Pulled muscle in knee cap. Knee Strain and Sprain: Causes, Symptoms, and Treatment Options

14.08.202122.07.2023 by alexxlab

What are the common causes of knee strains and sprains. How can you identify the symptoms of these injuries. Which treatment options are most effective for knee strains and sprains. When should you seek medical attention for knee pain.

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Understanding Knee Strains and Sprains

Knee strains and sprains are common injuries that can affect athletes, active individuals, and even those with sedentary lifestyles. These injuries involve damage to the soft tissues surrounding the knee joint, including muscles, tendons, and ligaments.

A knee strain occurs when a muscle or tendon is stretched or torn. Tendons are fibrous cords that connect muscles to bones. On the other hand, a knee sprain involves the stretching or tearing of ligaments, which are tough bands of tissue that connect bones to each other within the knee joint.

Types of Knee Ligament Injuries

Anterior Cruciate Ligament (ACL) Injury
Lateral Collateral Ligament (LCL) Injury
Medial Collateral Ligament (MCL) Injury
Posterior Cruciate Ligament (PCL) Injury

These ligament injuries can range from mild stretches to complete tears, with varying degrees of severity and impact on knee function.

Common Causes of Knee Strains and Sprains

Knee strains and sprains can result from various factors, often involving sudden movements, overuse, or direct trauma to the knee. Understanding these causes can help in prevention and early intervention.

Traumatic Injuries

Trauma is a leading cause of knee strains and sprains. This can include sports injuries, falls, or any sudden impact that forces the knee joint beyond its normal range of motion. Contact sports such as football, basketball, and soccer carry a higher risk of these injuries due to the frequent collisions and rapid changes in direction.

Overuse and Repetitive Stress

Gradually increasing the intensity or duration of physical activities without proper conditioning can lead to overuse injuries. For instance, suddenly increasing running mileage or frequency without adequate preparation can overwhelm the knee’s supportive structures, resulting in strains or sprains.

Muscle Weakness and Imbalances

Weak muscles, particularly in the quadriceps, hamstrings, and calf, may fail to provide adequate support to the knee joint during physical activities. This lack of support can increase the risk of strains and sprains, especially during sudden movements or changes in direction.

Reduced Flexibility

Tight muscles and reduced flexibility around the knee joint can restrict motion and lead to functional weaknesses. This limitation in range of motion can make the knee more susceptible to injury during activities that require full joint mobility.

Poor Biomechanics

Improper running or walking form, such as overpronation (excessive inward rolling of the foot), can increase stress on the knee joint. This misalignment can contribute to the development of strains and sprains over time.

Risk Factors for Knee Strains and Sprains

Several factors can increase an individual’s likelihood of experiencing knee strains or sprains. Identifying these risk factors can help in implementing preventive measures and adjusting activities accordingly.

Participation in Contact Sports

Engaging in contact sports significantly elevates the risk of knee injuries. The frequent collisions, sudden stops, and rapid direction changes inherent in these activities place substantial stress on the knee joint and its supporting structures.

Previous Knee Injuries

A history of prior knee strains or sprains increases the likelihood of subsequent injuries. This heightened risk is due to potential weakness in the previously injured tissues or alterations in biomechanics following the initial injury.

Improper Footwear

Wearing shoes that do not provide adequate support or are ill-suited for specific activities can contribute to knee problems. Proper footwear plays a crucial role in maintaining correct alignment and reducing stress on the knee joint during physical activities.

Recognizing Symptoms of Knee Strains and Sprains

Identifying the symptoms of knee strains and sprains is crucial for prompt treatment and preventing further injury. While the severity of symptoms can vary, there are common signs to watch for:

Pain and tenderness in the knee area
Stiffness and difficulty moving the knee
Bruising and swelling around the joint
Instability or a feeling of the knee “giving way” when walking
A popping or snapping sound at the time of injury

The intensity of these symptoms often correlates with the severity of the injury. Mild strains or sprains may cause discomfort but allow for some continued activity, while severe injuries can result in significant pain, swelling, and inability to bear weight on the affected leg.

Diagnosis of Knee Strains and Sprains

Accurately diagnosing knee strains and sprains can be challenging due to the complexity of the knee joint and the similarity of symptoms across various knee injuries. Healthcare providers employ a comprehensive approach to ensure an accurate diagnosis.

Physical Examination

The diagnostic process typically begins with a thorough physical examination. The healthcare provider will assess the knee’s range of motion, stability, and areas of tenderness. They may also perform specific tests to evaluate the integrity of individual ligaments and muscle groups.

