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GENERAL INFORMATION, SIGNS & SYMPTOMS, OSTEOPATHIC AND SELF MANAGEMENT OF A
Knee Ligament Sprain

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Knee ligament sprains are common sport related knee injuries (of any sport and at any age). The Medial and lateral Collateral Ligament run on either side of the knee and work to prevent excessive movement of the knee joint.  The medial collateral ligament (runs on the inside of the knee) is more commonly injured.

Causes
  • Contact injury (e.g a direct force)
  • Non-Contact Injury (e.g. sudden overstretching, twisting, cutting/pivot of the knee)
  • Overuse (e.g. repetitive strain - sometimes an injury of swimmers with a "whip-kick" technique)
Grading of the Sprain
Sprains are graded depending on severity:
  • Grade 1: Few torn fibers with the structure of the knee working and moving relatively well.
  • Grade 2: Incomplete tear with some ligament instability 
  • Grade 3: Complete tear of the ligament and severe instability.

Signs and Symptoms
  • Pain will generally relative to the severity (or grading) of the injury.
  • A distinct point of tenderness over the ligament with/without bruising and/or swelling over the area.
  • General knee pain and swelling. Other structures such as the cartilage of the knee joint and/or the knee ACL ligament may also be damaged and producing pain in other areas of the knee (this is more common with medial knee injuries).

Osteopathic Treatment

  • Your osteopath will perform a detailed past medical history and physical examination to determine the structures damaged in your knee and grade the knee injury.
  • Initial treatment will focus on reducing pain and enhancing drainage and blood flow to the damaged tissues.
  • Your osteopath may refer you for imaging studies (MRI/CT or ultrasound) to for clarification on the tissue damage or to rule out other causes.
  • Osteopathic treatment focuses on tissue healing, restoring joint function and preventing further damage to the area.
  • Osteopathic rehabilitation principals with aim for restoring joint strength and stability as pain permits.
Management of Grade 1 and Grade 2 Sprains
Timelines are determined by the severity of the injury. This will determined by your osteopath.
  • A short course pain relieving and/or anti-inflammatory medication may be of benefit with consultation of your doctor or pharmacist.
  • Ice is beneficial in the first 24-48 hours (3 sets of 10 minutes on 10 minutes off - 2 or 3 times per day). Stop using ice with any discomfort or if there is no relief.
  • Once pain has settled you will be prescribed stretching and strengthening exercises with an aim to restoring your knee to its pre-injury state and make it stronger with an aim to prevent recurrence.
  • An important element of recovery is restoration of your lower limb biomechanics. Your osteopath will guide you through this.
  • You will also be educated on lifestyle and ergonomical factors that may have contributed to the sprain.
  • Click Here for stretches for The Knee
  • Click Here for strengthening for The Knee
Healing times
Healing of collagen of a partial ligament tear can take several months1,2. Returning to normal activities is determined by the severity of the sprain/tear and may take place before complete healing in some cases if the knee has appropriate stability.


References
  • 1. Frank C. Ligament Healing: Current Knowledge and Clinical applications. J Am Acad Orthop Surg 1996;4:74-83
  • 2. Frank C, Shrive N, Hiraoka H et al. Optimisation of the biology of soft tissue repair. J Sci Med Sport 1999;2(3):190-210