Lets Start The Treatment
You may have knee pain due to a minor sprain or strain that will get better over time with treatments you can do on your own. But, then again, it can be quite hard to predict these things.
- Try the “traditional” route:
- Rest avoid those activities that you think may have triggered the knee pain
- Ice (for the first 48 hrs. after a minor injury)
- Ointments or creams, such as Ben Gay or Icy Hot
- Brace/ACE wrap — you can find these in surgical supply stores or many drug stores
- Non-prescription pain relievers, such as acetaminophen or ibuprofen (unless your doctor has instructed you to avoid these).
- If your knee pain persists, return to this decision guide for more information. In the meantime, try the treatments above and for more information on knee strains and sprains read this article.
- Knee Sprain
What Is Strain?
A muscle strain is the stretching or tearing of muscle fibers. Most muscle strains happen for one of two reasons: either the muscle has been stretched beyond its limits or it has been forced to contract too strongly. In mild cases, only a few muscle fibers are stretched or torn, and the muscle remains intact and strong. In severe cases, however, the strained muscle may be torn and unable to function properly. To help simplify diagnosis and treatment, doctors often classify muscle strains into three grades, depending on the severity of muscle fiber damage:
Grade I strain In this mild strain, only a few muscle fibers are stretched or torn. Although the injured muscle is tender and painful, it has normal strength.
Grade II strain This is a moderate strain, with a greater number of injured fibers and more severe muscle pain and tenderness. There is also mild swelling, noticeable loss of strength, and sometimes a bruise.
Grade III strain This strain tears the muscle all the way through, sometimes causing a “pop” sensation as the muscle rips into two separate pieces or shears away from its tendon. Grade III strains are serious injuries that cause complete loss of muscle function, as well as considerable pain, swelling, tenderness and discoloration. Because Grade III strains usually cause a sharp break in the normal outline of the muscle, there may be an obvious “dent” or “gap” under the skin where the ripped pieces of muscle have come apart.
Almost all types of athletic activity carry some risk of muscle strains, but these injuries tend to happen most often in contact sports, such as football, and in sports that require quick starts, such as basketball and tennis. Among high school athletes, strains account for about one-third of all injuries in baseball and about 25% of all injuries in soccer, football and volleyball. you also can strain a muscle by lifting a heavy carton or by simply stepping off a curb. In the United States, strains and sprains account for more than 4.5 million doctor visits every year. More than one-third of these injuries happen to active young adults between the ages of 25 and 44. Men are about 30% more likely to be injured than women.
Symptoms of muscle strain include:
- Muscle pain and tenderness, especially after an activity that stretches or violently contracts the muscle Pain usually increases when you move the muscle but is relieved by rest.
- Muscle swelling, discoloration or both
- Muscle cramp or spasm
- Either a decrease in muscle strength or (in Grade III strains) a complete loss of muscle function
- A pop in the muscle at the time of injury
- A gap, dent or other defect in the normal outline of the muscle (in Grade III strain)
- Expected Duration
How long a sprain lasts depends on the location and severity of the injury. Symptoms of a mild back strain usually improve within one to two weeks and are gone within four to six weeks. In the legs, mild or moderate strains may take up to 8 to 10 weeks or more to heal. Symptoms of a severe (Grade III) strain may persist until the torn muscle is repaired surgically.
To help prevent muscle strains:
- Warm up before participating in sports and activities.
- Follow an exercise program aimed at stretching and strengthening your muscles.
- Increase the intensity of your training program gradually. Never push yourself too hard, too soon.
- Maintain a healthy body weight. Obesity can stress muscles, especially in your legs and back.
- Practice good posture when you sit and stand.
- Use the correct technique when you lift heavy loads.
If you have a Grade I or Grade II strain, your doctor will ask you to follow the RICE rule:
- Rest the injured muscle (and take a temporary break from sports activities).
- Ice the injured area to reduce swelling.
- Compress the muscle with an elastic bandage.
- Elevate the injured area.