Medical History Review

A detailed medical history, including information about the onset of symptoms, mechanism of injury, and any previous knee problems, provides valuable context for the diagnosis. This information helps the provider understand the nature and potential severity of the injury.

Imaging Studies

To confirm the diagnosis and rule out other potential issues, imaging studies may be necessary:

X-rays: While they don’t show soft tissue injuries directly, X-rays can help rule out fractures or other bone-related issues.
MRI (Magnetic Resonance Imaging): This advanced imaging technique provides detailed views of soft tissues, allowing for precise identification of strains, sprains, and other knee injuries.

These diagnostic tools help healthcare providers determine the exact location and extent of the injury, which is crucial for developing an effective treatment plan.

Treatment Options for Knee Strains and Sprains

The treatment of knee strains and sprains varies depending on the severity of the injury and the specific structures affected. A comprehensive approach often involves a combination of conservative measures and, in some cases, more advanced interventions.

Conservative Management

For mild to moderate strains and sprains, conservative treatment is often sufficient. The RICE protocol (Rest, Ice, Compression, and Elevation) forms the cornerstone of initial management:

Rest: Avoiding activities that exacerbate pain and allowing the injured tissues to heal.
Ice: Applying cold therapy to reduce swelling and alleviate pain.
Compression: Using elastic bandages to minimize swelling.
Elevation: Keeping the affected leg elevated to reduce blood flow and swelling.

Additionally, over-the-counter anti-inflammatory medications can help manage pain and reduce inflammation.

Physical Therapy

Physical therapy plays a crucial role in the recovery process for knee strains and sprains. A tailored rehabilitation program focuses on:

Restoring range of motion
Strengthening muscles supporting the knee
Improving flexibility
Enhancing proprioception and balance
Gradually reintroducing sport-specific activities

Physical therapists employ various techniques, including targeted exercises, manual therapy, and modalities like ultrasound or electrical stimulation, to promote healing and prevent recurrence.

Bracing and Support

For moderate to severe injuries, or during the early stages of recovery, knee braces or supports may be recommended. These devices provide stability to the joint, reduce stress on injured tissues, and can help prevent further injury during the healing process.

Advanced Treatments

In cases of severe strains or sprains, or when conservative measures fail to provide adequate relief, more advanced treatments may be considered:

PRP Therapy

Platelet-Rich Plasma (PRP) therapy is an innovative treatment that involves injecting a concentration of the patient’s own platelets into the injured area. This approach aims to accelerate healing by delivering growth factors directly to the damaged tissues.

Surgical Intervention

While rare for most strains and sprains, surgical repair may be necessary for complete ligament tears or injuries that fail to respond to conservative treatment. The specific surgical approach depends on the nature and location of the injury.

Recovery and Rehabilitation

The recovery process for knee strains and sprains is critical for restoring function and preventing future injuries. The duration and intensity of rehabilitation vary based on the severity of the injury and individual factors.

Timeline for Recovery

Recovery times can range from a few weeks for mild strains to several months for severe sprains or tears:

Mild strains or sprains: 6-8 weeks with proper care and rehabilitation
Moderate injuries: 8-12 weeks of dedicated treatment and therapy
Severe strains or complete ligament tears: 3-4 months or longer, especially if surgical intervention is required

It’s crucial to follow the rehabilitation plan closely and avoid returning to full activity too soon, as this can increase the risk of re-injury.

Gradual Return to Activity

The return to normal activities or sports should be gradual and guided by a healthcare professional. Typically, this process involves:

Regaining full range of motion
Restoring strength to pre-injury levels
Achieving functional stability in the knee
Progressing through sport-specific drills and exercises
Gradually increasing intensity and duration of activities

Patients should be able to perform basic exercises like squatting, running, and side-to-side movements without pain before returning to more demanding activities.

Long-term Management

Even after full recovery, ongoing management is important to prevent recurrence:

Maintaining strength and flexibility through regular exercise
Using proper techniques and equipment during sports and physical activities
Wearing appropriate footwear and supportive devices if recommended
Monitoring for any signs of recurring pain or instability

Prevention Strategies for Knee Strains and Sprains

While not all knee injuries can be prevented, implementing certain strategies can significantly reduce the risk of strains and sprains. These preventive measures are particularly important for athletes and individuals engaged in regular physical activity.

Proper Warm-up and Stretching

Engaging in a thorough warm-up routine before physical activity helps prepare the muscles and joints for exertion. Dynamic stretching, which involves moving parts of your body and gradually increasing reach, speed, or both, is particularly effective in improving flexibility and reducing injury risk.

