Knee Sprain

A sprain is a ligament injury. There are four main ligaments in the knee which are commonly injured. These are:

• Medial ligament sprain - on the inner knee joint.
• Lateral ligament sprain - on the outer knee joint.
• Anterior cruciate ligament sprain - deep inside the knee.
• Posterior Cruciate ligament sprain - deep inside the knee.

Severity:

• A grade 1 injury is a minor tear where up to 10% of the fibres are torn.
• A grade 2 injury is more severe and may be anything from 10 to 90% of the fibres being damaged. This can be broken down further into grade 2- and 2+.
• Grade 3 injuries are complete ruptures of the ligament.

Causes of Knee Sprains

Most knee sprains occur during a forceful movement at the knee, particulary twisting or side-ways movements which over-stretch the ligament.

Tackles in sports such as football and rugby are common examples. Also having the foot planted and twisting the upper body, such as in Netball pivoting, can lead to an ACL injury.

the MCL in particular can be injured as a result of long term stresses on the ligament, which tend to cause stretching and inflammation of the ligament, without an actual tear. This is caused by increased pressure on the inner knee, usually by faulty biomechanics. Overpronation at the foot, combined with weak hip abductors, result in the knee falling inwards and stressing the MCL.

Treatment

Treament of knee sprains is the same for grade 1 and 2 injuries although more severe injuries will take longer in each stage of treatment. Grade 3 injuries are more difficult to treat and may require surgery, especially if any other injuries are involved.

Stage 1:

• Rest, Ice, Elevate and Compress to reduce swelling, pain and bruising.
• If necessary, use crutches to enable the knee to rest and reduce the weight on the knee, until pain allows full weight bearing.
• You may be prescribed anti-inflammatory medications such as Ibuprofen to ease the pain.
• Mobility exercises can begin once pain allows. This involves gently bending the knee as far as is comfortable.

Stage 2:

• Continue with mobility exercises.
• Proceed to full weight bearing as soon as possible.
• A physical therapist may use techniques such as ultrasound or massage to help the ligament to heal.
• Strengthening exercises such as straight leg raises and contracting the quad and hamstring muscles are recommended to avoid a loss of muscle mass.

Stage 3:

• Full weight bearing should be possible by now.
• Start to increase the strengthening exercises to include squats and lunges etc.
• Balance exercises using a wobble board are also great at this point.