Part of UT Health San Antonio
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.
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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
- A blow to the outer or inner side of the knee
- A 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, 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 for stability and pain.
Images may be taken of your knee. This can be done with:
A minimally invasive procedure may be done to look inside of your knee. This is called an arthroscopy.
Grades
Knee sprains are graded according to their severity.
- 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
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Treatment
Treatment includes:
Rest, Ice, Compression, and Elevation
The RICE method may help reduce discomfort and swelling:
- R est—Avoid putting any pressure on your knee by not walking on that leg.
- I ce—Apply ice or a cold pack to the knee to reduce pain and swelling.
- C ompression—Wrap your knee in an elastic bandage to limit swelling.
- E levation—Keep the injured knee raised above the level of your heart. This will help drain fluid and reduce swelling.
Medication
Medication may help to manage discomfort. Options include:
- Over-the-counter pain medication
- Creams or patches that are applied over the area
Knee Support
Crutches may be needed to keep pressure off of the knee.
A brace may be recommended. Some may keep the knee from moving at all. Other braces may allow some movement and provide support when returning to activities. Braces are not advised for children.
Rehabilitation Exercises
Exercises may be advised to to help restore flexibility, range of motion, and strength. You may be referred to a physical therapist.
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.
RESOURCES:
American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org
Ortho Info—American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org
CANADIAN RESOURCES:
Canadian Orthopaedic Association
http://www.coa-aco.org
Canadian Orthopaedic Foundation
http://www.canorth.org
REFERENCES:
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.
Derry S, Moore RA, Gaskell H, McIntyre M, Wiffen PJ. Topical NSAIDs for acute musculoskeletal pain in adults. Cochrane Database Syst Rev.2015;(6):CD007402.
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.
Lowe WR, Warth RJ, Davis EP, Baily L. Functional bracing after anterior cruciate ligament reconstruction: a systematic review. J Am Acad Ortho Surg.2017;25(3):239-249
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, 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 11, 2018.
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.
Sprains and strains. National Institute of Arthritis and Musculoskeletal and Skin Diseases—National Institutes of Health website. Available at: https://www.niams.nih.gov/health-topics/sprains-and-strains. Updated January 30, 2015. Accessed June 11, 2018.
Last reviewed May 2018 by EBSCO Medical Review Board Laura Lei-Rivera, PT, DPT, GCS Last Updated: 2/7/2018