616281181
Causes of knee sprain
The knee joint connects the two longest bones of the human body that are part of the musculoskeletal apparatus, they are subjected to a great deal of strain, making the ligaments susceptible to various types of injury. Knee sprains are quite common, both among professional athletes and amateur athletes. The risk of injury is particularly high when performing activities that require loading the limb while bending or twisting, for example: soccer, basketball or ice hockey.
Most knee sprains occur as a result of a direct blow to the knee by an external force, such as in soccer, when a player's foot makes contact with the turf and another player "bumps" into his knee. Among the most common causes are also those resulting from large overloads during sudden stops and changes in direction, which are also part of the game of soccer or basketball. Knee joint injury is common in dynamic sports, such as ice hockey, where the knee joint is twisted or hyperextended. Causes can include injuries caused by improper or excessive physical activity without prior preparation.
Symptoms of a knee sprain
Knee sprain is an injury that is quite common and, unfortunately, sometimes serious, involving partial damage to ligaments - a tear or complete damage - rupture of ligaments and meniscus and cartilage. Such damage can occur to the anterior cruciate ligament (ACL) or posterior cruciate ligament (PCL), tibial collateral ligament (MCL) or fibular collateral ligament (LCL). Among the most common symptoms are acute pain inside the joint aggravated during movements, hematoma occurring due to damage to vascularized structures (ligament, meniscus), rapidly increasing swelling and swelling within the knee.
Athletes who have suffered a knee sprain, depending on the severity of the injury, may experience varying degrees of pain: dull and throbbing in mild sprains, and sharp and constant in more severe cases. It is worth noting, however, that pain varies widely and is nevertheless a subjective sensation. The pain usually subsides when the knee is at rest and returns with movement.
Among the accompanying symptoms of a sprained knee joint may be: a jumping sensation and instability of the knee, restriction of knee mobility, reflex avoidance of movement provoking knee pain when walking. The timing of the injury is important. If the athlete hears a distinctive popping sound at the time of the sprain, this may indicate a rupture of one of the four major ligaments of the knee. This is associated with the more serious injury of a grade III sprain. A person who continues to put weight on the limb by playing sports, despite the injury to the knee structures, risks further damage to the knee joint. To minimize the risk of further injury, follow the PRICE post-trauma protocol immediately and consult an orthopedist.
Knee sprain - degrees of damage to a particular ligament.
- Grade I ligament injury: damage to a small number of fibers of the ligament and the joint capsule. Such an injury is accompanied by local soreness, mild swelling, pain or bruising, with the stability of the joint preserved. A person can put weight on the affected limb.
- Grade II ligament injury: damage to most of the fibers of the ligament with partial rupture. Such an injury is accompanied by more intense pain. When the affected limb is loaded, the knee may be less stable.
- Grade III ligament injury: this is the most severe sprain with complete rupture of the ligament, which in some cases may separate from the bone. Such an injury is accompanied by swelling and bruising, and it may not be possible to put weight on the affected limb due to the pain of loss of knee stability.
Risk factors for knee sprain
Any athlete, whether professional or amateur, can experience a knee sprain. There are several risk factors that can increase the likelihood of a knee sprain. These will certainly include past injuries. A previous knee sprain increases the likelihood of re-injury. Added to this is damage to the meniscus and ligaments, which weakens the stability of the knee joint. A natural risk of knee dislocation is playing dynamic and contact sports like soccer, basketball and ice hockey.
Among amateurs, this will be an inadequate effort for their level of sport. People who increase the volume of their training too quickly, or the level of sports competition they participate in, naturally increase the risk of twisting the knee. Among the causes, we can also include improper footwear, which should be adapted to the biomechanics of the athlete and be suitable for the sport.
Knee sprain - diagnosis
The basis of diagnosis is a medical history and examination. The orthopedist will want to know how the knee injury occurred, what symptoms the patient experienced and whether he has suffered a similar injury before. When suspecting a knee sprain, the doctor will want to rule out other possible causes of pain. An important part of the diagnostic process is a physical examination, during which the doctor evaluates all the ligaments of the knee. The orthopedist also asks the patient about symptoms, what movements cause pain, and in what positions the discomfort decreases.
Diagnostic imaging is very important, allowing visualization of the anatomical structures inside the knee to assess the severity of the damage. An X-ray, ultrasound or MRI helps determine whether other structures in the knee have also been damaged. An X-ray helps diagnose a bone fracture, while an MRI allows visualization of soft tissue injuries as well, such as damage to ligaments, meniscus or articular cartilage.
Knee injury - immediate help
A sudden knee injury can cause significant pain and swelling in the joint within seconds. Therefore, it is very important to immediately stop the physical activity at which the knee was sprained and apply the PRICE protocol as soon as possible. This procedure includes protection - that is, protecting the painful area from re-injury, rest - that is, limiting movement, cooling the knee to reduce swelling, applying gentle pressure to reduce swelling, and elevating the limb above the heart line. We described the PRICE protocol, as well as two other procedures after a limb injury, in the article "Ankle sprain."
Non-surgical treatments - knee rehabilitation
Treatment of damaged structures can be done through non-surgical procedures that focus on restoring full strength to the knee joint. To do this, it is best to make a rehabilitation appointment with an experienced physiotherapist, who will prepare appropriate exercises for the knee joint to restore its stability and full range of motion. Initially, these will be exercises with light weights, mainly using suspenders and resistance bands. Over time, in a progressive manner, the weight will be raised and the number of repetitions will increase. At the same time, the physiotherapist will suggest stretching exercises that will gradually increase flexibility. Range of motion, as well as the absence of pain, lack of swelling and adequate muscle strength are a sure indicator that the athlete is almost ready to return to sports training. The length and intensity of the rehabilitation program depends on the severity of the injury, the age of the patient and the level of sports competition in which he or she participates.
Surgical treatment - arthroscopy
In the case of a serious knee sprain (mainly grade III), surgery may be necessary to repair the torn ligament and associated damage such as a ruptured meniscus. The surgical procedure is most often performed arthroscopically (depending on which ligament is involved), which is minimally invasive. Knee arthroscopy involves making a small incision and inserting a miniature camera into the knee joint to assess the extent of damage. Small tools are then inserted into the knee to remove or repair the damaged tissue. You can see exactly what such a procedure looks like in our article "ACL reconstruction - how does the surgery go?".
Can a knee joint injury be avoided?
Preventing knee joint injuries, including the described knee sprain, most effective training programs aimed at their prevention primarily include elements of strength, balance/proprioceptive and agility training. For a suggestion of such exercises, we refer you to the article by Mariusz Golinski - Rehasport Motor Preparation Coach.
Related articles:
Learn about other possible injuries to the knee joint.
Bibliography:
- "Knee Stability and Movement Coordination Impairments: Knee Ligament Sprain" - Journal of Orthopaedic & Sports Physical Therapy - Volume 40 Issue 4 - 2010
- "Epidemiology of Knee Sprains in Youth, High School, and Collegiate American Football Players" - Journal of Athletic Training- Volume 52, Issue 5 - 2017
- "What Is a Knee Sprain?" - Sports-Health - By J. Dean Cole, MD - 2016
- "Collateral Ligament Injuries" - Ortho Info - Jocelyn Ross Witstein, MD, FAAOS - 2021
