All About Knee Sprains

1) What is a Sprained Knee?

A sprained knee is a common form of knee injury. The knee joint is made up of four ligaments, namely the lateral collateral ligament, medial collateral ligament, posterior cruciate ligament, and anterior cruciate ligament (popularly known as the ACL). These ligaments give support to the knee joint and help us to turn, walk, and twist. When one or more of these ligaments are injured, it results in knee sprain. So, knee sprain is defined as an injury or damage to the ligaments or fibers surrounding the knee joint. Injury may be due to tearing or sudden stretching of the ligaments during a twisting movement. The medial collateral ligament is the ligament which is most commonly affected during a knee sprain. Lateral collateral ligament injury is a very rare form of injury as it occurs only during accelerated rotation as opposed to other types of movement.

 

2) Grades of Knee Sprain

There are three grades of knee sprain. In grade 1, few fibers are damaged which heals on its own and does not need any medical assistance. In grade 2, damage occurs to more fibers with the ligament being intact which requires treatment. In grade 3, rupture of the ligament takes place.  A grade 3 sprained knee typically requires surgery.

 

The general causes of knee sprain are abnormal twisting of the knee and abrupt movement of the knee during sports which include running, changing direction, and jumping. Knee sprain commonly occurs in sports such as hockey, basketball, skiing, and football due to hyperextension of the knee. Knee sprain also occurs due to direct hits to the back, sides, or front of the knee, usually occurring during a football tackle. Falling or tripping when the knees are bent also causes sprained knee.

 

3) Signs and Symptoms of a Sprained Knee

Symptoms of knee sprain are generally experienced immediately, but the symptoms can show even after two days of injury. The symptoms experienced depend on the severity of the knee sprain.  You can identify knee sprain with the following signs and symptoms:

- inability to move the knee

- stiffness

- pain

- tenderness

- painful popping sounds that can be heard

- swelling

- bruising

- knee buckling when walking

 

4) First Aid of a Knee Sprain

First aid in case of an emergency can be done to prevent exacerbation of the injury and its symptoms. First aid is given to control pain and swelling of the knee area. The P.R.I.C.E method should be followed during first aid treatment. P.R.I.C.E means protect, rest, ice, compress, and elevate.

Protect – Splints, braces, bandages, and crutches are used to restrict the movement of the knee joint thereby preventing further injury to the ligament.

Rest – Rest speeds up the healing process, but complete bed rest should be avoided in order to prevent deconditioning. Three-limb exercises which include the use of arms and the uninjured leg can be done to regulate conditioning of the heart. Rest should be given to the injured knee with keeping weight off the knee until the pain fades away.

Ice – Icing the injured area helps in reducing swelling and redness since ice causes constriction of blood vessels. Immediately after the injury, an ice pack can be applied to the area. Ice can be wrapped in a towel and applied to the affected area. It is applied for 15 t0 20 minutes at a time for 2 days.

Compression – Compressing the affected area also helps in reducing swelling of the knee joint. This can be done with the use of elastic bandage and compressive sleeves or wraps. Elastic and neoprene bandages are the best for knee sprain. Wrapping the knee in criss-cross direction will provide effective results. The elastic bandage can be loosened or tightened according to the comfort of the individual. The bandage should not be very tight causing numbness or tingling.

Elevation – Elevation helps to relieve the pain as well as swelling of the affected area. Supporting and propping the knee with few pillows will provide relief. Excess fluid is drained back into the body through elevation. Lying down and raising the leg higher than the heart level is very effective. Elevation can be continued until the swelling decreases and can be done overnight and even during the day.

 

5) Caring for a Sprained Knee

Over-the-counter pain medications and nonsteroidal antiinflammatory drugs such as ibuprofen, naproxen, aspirin, acetaminophen, and indomethacin are also administered to provide pain relief and decrease swelling. Braces, bandages, and crutches can be used until weight-bearing can be tolerated. Heat should be applied on the joint after some time to bring back flexibility to the joint.

If the sprain does not improve, it is better to get medical assistance. In case of severe knee sprain, it is advisable to consult a physician or orthopedist who will diagnose the severity of the sprain using imaging such as MRI. The physician will advise rehabilitation exercises including physical therapy, range of motion exercises, and strengthening exercises.

If there is a possibility of infection, the synovial fluid from the knee joint is drained out with the help of a needle and syringe assembly and sent to pathology for the presence of any infectious organisms. In case of a ligament rupture, reconstruction surgery using a graft from a donor is the only option to recover from the injury.

 

6) Preventing Knee Sprain

There are some steps to prevent sprained knee.  Her are a few suggestions:

- warming-up and stretching before exercising

- strengthening calf and ankle muscles

- wearing correct shoes with appropriate shock absorption and shoe inserts

- wearing required protective gear for sports

- maintaining appropriate body mass index

- avoiding sudden increase in the intensity of physical exercises

- using specially designed shoe cleats during sports

- using two-mode release bindings during skiing

Strengthening of the lower body also helps in preventing knee sprains. This includes strengthening of the quadricep muscles, gluteal muscles, hamstring muscles and calf muscles which play a vital role in supporting the knee joint. Athletes are the most frequently affected by knee sprain, so taking care during sports can prevent the occurrence of knee sprain.

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