A knee sprain is a tear or complete rupture of one or more of the knee ligaments. Knee ligament injuries are particularly common in sports that involve tackling (eg rugby) or twisting (eg netball). Some knee sprains lead to prolonged absence from sport. These injuries are very serious and often require surgery.
How do knee sprains occur?
The knee is subject to large stresses and impact forces. Damage can occur:
- during contact with another player, for example a blow to the outside of the knee while the foot is planted on the ground
- by forces created by the athlete, such as a sudden sidestep or twist while running.
Treatment
Apply the R.I.C.E.D. procedure.
Rehabilitation
Always seek the advice of a medical professional for a rehabilitation programme specific to you and your injury. To minimise the risk of re-injury, ensure you are completely rehabilitated before returning to competition.
Range of motion
Range of motion can be improved by:
- lightly stretching the muscles around the knee
- bending and straightening the knee.
Once pain and swelling decrease, cycling is also recommended.
Cardiovascular fitness
Non-weight bearing activities are good options at the beginning of rehabilitation, for example:
- swimming
- cycling
- arm ergometry (grinding).
A return to more specific activities such as jogging can be made as joint strength and stability allow.
Strength
Gentle strengthening exercises should be started early in the rehabilitation process to minimise muscle wasting and increase the speed of recovery.
Balance
Balance exercises, such as standing on one leg, help to minimise the likelihood of future sprains. Balance exercises can be made more difficult by performing them:
- with your eyes closed
- on an uneven surface such as a gravel pathway
- on an unstable surface such as a mattress.
Psychological status
Gradually attempting more difficult agility tasks and setting realistic goals and timeframes may help rebuild sporting confidence.
Sport-specific rehabilitation
Rehabilitation should involve some ecentric training of the quadriceps. This involves the quadriceps developing tension while lengthening to control a movement. Examples of ecentric training of the quadriceps include:
- knee bending when landing from a jump
- running down hills and stairs
- sudden decelerations when running at speed
- hopping.
Return to play
A player is ready to return to play when they can perform the following moves at 1/2 speed, then 3/4 speed, and finally at full speed:
- run a tight figure of eight
- cut at both 45 and 90 degree angles off both feet.
Reduce the risk of re-injury
Always seek the advice of a medical professional before returning to sport. Inadequate rehabilitation will increase the risk of re-injury. You can reduce re-injury by:
- continuing stretching, balance and strengthening exercises of the lower limb, particularly the quadriceps and hamstrings
- warming up before any explosive movements or impacts
- using good technique when landing from jumps, tackling, pivoting etc
- warming up and cooling down correctly.
Note:
Most braces are not effective in reducing the risk of re-injury.
If knee injuries continue to occur, consult a medical professional for advice on other possible contributing factors.
Resources
For more information, see Knee sprains (PDF 182K).
Last updated: 20 April 2009