To help relieve muscle pain and swelling, your doctor may prescription pain medications or muscle relaxants. If you have a severe Grade II or Grade III strain, your doctor may refer you to an orthopedic specialist. Depending on the severity and location of your muscle strain, the orthopedist may immobilize the injured muscle in a cast for several weeks or repair it surgically. Whether your strain is mild or severe, your treatment will not be complete until you finish a rehabilitation program aimed at restoring normal movement and strength to your injured muscle.
When To Call A Professional ?
Call your doctor promptly if:
- You hear or feel a pop in your muscle at the time of injury.
- You have severe pain, swelling or discoloration in the injured muscle.
- Your injured muscle is obviously weak or has difficulty moving compared to the same muscle on the opposite side of your body.
- You have mild muscle symptoms that do not improve after 48 hours.
- You have severe back pain that makes it impossible for you to perform normal daily activities, or you have mild back pain that worsens after a few days.
- You are being treated for a strained back, and your symptoms do not improve within two weeks.
- You have back pain together with any of the following symptoms, which can signal a medical problem that is more serious than a mild back strain:
- Fever or chills
- Pain or a burning feeling when you urinate
- Sudden weakness, numbness or tingling in a leg
- Numbness in your groin or rectum
- Difficulty controlling your bladder or bowel function
Recovery depends on the location and severity of your muscle strain. In general, almost all Grade I strains heal within a few weeks, whereas Grade II strains may take two to three months or longer. After surgery to repair a Grade III strain, most people regain normal muscle function after several months of rehabilitation.
What Is Sprain?
A knee sprain is an injury of the ligaments, tough bands of fibrous tissue that connect the bones of the upper and lower leg at the knee joint. The knee joint has four major ligaments.
Anterior cruciate ligament (ACL) The ACL and the posterior cruciate ligament (PCL) bridge the inside of the knee joint, forming an “X” pattern that stabilizes the knee against front-to-back and back-to-front forces. The ACL typically sprains during one of the following knee movements: a sudden stop; a twist, pivot or change in direction at the joint; extreme over straightening (hyperextension); or a direct impact to the outside of the knee or lower leg. These injuries are seen among athletes in football, basketball, soccer, rugby, wrestling, gymnastics and skiing.
Posterior cruciate ligament (PCL) The PCL works with the ACL to stabilize the knee. It most often sprains because of a direct impact to the front of the knee, such as hitting the knee on the dashboard in a car crash or landing hard on a bent knee during sports. In athletes, PCL injuries are most common among those who play football, basketball, soccer and rugby.
Medial collateral ligament (MCL) The MCL supports the knee along the inner side of the leg. Like the ACL, the MCL can be torn by a direct sideways blow to the outside of the knee or lower leg, the kind of blow that can happen in football, soccer, hockey and rugby. The MCL can be injured by a severe knee twist during skiing or wrestling, particularly when a fall twists the lower leg outwards, away from the upper leg.
Lateral collateral ligament (LCL) The LCL supports the outer side of the knee. It is the least likely knee ligament to be sprained because most LCL injuries are caused by a blow to the inside of the knee, and that area usually is shielded by the opposite leg.
Like other types of sprains, knee sprains are classified according to a grading system:-
Grade I (mild) This injury stretches the ligament, which causes microscopic tears in the ligament. These tiny don’t significantly affect the overall ability of the knee joint to support your weight.
Grade II (moderate) The ligament is partially torn, and there is some mild to moderate instability (or periodic giving out) of the knee while standing or walking.
Grade III (severe) The ligament is torn completely or separated at its end from the bone, and the knee is more unstable.
When one knee ligament suffers a serious sprain, there is a good chance that other parts of the knee may also be injured. For example, because the MCL helps to protect the ACL from certain types of extreme knee forces, the ACL can become vulnerable to injury when the MCL is torn. In more than half of moderate or severe MCL sprains, the ACL also is sprained.
Knee sprains are very common in the United States. ACL sprains alone affect 100,000 to 250,000 Americans each year. MCL injuries probably are even more common than ACL sprains, but many are so mild that they don’t result in a visit to a doctor.
