So you have just had a knee injury… what??

Knowing what to do after a knee injury can make the difference between a laundry list of medical expenses or a steady recovery process saving you both time and money. Often times we feel pain and act quickly because we are not sure what to do. Here you will learn a step by step tutorial to help take ownership of your injury and get back to the activities you enjoy most!

Can you put weight on it?

If you sustain a knee injury, the first thing you want to determine is can you put any weight on the injured leg? If the knee is too painful or unsteady/not secure avoid bearing weight on the involved leg and use crutches if available.

If you are able to bear weight on the involved knee/leg, next question you want to ask yourself is, “Where is most of my pain?”. This may be able help rule in/out many diagnosis for the knee such as if the pain is deep inside it can be a joint issue/ligamentous/meniscal. If the pain is on the outside of the knee it can be a soft tissue problem you may be dealing with.

What are some immediate things I can do to support my knee?

Once you are in a safe location try to ice and elevate the involved leg. Icing has many benefits including reduction of pain, managing swelling, and preserving the good cells that were not injured by the trauma. Optimal parameters for icing including 2-3x/day for 15-20 minutes. NSAIDs such as ibuprofen can also beneficial in alleviating pain as well as managing any swelling that may occur. Lastly if the knee feels unstable or not secure, an over the counter knee brace or compression sleeve can help promote stability and reduce pain around the joint.

Do I really need imaging?

If your knee injury was traumatic in nature it is best to consult with a medical professional. They can determine the appropriateness for obtaining imaging associated with the injury. There is a criteria listed below that health care practitioners use as a guideline to determine if imaging should be obtained called the Ottawa knee criteria. If you meet this criteria, imaging should be a priority to rule out/in a significant knee injury.

What are some things I can do after the initial injury to help get me moving?

Active recovery is the key here! This will help promote safe movements/activities of the knee that will help promote mobility, desensitize pain, and build strength. The activities listed below will help get a jump start on your path to recovery after sustaining a knee injury. The reason why these activities are strongly recommended are due to the fact that the worst thing you can do is to avoid movement and not do anything.

Swelling is another big issue after an injury. Swelling can cause difficulty with activating the quadriceps, can cause increased knee pain, and decreased mobility within the knee joint. Swelling should be a number one priority after a knee injury. Exercises that help with this are mobility exercises (listed below) that help circulate the fluid around the involved area.

Swelling is not the only benefit from performing mobility or range of motion exercises. Another importance of these exercises is to prevent stiffness which is a common complaint people have post injury. Often times our bodies go into a state of protection mode, trying to isolate the involved body part from further injury. The problem here is that too often this protection mode can be too persistent and limit how quick recovery can take place. Mobility/range of motion exercises can help regulate this. Try to move bend and straighten the knee through a pain free range. Below are two exercises that can help regain/maintain the mobility in your knee.

Seated Knee Flexion/Extension 

  • Fully attempt to straighten and bend your knee through a pain free range of motion
  • Perform 20-30 repetitions every other hour or more frequently if possible

Heel Slides

  • Slide your heel towards your bottom
  • You may use a sheet or towel to help pull your knee further if assistance is needed
  • Perform 4 sets of 15 repetitions once a day

Building a foundation for the muscles surrounding the knee is imperative in order to decrease disuse atrophy/weakness. The muscles in the front of your thigh, also called the quadriceps, are subject to weakness and loss of motor control immediately after a knee injury. This is partially due to swelling within the joint as well as from disuse immediately after injury. A quad set is a simple but effective exercise to prevent disuse atrophy and maintain strength in the quadriceps.

Quad sets on a towel

  • Attempt to bring the back of your knee towards the table and squeeze the muscles at the front of your thigh
  • This exercise will also help promote knee straightening which could effect your walking if you are lacking this motion
  • Perform 10 times for 4 sets with 10 second holds 2-3 times a day

Straight Leg Raise

  • Bend the opposite knee to approximately 100 degrees
  • Keep the knee straight and raise your knee up to the level of the opposite knee
  • Perform 3 sets of 15 repetitions once a day
**Disclaimer: these exercises should not be painful! A traffic light analogy is perfect here…green light (no pain) = good stress, yellow light (some discomfort) = appropriate stress to create change, red light (pain during and after) = the stress is currently too much for the joint.**

While sustaining a knee injury and knowing what to do after can be scary, we hope that you may have a better understanding as to what you can do to help get you on the right track to recovery. If you find yourself needing more help, seek out a practitioner that can help get you the results that you want! Whether it is Pinnacle Movement and Performance or another medical practitioner, a physical therapist can provide hands on techniques and therapeutic exercises to help reduce pain, improve muscle activity, and increase motion in your knee.

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Thanks for reading!