Strength Training

Strengthening the muscles that support the knee, including the quadriceps, hamstrings, and calf muscles, can enhance joint stability and reduce the risk of strains and sprains. A balanced strength training program should target all major muscle groups around the knee.

Proper Technique and Form

Learning and maintaining proper form during physical activities, especially in sports that involve running, jumping, or sudden changes in direction, is crucial. This includes:

Proper landing techniques to absorb shock
Correct running form to minimize stress on the knees
Appropriate pivoting and turning mechanics in sports like basketball or soccer

Appropriate Footwear

Wearing shoes that provide adequate support and are suitable for the specific activity can help maintain proper alignment and reduce stress on the knees. This is particularly important for activities like running or sports that involve frequent direction changes.

Gradual Progression in Training

Avoiding sudden increases in training intensity or duration is crucial for preventing overuse injuries. A gradual progression in activity level allows the body to adapt and strengthens supporting structures over time.

Cross-training

Incorporating a variety of exercises and activities into a fitness routine can help prevent overuse injuries by distributing stress across different muscle groups and joints. This approach also helps in developing overall body strength and flexibility.

When to Seek Medical Attention

While many knee strains and sprains can be managed with home care, certain situations warrant prompt medical attention. Recognizing these signs is crucial for preventing further injury and ensuring proper treatment.

Severe Pain or Swelling

If pain is severe, persists beyond a few days, or is accompanied by significant swelling, it’s important to consult a healthcare provider. These symptoms may indicate a more serious injury that requires professional evaluation and treatment.

Inability to Bear Weight

Difficulty or inability to put weight on the affected leg could signify a severe sprain or other serious knee injury. This situation requires immediate medical assessment to determine the extent of the injury and appropriate treatment.

Visible Deformity

Any noticeable deformity in the knee area, such as an obvious misalignment or protrusion, should be evaluated by a medical professional as soon as possible. This could indicate a dislocation, fracture, or severe ligament tear.

Persistent Instability

If the knee feels unstable or gives way during normal activities, even after initial rest and home treatment, it’s important to seek medical advice. Chronic instability can lead to further injury and may indicate incomplete healing or a more severe underlying issue.

Lack of Improvement

If symptoms do not improve or worsen despite following conservative treatment measures for several days, consulting a healthcare provider is advisable. This could indicate that the injury is more severe than initially thought or that the current treatment approach is not effective.

By understanding the nature of knee strains and sprains, recognizing their symptoms, and knowing the appropriate treatment and prevention strategies, individuals can better manage these common injuries. Whether you’re an athlete looking to optimize performance or someone seeking to maintain an active lifestyle, taking proactive steps to protect your knees is essential for long-term joint health and overall well-being.

Knee Strain or Sprain | Orthopedics

What is a knee strain or sprain?

A knee strain occurs when a muscle or tendon is torn or stretched. The tendons are fibrous cords that connect muscles to bones.

A knee sprain occurs when the ligaments in the knee joint stretch or tear. Ligaments connect the bones of your lower leg to the bones in your thigh together in your knee joints.

Common related conditions

Anterior Cruciate Ligament (ACL) Injury
Lateral Collateral Ligament (LCL) Injury
Medial Collateral Ligament (MCL) Injury
Posterior Cruciate Ligament (PCL) Injury

Causes of a knee strain or sprain

Injuries — trauma, sports injuries or falls that overstretch the joints and soft tissue that surround the knee and cause a knee sprain or strain.
Overuse — building up too quickly in a sport, such as running, can overwhelm the body and lead to knee strains or sprains.
Muscle weakness — muscles that can’t support the knee joints can cause a knee strain or sprain.
Reduced flexibility — tight muscles can restrict joint motion and lead to functional weaknesses at the knee joint to cause a knee strain or sprain.
Running form — overpronating when running or walking can increase stress to the knee and cause a knee strain or sprain.

Risk factors for a knee strain or sprain

Contact sports — participating in contact sports such as football, basketball and soccer put you at a higher risk for knee sprains or strains.
Prior knee strains or sprains — prior sprains or strains to the knee make you more likely to suffer another knee sprain or strain.
Improper footwear — wearing improper footwear can put additional pressure on the knee joint and cause a knee strain or sprain.

Symptoms of a knee strain or sprain

Pain and tenderness in the knee
Stiffness, bruising and swelling in the knee
Instability when walking
Popping noise when injured

Diagnosis of a knee strain or sprain

Diagnosing a knee sprain or strain is challenging due to the complexity of the knee. Your physician will perform a variety of physical tests, as well as take a full medical history, to determine the exact cause and location of the injury.

