SPRAINED KNEE

QUESTIONS AND ANSWERS

Classification System

Any damage to a knee ligament is classified as a sprain by doctors, who grade the severity of the sprain using the following scale:

• Grade I: A person overstretches the ligaments in a modest grade 1 sprain, but the ligaments are still able to stabilize the knee joint.
• Grade II: A person with a moderate grade II sprain will have evidence of a partial ligament tear. When someone puts weight on the afflicted leg because the ligament is loose, the knee may feel unstable and different.
• Grade III: The most serious kind of sprain is a grade III. The ligament has completely torn here. It has a major loss of function and range of motion as well as severe instability. The leg may be difficult or impossible to bear weight on due to excessive swelling and bruising.

Long-Term Complications from ACL and PCL Sprains

ACL (anterior cruciate ligament) and PCL (posterior cruciate ligament) sprains are significant knee injuries that commonly affect athletes and active individuals. While these injuries often boast a positive recovery rate, it’s crucial to consider potential long-term complications.

Osteoarthritis Development

One of the principal concerns following an ACL or PCL sprain is the increased likelihood of developing osteoarthritis in the affected knee. This degenerative joint disease may take several years to manifest, often emerging long after the initial injury has healed. Patients may start noticing symptoms such as joint pain, stiffness, and reduced mobility, which can progressively worsen over time.

Structural Instability

Even though many recover fully, some individuals might experience persistent knee instability. This can result in a higher risk for future knee injuries, as the joint may not be as strong or stable as it was pre-injury.

Scar Tissue Build-Up

Additionally, scar tissue can develop around the ligaments during the healing process. This could restrict movement and cause discomfort or pain during physical activities. In some cases, this scar tissue might require further medical intervention to improve mobility.

Ongoing vigilance and proper management, including regular physical activity tailored to strengthen the knee, can help mitigate these complications. Consulting healthcare professionals for personalized advice can be beneficial in managing and reducing long-term risks.

Sprained Knee Symptoms

Depending on which ligament a person has strained in their knee, the associated symptoms may change. Also, the knee may snap and buckle as a result of damage to one of the ligaments, which can hurt and swell. A popping sound is frequently audible when some ligaments are torn. As the individual tries to stand on the leg, it can possibly give way. Swelling may also happen, often within 24-36 hours.

MCL Sprain Symptoms

If the MCL is sprained, you’ll likely experience:

• Knee pain and swelling: Often localized to the inner side of the knee.
• Knee buckling toward the outside: This instability is a key indicator of MCL issues.
• Tenderness over the torn MCL: Particularly noticeable at the inner side of the knee.

According to our doctors and surgeons, the interior of the knee will hurt if MCL damage develops. If the LCL is injured, the pain occurs on the outside of the knee. Multiple knee ligament sprains, sometimes known as the “unhappy trifecta,” can accompany ACL damage.

Recognizing Symptoms of a PCL Sprain

A Posterior Cruciate Ligament (PCL) sprain can manifest through several noticeable symptoms. Understanding these signs can help identify the condition early and seek appropriate care. Here’s what to watch for:

• Swelling: You may see some swelling around the knee, which can appear mild but noticeable, potentially affecting the joint’s movement.
• Knee Stability: Even slight instability or a feeling of the knee being unstable or giving way can occur. This is often more evident during physical activity.
• Restricted Motion: Flexibility might be slightly compromised, making it challenging to move the knee fully, which can interfere with daily activities.
• Pain: Discomfort usually arises at the back of the knee. This pain tends to intensify when performing actions such as kneeling, bending, or placing weight on the joint.

These indicators can sometimes overlap with other knee issues, so it’s essential to consult a healthcare professional for a precise diagnosis if you notice these symptoms.

Symptoms of an LCL Sprain

• Knee Pain and Swelling: Pain typically manifests on the outer side of the knee.
• Knee Buckling: The knee may buckle toward the inside, leading to instability.
• Tenderness: There is often an area of tenderness over the torn LCL, specifically at the outer side of the knee.

