What is a traumatic knee injury?

Knee injuries are common and can occur after a trip, twist, impact or other trauma, often while exercising or playing sport.

Your knee is likely to be painful or tender and might be swollen or bruised.

You may not be able to put weight through your knee very well, or be able to use it as normal.

Most mild to moderate traumatic knee injuries will get better over time with the appropriate care, and can often be self-managed, without needing to see a GP or physiotherapist.

Anatomy

The ligaments of the knee maintain the stability of the knee. Each ligament has a particular function in helping to maintain optimal knee stability.

The menisci correct the lack of congruence between the articular surfaces of tibia and femur, increase the area of contact and improve weight distribution and shock absorption. They also help to guide and coordinate knee motion, making them very important stabilisers of the knee.

When should I see my GP or physiotherapist?

Many episodes of knee pain get better or improve on their own, however you should seek medical advice for the following:

• After a severe traumatic or high impact injury
• Leg giving way at the time of injury
• Inability to continue activity immediately following injury
• Marked swelling
• Pop (heard or felt) at the time of injury
• If the pain is severe or the knee is hot, red or very swollen
• If you have tingling or numbness down the leg
• If you develop acute knee pain at the same time as feeling unwell or having a fever you should see your doctor immediately
• If your knee is ‘locked’ into one position and you cannot move it
• If your knee is giving way repeatedly

How can I help myself to get better?

Minor injuries, such as mild sprains and strains, can be treated at home and should start to improve after a few days. Using a POLICE, (previously known as RICE) regime initially can help.

• POLICE infographic

POLICE regime

POLICE stands for protect, optimal loading, ice, compression and elevation

Protection: You need to avoid further injury, or worsening the current one. This may mean some limited rest, or may mean using crutches to reduce the load on your injured knee.

Optimal loading:  Try to avoid complete rest. Keep yourself moving as normally as possible within the limits of your pain, as this will aid recovery.

Ice: Applying crushed ice in a towel to the area for 10 minutes a couple of times a day might help reduce pain and swelling.

Compression: Temporarily using a compression stocking or bandage around your injured knee can help reduce swelling.

Elevation: Elevating your injured knee, for example, by resting it up on some cushions on a chair or stool when sitting, can also help to reduce swelling.

Sedentary and inactive lifestyles increase the risk of developing pain and can also delay your recovery. Being active for 30 minutes in your day can make a big difference in your overall health and improve your pain.

Pain relief

Getting the right pain relief to allow you to return to your usual activities can be an important factor in the early stages. Pain killers, such as ibuprofen, paracetamol and gels can help. Make sure you discuss this with your GP or pharmacist.

Exercise

Keeping your knee moving is important to stop structures stiffening up and your muscles becoming weak. You need to find the right balance between rest and exercise, some people find too much increases the pain while too little makes the knee stiffen up. Little and often movement is usually the best approach to help you get your knee back to normal.

Some basic exercises can be useful in easing your knee pain and to help it move better. If you do activities at work or do sport or exercise which increases your pain it may help to reduce or stop this for a short period, until the pain settles. You should then aim to slowly work back up to your previous activity level. If exercising does not affect your symptoms or improves them, try to stay as active as possible.

Here are some simple exercises for the initial period after an injury:

Start the exercises below as pain and swelling allows 48 hours after your injury. They may involve movements which cause discomfort over the injured area. Whilst it is important to move the knee to prevent stiffness do not push into pain as this can overstretch healing tissue.

• Returning to driving and work will depend on your individual injury and what your occupation is.
• We recommend before returning to driving that you can perform an emergency stop without hesitation and discomfort and inform you insurance company.
• As you return to work you may find that your swelling and discomfort increases. This is usually because as activity increases the ability and time to elevate and place ice on the area decreases. This change may be a more significant if you do a manual job.
• Prior to returning to sport make sure you have no pain or swelling. You should be able bend and straighten your knee equal to the other side, stretch your gastrocnemius and soleus equal to the other side, can perform single leg calf raises to equal height and repetitions compared to the unaffected side and have equal ability to balance. You should also be able to hop equal to the opposite side. Return to sport should be with graded return; for example returning to light jogging or training before taking part in a match.

If you have any concerns regarding your recovery please see your GP.