A patient could have multiple knee injuries at one time, so your doctor may order an x-ray or MRI. These imaging modalities will be able to identify what is causing the symptoms and help the provider determine the best treatment for your case.

Treatment for a knee strain or sprain

Many patients can self-treat knee strain or sprain with rest, ice, compression, elevation and anti-inflammatory medication. If the pain is moderate to severe, your physician may require you to wear a brace over the knee to provide stability. More advanced knee strains or sprains can be treated with the following treatments:

Physical therapy and rehabilitation — physical therapy is crucial to help strengthen the knee after a strain or sprain; your physical therapist will work with you to gradually add exercises that will help restore mobility in the knee.
PRP therapy (Platelet-rich plasma) — PRP therapy for knee strains or sprains is a newer therapy where your orthopedic physician will remove a blood sample from the patient, put the blood in a centrifuge to separate out the platelets (which contain growth factors that are important in healing injuries) and then inject them back into the patient at the affected site in the knee.

Recovery from a knee strain or sprain

It is important to work with your physician closely before you return to your everyday routine. When recovered, you should be able to perform simple exercises such as squatting, running, side to side motions and jumping without pain.

A mild sprain is healed after six weeks of resting and treating the knee. A severe strain or sprain can take as long as three to four months. The exact recovery time will depend on the treatment plan that your doctor and physical therapist recommend for you as well as the nature of the injury.

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Symptoms, causes, treatment options, and more

Knee strains are a common injury involving a torn muscle or tendon around the knee. Strains are often related to sports injuries.

According to a 2012 analysis, knee sprains and strains are the most common knee injuries seen in emergency rooms in the United States, accounting for 42.1% of cases.

This article explores the symptoms and possible causes of knee strains and sprains, along with available treatment options.

Knee strains affect the muscles or tendons.

The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) state that they occur when a tendon or muscle stretches or tears. A tendon is a structure in the body that connects muscles to a bone.

A muscle strain around the knee is often due to overuse. The NIAMS indicate that a person may strain their knee from stressing the muscles, lifting heavy weights, or a sudden injury.

There are three grades of muscle strain based on severity.

They include:

Grade 1: A few muscle fibers are torn or stretched, and the muscle retains full strength.
Grade 2: This involves more muscle fibers being stretched and torn. The muscle becomes weaker and is more painful.
Grade 3: The most severe type of strain involving significant or complete tearing of the muscle or tendon, which causes loss of function.

There are several potential symptoms of a knee strain. According to the NIAMS, they commonly include:

cramping in the muscles around the knee
spasms in the muscles
swelling
bruising
difficulty with moving the muscles or walking

The severity of symptoms will vary according to the severity of the strain.

While strains affect the muscles and tendons, sprains affect the ligaments.

The NIAMS define a sprain as an injury to one or more ligaments from a stretch or tear. Ligaments are tough connective tissues linking bones to other bones.

There are four major ligaments of the knee joint. Of these, the anterior cruciate ligament (ACL) experiences the most injuries. A person can injure their ACL through contact, such as a football tackle, or without contact, which commonly occurs due to a sudden twisting motion.

Although both cause pain and swelling, knee sprain symptoms also often include difficulty putting weight on the leg, alongside pain with range of motion.

Learn more about sprains vs. strains here.

The most common causes of knee strains include:

twisting or lifting a heavy object without proper support
recent injury to the knee or muscle
overuse of the muscle

A tear to the tendons that run through the knee is a common sports injury.

According to the American Academy of Orthopaedic Surgeons (AAOS), two common tendon tears in the knee include a patellar tendon tear and a quadriceps tendon tear.

Common causes of tears to these tendons include:

landing awkwardly
direct force to the front of the knee
falling
misstepping and “jamming” the knee

Often, people can treat knee strains at home.

The NIAMS and AAOS recommend following the RICE method following a knee injury, which stands for:

Rest: May include using assistive walking devices to avoid moving or putting weight on the knee.
Ice: Wrap ice with a towel and apply to the knee to help reduce swelling.
Compression: This can involve using a wrap or specialized bandage to apply pressure to the knee.
Elevation: This can help reduce swelling.

Learn more about the RICE method here.

In addition to RICE, over-the-counter anti-inflammatory medications, such as acetaminophen or ibuprofen, may reduce pain and swelling.

It is always best to consult with a doctor if a person is unsure which medication to use, or if they take regular prescription medications.

Although people may need surgery for some knee injuries, a doctor may recommend several non-surgical treatments before discussing surgical options.