Understanding these distinct symptoms helps in distinguishing an LCL sprain from other ligament injuries, offering clarity for a more accurate diagnosis and effective treatment plan.

Symptoms of an ACL Sprain

If you’re wondering what signals an ACL sprain, here are the key symptoms to watch for:

• Audible Pop: You might hear or feel a pop in your knee right when the injury occurs.
• Swelling: Noticeable swelling typically develops within hours after the injury. It’s important to monitor this as it can indicate an ACL tear.
• Intense Pain: The pain can be so severe that it stops you from continuing with activities, especially high-impact sports.
• Bruising: Expect to see bruising around the knee area, appearing as black-and-blue marks.
• Knee Instability: A common sensation is feeling that your knee might collapse or give way under pressure, making standing difficult.

Each of these symptoms can vary in intensity, but they commonly point towards an ACL strain, requiring prompt attention. It’s advisable to consult a healthcare professional for a precise diagnosis and treatment plan.

Causes of Each Type of Sprain Knee

When the knee undergoes a forceful muscular contraction or makes direct contact with anything, it sprains. For instance, this injury might occur when a runner changes direction too rapidly or while participating in sports.

Cruciate Ligaments

The ACL is the knee ligament that sustains injuries the most frequently. When a person abruptly changes directions, usually while moving quickly, the ACL may be injured. It often happens during activities like a sudden stop, a twist or pivot, or a change in direction at the joint. Additionally, extreme over-straightening, known as hyperextension, can also lead to an ACL sprain. The knee may also suffer from a blunt force, such as during a tackle in football. These injuries are common among athletes in sports like football, basketball, soccer, rugby, wrestling, gymnastics, and skiing.
In instances where the front of the knee is directly contacted, such as in football, PCL injuries frequently occur.

The PCL works closely with the ACL to stabilize the knee. It most often sprains due to a direct impact to the front of the knee, like hitting the knee on the dashboard in a car crash or landing hard on a bent knee during sports. Athletes in football, basketball, soccer, and rugby commonly experience PCL injuries. By understanding these mechanisms and sports associations, athletes and enthusiasts can better prepare and protect their knees from these common injuries.

Collateral Ligaments

These ligament injuries usually occur when a force pushes the knee sideways. When there is a direct blow to the outside of the knee, it can result in an MCL ligament injury. Also, MCL injuries can occur with improper landings that put a “valgus” force on the knee. Furthermore, a blow to the inside of the knee can push the knee outward and damage the LCL. Lateral collateral ligament injuries are common in contact sports.

Sprained Knee Treatment

Depending on the extent of your child’s injury and the specific area of the knee that was hurt, your doctor will advise a course of therapy.

Pain medication

Our doctor may recommend over-the-counter pain relievers such as acetaminophen.

Rest

Avoid doing anything that puts too much strain on your child’s knee and puts him or her in danger of further injuring it. Playing sports should be avoided until the knee is healed.

While sitting or sleeping, parents can also prop their child’s leg up on pillows to get it higher than the heart to help reduce the swelling.

Ice for a knee sprain

To minimize swelling, apply an ice pack to the knee for 20 minutes every few hours (but check with our doctor first, especially if your child has diabetes). The ice might also halt any internal bleeding and reduce pain.

Compression

With caution, avoid wrapping your child’s knee too tightly with an elastic bandage, as this might prevent blood flow and cause additional swelling. Loosen the bandage if it causes swelling in the lower leg, knees to go numb, or the wrap causes more pain.

Immobilization of a knee sprain

Our doctor might suggest that you immobilize or stop your child from moving the knee for a short while. This gives your child’s body time to recover naturally and enables any swelling and soreness to go down. Our doctor might recommend wearing a brace over your child’s knee to support and protect the joint as it recovers. Additionally, most braces have movable pieces and extend above and below the knee; their main function is to allow your child to walk and gently flex the knee while wearing them. Your child can’t move his or her knee from side to side or overextend the joint in any way while wearing the brace.

