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Knee Sprain

Definition

A knee sprain is the stretching or tearing of ligaments that support the knee. Ligaments are strong bands of tissue that connect bones to each other.

Ligaments of the Knee
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Causes

Knee sprains may be caused by:

  • Forced twisting of the knee
  • Stopping suddenly while running
  • Shifting your weight while running or skiing
  • Landing awkwardly after jumping
  • Blow to the outer or inner side of the knee
  • Blow to the front of the knee while the knee is bent and the foot is firmly planted on the ground

Risk Factors

Factors that may increase your chance of developing a knee sprain include:

  • Playing sports
  • Poor coordination
  • Poor balance
  • Inadequate flexibility and strength in muscles and ligaments
  • Loose joints

Symptoms

Symptoms include:

  • Pain in the knee
  • Swelling, redness, warmth, or bruising around the knee
  • Decreased range of motion in the knee
  • Inability to stand on the affected leg
  • Tenderness where the injured ligament attaches to a bone in the knee
  • Swelling within the knee

Diagnosis

You will be asked about your symptoms and how the injury occurred. The knee will be checked to see how stable the joint is and how severe the pain is.

Images may be taken of your bodily structures. This can be done with:

A minimally invasive procedure may be done to look inside of your knee. This can be done with arthroscopy .

Grades

Knee sprains are graded according to their severity. The injury is considered more severe if more ligaments are involved.

  • Grade 1
    • Stretching and micro-tearing of ligament tissue
  • Grade 2
    • Partial tearing of ligament tissue
    • Mild instability of the joint when tested
  • Grade 3
    • Severe or complete tearing of ligament tissue
    • Significant instability of the joint
Grade 2 Sprain of Knee
Sprained ligament knee
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Treatment

Treatment includes:

Rest, Ice, Compression, and Elevation

The RICE method may help reduce discomfort and swelling:

  • Rest—Avoid putting any pressure on your knee by not walking on that leg.
  • Ice—Apply ice or a cold pack to the knee to reduce pain and swelling.
  • Compression—Wrap your knee in an elastic bandageto limit swelling and provide support.
  • Elevation—Keep the injured knee raised above the level of your heart. This will help drain fluid and reduce swelling.

Medication

Over-the-counter pain medication or topical pain medications in the form of creams or patches can be applied to the skin to reduce discomfort.

Knee Support

A brace may keep the knee from moving. Crutches may also be used with the brace. A brace may be needed when returning to sports. It may need to be custom made to support your knee rather than keep it from moving. Braces are not advised for children.

If you have a severe sprain, you may need to wear a short leg cast for 2-3 weeks.

Rehabilitation Exercises

Exercises may be advised to restore flexibility, range of motion, and strength. A referral to a physical therapist may be needed.

Surgery

Surgery may be needed if a ligament is torn completely.

Prevention

To reduce the risk of knee sprains:

  • Warm up and stretch before exercise. Cool down and stretch after exercise.
  • Take a break from sports and exercise when you feel tired.
  • Do exercises that strengthen the leg muscles.
  • Learn the proper technique for sports and exercise. This will decrease stress on all muscles, ligaments, and tendons, including those around the knee. Also, wear the proper equipment.
  • Ask your doctor if you should use a brace.

Revision Information

  • American Orthopaedic Society for Sports Medicine

    http://www.sportsmed.org

  • Ortho Info—American Academy of Orthopaedic Surgeons

    http://orthoinfo.aaos.org

  • Canadian Orthopaedic Association

    http://www.coa-aco.org

  • Canadian Orthopaedic Foundation

    http://www.canorth.org

  • Birmingham TB, Bryant DM, Griffin JR, et al. A randomized controlled trial comparing the effectiveness of functional knee brace and neoprene sleeve use after anterior cruciate ligament reconstruction. Am J Sports Med. 2008;36(4):648-655.

  • Donnell-Fink LA, Klara K, Collins JE, et al. Effectiveness of knee injury and anterior cruciate ligament tear prevention programs: A meta-analysis. PLoS ONE. 2015;10(12):e0144063. Available at : http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0144063. Accessed June 2, 2016.

  • Martin TJ. American Academy of Pediatrics: Technical report: knee brace use in the young athlete. Pediatrics. 2001;108:503-507.

  • Najibi S, Albright JP. The use of knee braces, part 1: prophylactic knee braces in contact sports. Am J Sports Med. 2005;33:602-611.

  • Petersen W, Braun C, et al. A controlled prospective case control study of a prevention training program in female team handball players: the German experience. Arch Orthop Trauma Surg. 2005;125:614-621.

  • Rayan F, Bhonsle S, et al. Clinical, MRI, and arthroscopic correlation in meniscal and anterior cruciate ligament injuries. Int Orthop. 2009 Feb;33(1):129-132.

  • Roth J and Taylor DC. Management of acute isolated medial and posteromedial instability of the knee. Sports Med Arthroscopy Rev.2015;23(2):71-76.

  • Sprains and strains: what's the difference? Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00111. Updated July 2015. Accessed June 2, 2016.

  • Sprains, strains and other soft-tissue injuries.Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://www.orthoinfo.org/topic.cfm?topic=A00111. Updated July 2015. Accessed June 2, 2016.

  • Sugimoto D, Myer GD, Micheli LJ, Hewett TE. ABCs of evidence-based anterior cruciate ligament injury prevention strategies in female athletes. Current Phys Med Rehabil Rep. 2015;3(1):43-49.

  • What are sprains and strains? National Institute of Arthritis and Musculoskeletal and Skin Diseases—National Institutes of Health website. Available at: http://www.niams.nih.gov/Health%5FInfo/Sprains%5FStrains/sprains%5Fand%5Fstrains%5Fff.pdf. Accessed June 2, 2016.

  • 1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.