According to the AAOS, some common treatments may include:

physical therapy
immobilizing the knee with a brace
using crutches

If the knee strain or sprain is severe, surgery may be necessary to restore stability and function.

Recovery time varies greatly from person to person, according to the severity of the injury and whether they underwent an operation.

The United Kingdom’s National Health Service (NHS) note that people experiencing strains will feel better after 2 weeks. However, more severe injuries can take significantly longer.

Following a knee strain or sprain, a person should avoid strenuous exercise, such as running and jumping, until symptoms improve significantly. This recommendation is to avoid the risk of further damage.

The AAOS note the following recovery times for a tendon tear:

for mild cases, it can take 3–6 weeks to recover
after surgery, it can take 6 months to a year for complete recovery

Although a person can treat most minor knee sprains and strains at home, the AAOS recommend seeking immediate medical attention for a knee injury if people experience any of the following:

severe pain at the site
hearing or feeling a popping noise or sensation at the time of injury
limping
inability to move the knee
swelling at the injury site

A person should also seek medical attention if the pain or swelling gets worse, or if new symptoms develop. Always consult with a doctor if there is no improvement in symptoms following home treatment.

To diagnose a knee strain or sprain, a doctor will ask questions about a person’s symptoms, medical history, and if they participate in sport or similar activities.

They will then examine the knee and test for strength and range of motion, alongside other tests.

Healthcare professionals will usually obtain X-rays to check for broken bones. A doctor may also order an MRI to examine the tendons and ligaments of the knee.

Preventing a knee sprain or strain is not always possible, but there are ways to reduce the chances of sustaining injury.

The NIAMS recommend the following:

eating a healthful diet
maintaining a moderate weight
wearing properly-fitted shoes
avoiding exercising or playing sports when tired or in pain
running on flat surfaces
warming up and stretching before exercise
taking part in regular exercise
wearing protective equipment when playing sports

A knee strain occurs when a muscle or tendon stretches or tears. The severity of the strain can vary from mild to severe.

Mild cases often do not require medical attention, and a person can treat them at home.

More severe cases may require immobilization, physical therapy, or surgery. Recovery times can vary based on how severe the strain is and can range from several weeks to a year.

Sprain of the knee joint – symptoms, causes, treatment

This disease is treated by a neurologist.

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Sprain of the ligaments of the knee joint – damage to the structures of the ligamentous apparatus due to excessive physical or mechanical stress on the knee. According to the localization of the injured area, they are divided into stretching of the medial, lateral, anterior and posterior cruciate ligaments.

CMDT specialist tells

Kuchenkov A.V.

Orthopedist • Traumatologist • Surgeon • Phlebologist • Sports doctor • 25 years of experience

Publication date: May 11, 2021

Verification date: January 08, 2023

All facts have been verified by a doctor.

Contents of the article

Causes

Symptoms of knee sprain

Stages of development

The pathological condition is divided into three degrees according to the severity of injuries:

Mild first degree – minimal manifestation of symptoms that disappear within the next two weeks
Medium second degree is characterized by difficulty in movement, pain, swelling. Damaged ligaments are not able to maintain the integrity of the joint
Severe third degree with complete or partial rupture of the ligaments. It occurs with severe pain, loss of joint stability. Accompanied by rupture of nerve fibers, blood vessels, bleeding into the articular cavity.

More often, damage to several ligaments is diagnosed at the same time: injuries of the internal collateral plus anterior cruciate ligament, or external collateral with damage to the meniscus, tendons. This is due to the anatomically complex structure of the external lateral section.

How to diagnose

The doctor makes a preliminary diagnosis based on the patient’s complaints, visual examination, determination of injuries and their severity. Additionally assigned:

radiography to exclude a fracture
MRI is an informative method of layer-by-layer examination in different projections of all structures – ligaments, cartilage, tendons, soft tissues
ultrasound to detect inflammation, increase the volume of synovial fluid

In some cases, arthroscopy is prescribed – an invasive, low-traumatic method for examining and treating sprains of the internal ligaments of the knee.

Restoration of the knee joint: material from the specialists of the RC “Laboratory of Movement”

Which doctor to contact

How to treat a sprain

Rehabilitation after a sprain

Consequences

Prevention

Treatment and rehabilitation after a knee sprain in CMRT clinics

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Damage to the medial collateral ligament – symptoms, causes, treatment

A neurologist deals with the treatment of this disease.

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CMRT specialist tells

Kuchenkov A.V.

Orthopedist • Traumatologist • Surgeon • Phlebologist • Sports doctor • 25 years of experience

Publication date: June 07, 2021

Verification date: January 12, 2023

All facts have been verified by a physician.