Removing Fluid from the joint to reduce swelling

If your child’s symptoms include swelling, warmth, or redness, your doctor may recommend a procedure called a joint aspiration to remove fluid from the joint. During a joint puncture, doctors first inject a small amount of a local anesthetic to numb the skin, then insert the needle into the fluid-filled joint space. Your doctor will remove the fluid through the needle. This often helps relieve knee pain.

Knee sprain workouts and physical therapy

Depending on the severity of your child’s injury and where your child is in healing, a doctor or physical therapist may advise the following exercises:

• leg lifts
• thigh strengthening
• knee bending
• raising on toes
• thigh and calf stretches
• using the leg press and hamstring curl machines for weight training

Non-Surgical Treatments for a Knee Sprain

The majority of knee sprains are treatable with non-surgical methods that focus on restoring the knee’s full strength.

Physical therapy. After initial treatment to reduce pain, knee sprains are commonly treated with physical therapy. Physical therapy combines exercises to strengthen the knee with activities to increase flexibility and restore knee flexibility. His two main components of physical therapy are:

Weight training: The physical therapist will have the patient lift small amounts of weight in repetitive sets. This exercise may include resistance bands, weighted braces, or exercise equipment that affects the knee joint. Over time, increase the number of repetitions and the weight lifted in a controlled and progressive manner.

Stretching for flexibility. A therapist may want to periodically measure a particular athlete’s range of motion and offer stretches to increase the range of motion. A return to a fully normal range of motion and flexibility usually indicates that the athlete is almost ready to return to exercise training.

The length and form of your child’s physical therapy program will depend on several factors, including age, medical history, general health, and the degree of knee sprain.

Surgery for a Knee Sprain

Severe knee sprains may require surgery to repair damaged ligaments. Surgery is usually only recommended if the knee sprain is Grade III (complete ligament tear). Surgical repair of knee ligaments is usually performed arthroscopically, which is a minimally invasive approach. In arthroscopic surgery, a small incision (usually less than 1.2 cm) is made in front or behind the knee, and a very small medical camera is inserted into the leg. The camera helps the doctor evaluate the degree of a knee injury. Once this is done, a small tool is also inserted into the knee to remove or repair damaged tissue.

What is the Prognosis for People with ACL and PCL Injuries?

For individuals dealing with Anterior Cruciate Ligament (ACL) injuries, the outlook is quite promising with the right approach. Approximately 90% of those affected can anticipate a complete recovery when they undergo appropriate treatment combined with a robust physical therapy regimen.

When it comes to Posterior Cruciate Ligament (PCL) injuries, the prognosis is also favorable. Around 80% of individuals with PCL injuries can expect a full recovery. This positive outcome largely depends on receiving comprehensive care and participating in an effective rehabilitation program.

Key Techniques for Knee Sprain Rehabilitation

• Physical Therapy: Engaging in targeted exercises enhances strength and stability.
• Personalized Care: Tailored treatment plans aid in addressing individual needs.
• Consistent Monitoring: Regular check-ups ensure steady progress.

Both ACL and PCL injuries have strong recovery prospects, making a return to normal activities highly achievable with diligent effort and proper management.

Understanding Knee Sprain Recovery Times

Recovering from a knee sprain can vary greatly depending on several factors, including the specific type of strain, its severity, your rehabilitation regimen, and the athletic activities you engage in. Here’s a closer look at typical recovery durations:

Mild Sprains (Grade I and II)

For less severe injuries, such as Grade I and II medial collateral ligament (MCL) or lateral collateral ligament (LCL) sprains, healing is generally quicker. Most individuals can expect recovery within 2 to 4 weeks, assuming adherence to appropriate treatment protocols.