More than any other group, competitive athletes have a very high risk of knee sprains and other types of knee problems. In U.S. high schools, the knee is the most frequently injured joint among athletes who compete in football, soccer or wrestling. The knee is the most frequently injured joint among college wrestlers, and almost 40% of these injuries involve a torn ligament. Among alpine skiers, knee trauma accounts for 20% to 36% of all skiing injuries and typically involves some degree of damage to the ACL.
Symptoms of a knee sprain vary depending on the specific ligament that is torn:
- A pop inside your knee at the moment of injury
- Significant knee swelling within a few hours after injury
- Severe knee pain that prevents you from continued participation in your sport
- Black-and-blue discoloration around the knee
- Knee instability the feeling that your injured knee will buckle or give out if you try to stand
- Mild knee swelling, with or without knee instability
- Mild difficulty in moving the knee
- Mild pain at the back of the knee that worsens when you kneel
- Knee pain and swelling
- Knee buckling toward the outside
- An area of tenderness over the torn MCL (at the inner side of the knee)
- Knee pain and swelling
- Knee buckling toward the inside
- An area of tenderness over the torn LCL (at the outer side of the knee)
How long a knee sprain lasts depends on the type of knee sprain, the severity of your injury, your rehabilitation program and the types of sports you play. In general, milder Grade I and Grade II MCL or LCL sprains heal within 2 to 4 weeks, but other types of knee sprains may take 4 to 12 months.
- To help prevent sports-related knee injures, you can:
- Warm up and stretch before you participate in athletic activities.
- Do exercises to strengthen the leg muscles around your knee, especially the quadriceps.
- Avoid sudden increases in the intensity of your training program. Never push yourself too hard, too fast. Increase your intensity gradually.
- Wear comfortable, supportive shoes that fit your feet and fit your sport. If you have problems in foot alignment that may increase your risk of a twisted knee, ask your doctor about shoe inserts that can correct the problem.
- If you play football, ask your sports medicine doctor or athletic trainer about specific types of shoe cleats that may help reduce your risk of knee injuries.
- If you ski, use two-mode release bindings that are properly installed and adjusted. Make sure that the binding mechanism is in good working order and that your boots and bindings are compatible.
If you have a Grade I or Grade II knee sprain, your doctor probably will recommend that you follow the RICE rule:
- Rest the joint.
- Ice the injured area to reduce swelling.
- Compress the swelling with an elastic bandage.
- Elevate the injured knee.
Your doctor may suggest that you wear a knee brace for a short period of time and that you take a no steroidal anti-inflammatory drug (NSAID), to relieve pain and ease swelling. As your knee pain gradually goes away, your doctor will prescribe a rehabilitation program to strengthen the muscles around your knee. This program should help to stabilize your knee joint and prevent you from injuring it again.
If you have a Grade III knee sprain or if multiple ligaments are injured, treatment depends on the specific type of sprain:-
Grade III ACL or PCL sprain Your torn ligament may be reconstructed surgically using either a piece of your own tissue (auto graft) or a piece of donor tissue (allograft). Almost all knee reconstructions use camera-guided (arthroscopic) surgery.
Grade III MCL sprain This injury usually is treated conservatively with RICE, NSAIDs (such as ibuprofen) and physical therapy. In certain cases, surgery may be used to repair a torn MCL.
Grade III LCL sprain In a severe LCL sprain, the torn ligament often is repaired surgically.
Simultaneous injury of multiple ligaments Your doctor will discuss the various surgical options available.
When To Call A Professional ?
If you injure your knee, call your doctor to request an urgent evaluation if the knee:
- Becomes very painful or swollen
- Cannot bear weight
- Feels as if it will buckle or give out
About 90% of people with ACL injuries and 80% with PCL injuries can expect a full recovery after proper treatment and a good physical therapy program. Almost all MCL sprains and most LCL sprains have an excellent prognosis.
As a long-term complication, some people with ACL or PCL sprains eventually develop pain from osteoarthritis in the injured knee joint. This symptom may not start until 15 to 25 years after the initial knee injury.