Treatment for a knee injury depends on the part of the knee that is damaged and the extent of the damage.
Some injuries such as simple strains or sprains are treated with RICE therapy (rest, ice, compression, and elevation). Taking time off from sports and exercise may be enough for minor injuries to heal. Over-the-counter anti-inflammatories such as ibuprofen (Advil, Motrin) or naproxen (Aleve) may help treat the pain and inflammation from these minor injuries.
Knee immobilization or splinting keeps the knee from moving and decreases the chance of further injury. It can help stabilize an injured knee that may not be stable due to torn ligaments. It also keeps the knee from moving to assist in resting the knee.
Chronic knee injuries involving inflammation and bursitis may be treated with anti-inflammatories. Injections of cortisone (a steroid with powerful anti-inflammatory effects) may be helpful in these situations.
More extensive injuries involving torn ligaments, instability of the knee joint, swelling, decreased range of motion, or fractures will require an orthopedic surgeon consultation. In the initial stages of these more extensive injuries, RICE therapy can still be used. Staying off the leg by using crutches or a wheelchair may be advised.
Surgery may be indicated for tears of the ligaments or extensive damage to the menisci. Surgery may also be needed for fractures or dislocations of the knee. Some acute injuries such as those with high-force impact, or multiple parts of the knee damaged, may require emergency surgery.
Most knee surgery can be done arthroscopically, a procedure in which a camera is used and small punctures are made in the knee to insert instruments. Repairs can be done inside the knee without having the open the knee with a large incision. Most arthroscopic surgeries do not need to be done immediately after an acute injury. Some are delayed to allow for decreased inflammation.
After surgery, or if surgery is not an option, physical therapy can be used to strengthen and stretch the muscles surrounding the knee. Physical therapy can also allow for better movement mechanics of the leg and the knee to help prevent future injury.
What exercises are recommended, and what exercises should be avoided during rehabilitation for a knee injury?
During physical therapy for rehabilitation of a knee injury, the patient will be given specific exercises by the physical therapist in order to strengthen and stabilize the knee joint. These exercises include strengthening the front of the thigh (quadriceps), back of the thigh (hamstrings), calf, and hip. Consult your doctor and your physical therapist before starting any exercise program. Your physical therapist should insure that you are doing the exercises properly before doing them on your own.
If you have any pain or discomfort while doing prescribed exercises, see your doctor or physical therapist.
Some exercises that your physical therapist may recommend include the following:
- Quad sets
- Straight leg raises
- Straight-leg raise to the front
- Straight-leg raise to the back
- Hamstring curls
- Heel raises
- Heel dig bridging
- Shallow standing knee bends
The American Academy of Orthopedic Surgeons (AAOS) has an exercise guide that includes directions and pictures. Consult your doctor or physical therapist before trying any of these exercises on your own.
Some exercises to avoid following knee injury include the following:
- Full-arc knee extensions
- Deep squats
- Hurdler's stretches
These exercises can further stress already damaged knee joints.
What is the recovery time for a knee injury?
The recovery time for a knee injury depends on the type and severity of the injury. If the injury is significant enough to require surgery and/or physical therapy, the recovery time will be longer.
Simple strains or sprains can last for one to two weeks. More extensive injuries requiring arthroscopic surgery may take one to three months to heal.
Major traumatic injuries to the knee may take up to a year to heal.
Following the doctor's instructions for rest, immobilization, staying off your feet, and avoiding exercise that aggravates the injuries will help speed recovery.
Physical therapy can also speed recovery time. It is important to follow directions of your physical therapist to insure you are doing the exercises correctly and attaining the best results.
Chronic knee injuries that do not require surgery may flare up from time to time. Physical therapy, anti-inflammatory medications, and cortisone injections are used to provide temporary relief.