Severe Sprains (Grade III and Beyond)

More serious knee sprains, or those involving other parts of the knee, can require a more extended recovery period. In these cases, healing may take anywhere from 4 to 12 months. This prolonged duration often involves intensive rehabilitation and careful management to ensure successful healing.

Quick Recovery Tips

• Adhere to R.I.C.E.: Rest, ice, compression, and elevation can accelerate recovery, especially in the early stages.
• Follow Professional Guidance: Working closely with a physical therapist can optimize your rehabilitation program.
• Pace Your Return: Gradually reintegrating into activities can help prevent re-injury.

By understanding these timelines and following a structured recovery plan, you can support your knee’s healing process and safely return to your favorite sports and activities.

What Strategies Can Help Prevent Sports-Related Knee Injuries?

When it comes to protecting your knees during sports, a proactive approach is key. Here are some strategies to help keep your knees safe and sound:

1. Warm-Up and Stretching:
Starting any athletic activity with a proper warm-up is essential. Engage in dynamic stretches to loosen up your muscles and prepare your body for physical exertion. This reduces the risk of strains and injuries.

2. Strengthening Leg Muscles:
Focus on exercises that build strength in your leg muscles, particularly the quadriceps. Stronger muscles provide better support to your knees and help in stabilizing your legs during various movements.

3. Gradual Progression in Training:
Adopt a cautious approach to your training intensity. It’s important to increase your workouts gradually. Avoid the temptation to push too hard too quickly, which can strain your knees.

4. Appropriate Footwear:
Choosing the right shoes can make a significant difference. Wear shoes that offer support and comfort tailored to your specific sport. If you experience any foot alignment issues, consult a professional about orthotic inserts for better support.

5. Sport-Specific Equipment:
For sports like football and skiing, using the appropriate equipment is crucial. For example, football players can benefit from specialized cleats designed to reduce the risk of knee injuries. Skiers should ensure their bindings are correctly adjusted and compatible with their boots.

6. Use of Knee Braces:
If you’re prone to knee issues, consider using a knee brace. This can help provide additional support and may prevent future injuries, especially if you have a history of sprains.

Implementing these strategies can significantly reduce your risk of knee injuries, keeping you active and in the game.

Why Choose Medical City Children’s Orthopedics and Spine Specialists

Orthopedics is a specialty of the doctors and surgeons at Medical City Children’s Orthopedics and Spine Specialists. They understand your concerns, can answer your questions regarding your child’s condition, and know how to use their specialized knowledge and training to find a medical solution.  Richard Hostin, MD, Shyam Kishan, MD, and Kathryn Wiesman, MD, specialize in children and are considered to be the very best by many children’s doctors.

The following are just a few of the many reasons why patients might choose Medical City Children’s Orthopedics and Spine Specialists.

• Expertise in the spine: Our team comprises several spine experts. The team of specialists is spine experts.  They specialize in the diagnosis and treatment of spinal conditions, ensuring the best possible care for their patients.
• Cutting-edge technology: Our practice uses the latest technology and techniques to diagnose and treat a wide range of conditions.  In addition, we use minimally invasive procedures that reduce pain and promote faster recovery.
• Comprehensive care: Our practice offers a full range of services, from diagnostic imaging and physical therapy to surgery.  We ensure that patients receive complete, seamless care for their spinal conditions.
• Dedicated facilities: Medical City Children’s Orthopedics and Spine Specialists is dedicated to providing patients with a safe and comfortable environment.

Finally, our board-certified physicians and fellowship-trained orthopedic surgeons use the full range of treatments to treat their patients. Medical City Children’s Orthopedics and Spine Specialists are experts with offices in Dallas, Arlington, Flower Mound,  Frisco, and McKinney, TX,  and offer cutting-edge technology, full and expert care, and modern facilities to ensure the best possible care for their patients. Call today to make an appointment for your child.

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Footnote:

WebMD: Sprained Knee