How to treat a knee sprain?

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A lot of patients consult in physiotherapy for knee sprains. This injury occurs during false movements where the knee suffers a torsion or an excessive movement that causes structural damage.

The structures

The knee is composed of the femur, patella, tibia and fibula. Ligaments are the fibrous structures that connect one bone to another, like the femur and the tibia, and are responsible for the stability of the joint. In the knee, there are the anterior and posterior cruciate ligaments (ACL, PCL) and the internal and external collateral ligaments (ICL, ECL). The menisci are the two fibrocartilaginous structures between the femur and the tibia that reduce friction and dissipate load.

What is a knee sprain?

A knee sprain occurs when there is either a stretch (grade 1), a partial tear (grade 2) or a complete tear (grade 3) of one or more ligaments. Ligament damage often comes with meniscus damage and, in grade 3 sprains, bone tearing is possible.

Signs and symptoms

At first, a knee sprain may be manifested by pain, swelling, bruising and warmth, but also by a feeling of instability in the knee, expressed by weakness, lack of control and a disturbed balance. During the evaluation, we often note pain on palpation as well as disturbances in joint stability, strength, mobility, proprioception and load-bearing capacity.

Treatment

Your physiotherapist and physician can perform clinical tests to identify the injury. They can then guide you in its management. Magnetic resonance imaging (MRI) is used to determine the severity of the damage.

Treatment will vary according to the severity of the sprain. In severe cases, surgery may be indicated to reattach the torn ligament. Medication will improve the condition in terms of pain and inflammation. An orthosis may also be recommended to help stabilize the joint during activities.

In physiotherapy, the objectives are to ensure optimal healing, adequate mobility and strength and the absence of complications. Therefore, manual therapy, mobilizations, taping, electrotherapy, cryotherapy and thermotherapy, as well as exercises will improve the condition. It is important to have optimal strength and stabilization to compensate for the lack of stability. Your physiotherapist will also guide you in your return to sport or work.

Evolution

Knee sprains can heal in 4 to 6 weeks, but can sometimes take up to 3 months depending on a number of factors: severity, treatment received injury history, among others.

In conclusion, it is strongly recommended to consult a physiotherapist within the first 72 hours to optimize healing and obtain appropriate care.

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