How to Treat Knee Sprains

Knee sprains occur when the ligaments in the knee are injured. Ligaments are tough, elastic tissues that connect bones and stabilize joints. A sprain can affect several ligaments as the tissue fibers tear, usually leading to pain, swelling, and bruising. If diagnosed with a knee sprain, follow the steps below to speed up the recovery process.

Protect the knee. As soon as the knee is injured, protect it from further harm. Once a sprain occurs, stop using the knee and avoid any activity that caused the injury. Otherwise, the condition will worsen. If possible, sit down immediately and relieve any pressure on the knee.

• If you are in a public place, ask someone to help you to the doctor. Do not attempt to walk with an injured knee until it is assessed.
• See a doctor as soon as possible. Since the P.R.I.C.E. method is the most common treatment for knee sprains, the doctor may ask you to follow this method. Always strictly follow the doctor’s advice if the sprain is severe.

Allow your knee to rest. Within the first 48 hours after your injury, it is essential to give your knee adequate rest. This allows the ligaments time to recover. Doctors will likely advise you to refrain from using your knee during this period, and to use crutches for mobility instead.

• You may also be recommended to wear a brace if you are unable to keep your knee still during the healing process.

Ice compression. In the initial days following the injury, applying ice will help treat inflammation and alleviate pain. Place ice cubes or crushed ice into a sealed plastic bag, or use a frozen vegetable pouch. Wrap the ice pack in a towel or cloth, then apply it to your knee for 20 minutes per session. Repeat 4 to 8 times a day.

• Do not apply ice for more than 20 minutes at a time to avoid frostbite.
• You can also use a cold compression bandage instead of the ice pack.
• Ice treatment should be done for approximately 48 hours or until swelling subsides.

Knee compression. To reduce swelling after a sprain, wrap an elastic or regular bandage around the injured knee. The bandage should be snug enough to provide support, but not too tight to interfere with blood circulation.

• Remove the bandage while sleeping. Since your knee remains largely stationary during sleep, this is the time to let blood flow freely.
• If after 48 hours the swelling persists, your doctor may recommend continuing the compression.

Elevating your knee. In the days following your injury, try to keep your leg elevated as much as possible. Position your knee higher than your heart to reduce blood flow to the area and minimize swelling. Lie on your back or sit up straight, placing two or three pillows underneath your knee to raise it above heart level.

• The amount of elevation needed will vary depending on your position. You will need more pillows if sitting compared to when lying down.

Heat compress after 72 hours. After applying the P.R.I.C.E. method for the first 48-72 hours, you can incorporate additional treatments to further reduce pain and swelling. Use a heating pad or hot compress to relieve stiffness and discomfort. Apply heat for 20 minutes per session, four times a day, or as needed. This helps relax the muscles around your knee that have been still during the previous days of rest.

• You can also apply heat by using steam, soaking your feet in a whirlpool, or lying in a hot bath.
• Do not use heat before the 72-hour mark, as it could cause more harm than good. The increased blood flow to the knee while it's still in the early recovery phase can lead to additional bleeding and swelling.

Taking pain relievers. While waiting for your injury to heal, over-the-counter pain relievers are an effective way to manage discomfort. If the pain becomes unbearable, consider taking ibuprofen or acetaminophen.

• Brands like Advil and Motrin offer ibuprofen, while Panadol is a common brand for acetaminophen.
• You could also try anti-inflammatory medication like naproxen, which is sold under the same name, Naproxen.
• If pain and swelling persist for over a week, consult your doctor for a prescription anti-inflammatory medication.

Using anti-inflammatory creams. If you'd rather avoid taking oral pain relievers, you can use topical creams as an alternative. Ibuprofen-based creams are available at most pharmacies. This method works well for mild pain, as the topical cream isn't as strong as oral ibuprofen, so it's less effective for severe pain.

• Some anti-inflammatory creams are available only with a prescription. If you're interested in these options, it's best to consult your doctor.

Avoid alcohol consumption. During your recovery period, it's crucial to refrain from drinking any alcoholic beverages, especially in the early days following the injury. Alcohol impedes the body's ability to heal, and it can exacerbate inflammation and swelling.

• Consult your doctor to determine when it's safe to reintroduce alcohol. Ensure that your knee is fully healed before drinking again, so it doesn't hinder the healing process.

Exercise. Once your knee has healed, it is important to start moving it again. Your doctor will guide you through exercises that help restore the knee's mobility. The goal of these exercises is to reduce stiffness, strengthen the muscles, improve your range of motion, and enhance the flexibility of your knee joint. These exercises will also focus on improving balance and strength. You should perform these exercises multiple times a day to gradually improve over time.

• The type and duration of exercises depend on the severity of your injury. You may need to do more intense exercises if the injury was severe. Your doctor will determine how long you need to continue rehabilitation.

Physical therapy if needed. If your injury is severe, you may need to work with a physical therapist or continue therapy exercises at home for some time. Most cases do not require physical therapy, but it may be necessary for specific injuries to fully restore the ligament and knee to normal function.

• The exact approach will depend on your specific injury, but generally, physical therapy helps reduce stiffness, pain, and improves the knee's range of motion.

Gradually increase activity intensity. A few weeks after the injury, your doctor will likely recommend returning to regular activities without crutches or a cane. Before that, they will assess your knee's strength, flexibility, and range of motion.

• If the assessment shows no pain during movement, you may resume regular activities, including sports and other physical activities.

Surgery if necessary. In rare cases, surgery may be required. One of the main reasons for surgery is to repair a torn anterior cruciate ligament (ACL), which is essential for the knee's forward and backward movement. Since the ACL is a vital ligament, a torn or ruptured ACL requires focused rehabilitation to restore its original function. ACL surgery is common among athletes who need to regain full knee mobility and strength.

• Surgery may also be necessary if multiple ligaments are injured. Without surgical intervention, these ligaments may not recover properly.
• Surgery is usually a last resort; other treatments are typically explored first before surgery is considered.