A knee sprain is a ligament injury that is characterized by pain, a feeling of “dislocation”, swelling or even an inability to put the foot on the ground. How do you know if you have a sprained knee? can i walk?
The knee sprain causes walking discomfort and impacts the pursuit of many sporting or professional activities. It is manifested by damage to the ligaments and causes pain, sometimes cracking and swelling. Its recovery is usually long and complications can occur. Can I walk with a sprained knee? How is a sprained knee treated? How long to heal and deflate?
Definition: what is a sprained knee?
I’knee sprain East ligament damage allowing the stability of the knee joint and which makes following a trauma. She may be benign – this is called a “ligament distension“ou more seriousmeaning in this case that there is rupture of a ligament. “If the ligament is torn, there is a loss of stability of the joint which is no longer ensured by the affected structures, whether the external and internal lateral ones or the anterior or posterior cruciate ligaments. The latter is more rarely affected“, explains Dr. André Ferreira, orthopedic surgeon. Grade 1 to 2 knee sprain is a partial rupture of the MCL (“medial collateral ligament” previously called “internal lateral ligament”). This type of sprain is characterized by significant pain along the ligament, localized bleeding or swelling, and moderate laxity in forced valgus. Night pains are common. “This grade requires orthopedic treatment by immobilization relative to the knee joint, in particular making it possible to limit the lateral movements of the knee while retaining the possibility of flexing it“, continues the specialist.
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What are the symptoms of a sprained knee?
A knee sprain is manifested by:
- A pain immediate
- Sometimes a creak felt during the trauma, lasting with the solicitation of the affected knee.
- A impotence functional, more or less important (knee sometimes impossible to move)
- A edema or swelling
- Sometimes a hemarthrosis (blood in the joint) raising suspicion of a ruptured ligament.
If the feeling of “dislocation” is strong, you must immediately suspect central pivot injury (anterior cruciate ligament, sometimes posterior).
Can I walk with a sprained knee?
The first days after the accident, resting the joint is a fundamental part of rapid recovery. This is why wearing a splint is prescribed, but it is possible to walk reasonably (to drain the lower limb), while using the lift for example when possible; the use of crutches canes is sometimes necessary.
In order to determine the type of sprain and its severity, it is essential to know the mechanism of injury. To do this, the doctor performs a physical examination : he must know what was the position of the patient and the kinetic energy deployed at the time of the trauma. Then he tests the different ligaments by maneuvers comparing both knees. This clinical examination must be supplemented by A radiograph which will help to eliminate or not the existence of a joint displacement or a fracture, but which does not allow the integrity of the ligaments to be assessed. “Depending on the clinical elements and the known data of the accident, a torn ligament (serious sprain) and/or meniscal damage may be suspected, in this case an MRI is requested to complete the diagnosis“, adds the doctor.
In the case of a mild sprain, outpatient treatment (i.e. non-hospitable) is sufficient. It consists of :
- put to rest the knee joint,
- wear a splint for 2 to 3 weeks,
- take some anti-inflammatories or analgesics,
- ask some compresses of ice on the painful joint.
- participate in sessions re-education to a physiotherapist, if joint stiffness has set in.
On the other hand, “if there is a meniscal lesion, surgery (arthroscopy) can be considered to treat it. In the event of a ligament rupture, surgical reconstruction (surgical ligamentoplasty) can be performed followed by long-term physiotherapy rehabilitation”, advises our interlocutor. Whatever the diagnosis, any immobilization or use of crutch canes generally requires the prescription of a preventive treatment against thrombosis.
How long does it take to heal from a sprained knee?
► In case of benign sprain of the medial collateral ligament (internal lateral ligament), the resumption of activities is quite fast (1 to 2 weeks) but the pain can last 2 to 3 months, hampering the return to sport.
► In case of rupture of the anterior cruciate ligament treated non-surgically (licit when there is no perceived instability), it generally takes 6 weeks of rehabilitation but activities are possible to resume gradually from the second week.
► In the event of ligamentoplasty of the anterior cruciate ligament of the knee (50% of cases of rupture), rehabilitation to activities of daily living lasts 4 to 6 weeks, the time to recover satisfactory range of motion:
► Walking without crutches is usually possible after 15 to 21 days. Driving can then be resumed.
► Daily activities return to normal 45 days after surgery.
► Total and painless mobility of the knee is restored after about 3 months.
► The resumption of sports activities usual begins after the 6th postoperative month.
It is essential to wear shoes adapted to the physical activity practiced
How long does the swelling last in a sprained knee?
In general 21 to 45 days are needed for the knee to fully deflate.
How long to keep the splint for a sprained knee?
“We must keep it as short as possible to limit joint stiffness and muscle wasting“, insists Dr. Ferreira. Generally:
► 1 week in the event of isolated damage to the anterior cruciate ligament,
► 3 to 6 weeks in the event of damage to the medial collateral ligament (especially if there is concomitant damage to the anterior cruciate ligament).
► no splint to wear post-operatively.
What is the duration of sick leave for a sprained knee?
The duration of sick leave after a knee sprain depends on your profession (sedentary activity, work in a dominant or non-dominant standing position, carrying more or less heavy loads, moving to high places, etc.), your conditions. transport (duration of the journey and means used), the seriousness of the sprained knee: whether or not surgical treatment is necessary, the associated lesions, your state of health, the possibilities of adapting or modifying the position in the event of a very physical position, use at height, work on slippery or unstable ground.
► In case of isolated sprain of the internal lateral ligament, the interruption of professional activity is not systematic, especially if the activity is sedentary and the disease is mild. If a work stoppage is necessary (physical professional activity, more significant sprain), it does not generally exceed three weeks.
► After arthroscopic surgery for rupture of the anterior cruciate ligamentthe work stoppage often lasts between 3 and 6 weeks in the case of sedentary work and 2 to 3 months if the physical work takes place at height or on unstable ground (4 to 6 months in certain specific cases).
When you return to work, if the work stoppage is longer than 30 days, a follow-up visit to the occupational physician is mandatory within 8 days.
It is fundamental to wear shoes suitable for the physical activity performed and, for skiing, to correctly adjust the resistance of its bindings according to its weight. Likewise, a preliminary warm-up as well as sufficient hydration are essential in the context of a sporting activity.
Thanks to Dr André Ferreira, orthopedic surgeon at the Clinique du Parc in Lyon.