ten lifts make a set. Do five sets of this exercise and rest f
or 30 seconds or more, if needed, after each set.

Do the leg curl while lying on your stomach. Do 10 lifts per set for five sets.
If you are using a weight machine, you should hold for three seconds with the le
g bent. If you are using free weights, this is not necessary.

The purpose of these exercises is to strengthen the quadriceps muscles in the fr

ont of the thigh (leg extensions) and the hamstring muscles in the back of the t
high (leg curls). These muscles control the knee and must be restrengthened.

If you have a problem doing the leg extensions, that is, if your range of motion
is too limited or you find it too painful, then do isometric quadriceps exercis
es first.

Self Care
The immediate treatment for a sprained knee is the standard RICE formula. This i
s an acronym for Rest, Ice, Compression, and Elevation. These steps will help re
duce swelling and pain, and speed the healing process. Rest the knee while it ac
hes and ice it intermittently several times a day. Wrap it in an elastic bandage
in between icings, and keep it elevated as much as possible.

Questions To Ask Your Doctor About Knee Sprains

Where is the sprain located and how severe is it?
What treatment do you recommend?

What rehabilitation program do you recommend?

Will surgery be recommended?

Can conservative treatment be tried first?

Will the knee ligaments be permanently weak or susceptible to injury

Definition of Knee Sprains
By definition, a knee sprain is an injury to a knee ligament. The sprain may var
y in severity from a slight stretch to a complete tear of the ligament.
A mild, or grade 1, sprain simply stretches the ligament and causes pain and swe
lling. A moderate, or grade 2, sprain partially tears the ligament and is much m
ore disabling. A severe, or grade 3, sprain is a complete rupture and often need
s surgical repair.

Description of Knee Sprains

Most ligament injuries of the knee involve a tearing of either the medial collat
eral ligament (MCL) on the medial side of the knee (medial means toward the midl
ine of the body, and lateral means away from the midline), the anterior cruciate
ligament (ACL) deep inside the joint, or both ligaments. The posterior cruciate
ligament (PCL) is much less likely to sustain an injury than the ACL.
Text Continues Below
--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

Causes and Risk Factors of Knee Sprains

The most commonly sprained ligament is the medial collateral ligament (MCL). Thi
s ligament can be sprained by a blow to the outside of the knee, particularly if
your foot is planted on the ground when you are hit. The blow causes the knee t
o move toward the inside of the body and stretches the ligament. You will feel t
enderness and pain on the inside of the knee, and the knee will feel like it may
buckle or give way to the inside. Anything more than minimal pain should be tre
ated by a doctor.
A sprain on the outside of the knee, the lateral collateral ligament, is caused
by a blow to the inside of the knee, which forces the knee to the outside. This
is much less common than an MCL sprain because it is hard to get hit on the insi
de of the knee. Usually, your leg gets in the way and takes the blow.
Athletic or occupational trauma is usually the cause of an ACL injury. Sports th
at involve sudden acceleration and deceleration, such as basketball, soccer, fie
ld hockey, football and skiing, are frequently associated with ACL injuries. Nev
ertheless, ACL injuries can occur in any sport if the knee undergoes acceleratio
n-rotation-type movement. Disability may be immediate because of pain and (frequ
ently) swelling, which sometimes appears as soon as 1 to 4 hours after injury. H
owever, immediate disability does not suggest the degree or severity of a partic
ular type of injury. Patients may report that the knee "gave way" or became unst
able; an audible "pop" raises the specter of an ACL tear.

A good rule of thumb for these injuries is: if you receive a blow to the knee an
d the pain is on the same side of the knee that was hit, it is probably just a b
ruise, and the pain will go away rapidly. If the pain is on the opposite side of
the knee, consider this a serious injury that needs careful treatment.

Treatment of Knee Sprains

Surgery is needed for patients who fall into the high or moderate risk category
based on job, recreational, and/or athletic demands. Surgery may be considered f
or patients who are not at high risk but who experience symptoms during everyday
activities, such as walking on uneven surfaces and performing simple twisting m
aneuvers. Before surgery, it is necessary to establish whether there is a full r
ange of motion in the knee; if there is significant atrophy of the quadriceps an
d hamstrings, an intensive retraining period should be instituted before surgery
.
It is not uncommon for patients with ACL-deficient knees to have had multiple pr
ocedures to remove articular or meniscal cartilage fragments. With the loss of t
hese secondary restraints, the knee becomes more unstable, and the patient may b
ecome a surgical candidate based on overall knee instability. Physical therapy m
ay help enhance balance and proprioception.

Rehabilitation
If the MCL sprain is a mild one, an early rehabilitation program using a station
ary bicycle and leg extension and curl exercises is all you need. Begin by ridin
g the bicycle for 20 minutes. Keep the seat high so that the range of motion is
minimal. Do not put any drag on the bike; you are simply interested in moving th
e knee. In the very beginning, you may not be able to pedal all the way around.
Just pedal back and forth until you can come over the top.

Do the leg extension while seated at a bench or a table. Once you lift the weigh
t, hold at full extension for three seconds, and then very slowly lower your leg
. Concentrate on the slow movement down, which is the most important part of the
lift. Muscle contraction against weight while the muscle is lengthened builds t
he most strength. Ten lifts make a set. Do five sets of this exercise and rest f
or 30 seconds or more, if needed, after each set.

Do the leg curl while lying on your stomach. Do 10 lifts per set for five sets.
If you are using a weight machine, you should hold for three seconds with the le
g bent. If you are using free weights, this is not necessary.

The purpose of these exercises is to strengthen the quadriceps muscles in the fr

ont of the thigh (leg extensions) and the hamstring muscles in the back of the t
high (leg curls). These muscles control the knee and must be restrengthened.

If you have a problem doing the leg extensions, that is, if your range of motion
is too limited or you find it too painful, then do isometric quadriceps exercis
es first.

Self Care
The immediate treatment for a sprained knee is the standard RICE formula. This i
s an acronym for Rest, Ice, Compression, and Elevation. These steps will help re
duce swelling and pain, and speed the healing process. Rest the knee while it ac
hes and ice it intermittently several times a day. Wrap it in an elastic bandage
in between icings, and keep it elevated as much as possible.

Questions To Ask Your Doctor About Knee Sprains

Where is the sprain located and how severe is it?

What treatment do you recommend?

What rehabilitation program do you recommend?

Will surgery be recommended?

Can conservative treatment be tried first?

Will the knee ligaments be permanently weak or susceptible to injury