Knee Strain

Injury to the muscles or tendons that attach to bones in the knee. Muscles,tendons and bone comprise units. These units stabilize the knee joint and allow its motion. A strain occurs at a unit's weakest part. Strains are of 3 types:

• Mild (Grade I)-Slightly pulled muscle without tearing of muscle or tendon fibers. There is no loss of strength.
• Moderate (Grade II)- Tearing of fibers in a muscle, tendon or at the attachment to bone. Strength is diminished.
• Severe (Grade III)-Rupture of the muscle-tendon-bone attachment with separation of fibers. Severe strain requires surgical repair. Chronic strains are caused by overuse. Acute strains are caused by direct injury or overstress.

BODY PARTS INVOLVED

• Tendons and muscles in the knee region,especially the quadriceps and the hamstrings.
• Bones in the knee area, including the femur,patella, tibia and fibula.
• Soft tissue surrounding the strain, including nerves, periosteum (covering to bone), blood vessels and lymph vessels.

Causes

• Prolonged overuse of muscle-tendon units in the knee.
• Single violent blow or force applied to the knee.

Signs & Symptoms

• Pain when moving or stretching the knee.
• Muscle spasm in the knee area.
• Swelling over the injury.
• Loss of strength (moderate or severe strain).
• Crepitation ("crackling") feeling and sound when the injured area is pressed with fingers,
• Calcification of the muscle or tendon (visible with X-rays).
• Inflammation of the tendon sheath.

Treatment

Follow your doctor's instructions. Instructions are supplemental.

• Use ice massage 3 or 4 times a day for 15 minutes at a time. Fill a large styrofoam cup with water and freeze.Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
• After the first 24 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
• Take whirlpool treatments, if available.
• Wrap the injured knee with an elasticized bandage between treatments.
• Massage gently and often to provide comfort and decrease swelling.

Home Diet

Eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Prevention Tips

• Participate in a stretching, strengthening and conditioning program appropriate for your sport.
• Warm up before practice or competition.
• Tape the knee area before practice or competition.

Knee Sprain

Violent overstretching of one or more ligaments in the knee. Sprains involving two or more ligaments cause considerably more disability than single-ligament sprains. When the ligament is overstretched, it becomes tense and gives way at its weakest point, either where it attaches to bone or within the ligament itself. If the ligament pulls loose a fragment of bone, it is called a sprain-fracture. There are 3 types of sprains:

• Mild (Grade I)- Tearing of some ligament fibers. There is no loss of function.
• Moderate (Grade II)-Rupture of a portion of the ligament, resulting in some loss of function.
• Severe (Grade III)-Complete rupture of the ligament or complete separation of ligament from bone. There is total loss of function. A severe sprain requires surgical repair.

BODY PARTS INVOLVED

• Any of the many ligaments in the knee.
• Tissue surrounding the sprain, including blood vessels, tendons, bone, periosteum (covering of bone) and muscles.

Causes

Stress on a ligament that temporarily forces or pries the knee out of its normal location. Sprains occur frequently in runners, walkers, and those who jump in such sports as basketball, soccer, volleyball, skiing,and distance- or high-jumping. These athletes often accidentally land on the side of the foot.

Signs & Symptoms

• Severe pain at the time of injury.
• A feeling of popping or tearing inside the knee.
• Tenderness at the injury site.
• Swelling in the knee.
• Bruising that appears soon after injury.

How is a knee sprain diagnosed?

A caregiver will examine your knee and ask you questions about your activities. You may need x-rays or magnetic resonance (REZ-oh-nans) imaging (MRI). These tests will show a picture of the bones and tissues inside your knee. Caregivers can do these tests to learn if you have a fractured (FRAK-churd) (cracked or broken) bone or soft tissue damage.

Treatment

The immediate treatment for a sprained knee is the standard RICE formula. This is an acronym for Rest, Ice, Compression, and Elevation. These steps will help reduce swelling and pain, and speed the healing process. Rest the knee while it aches and ice it intermittently several times a day. Wrap it in an elastic bandage in between icings, and keep it elevated as much as possible.

Follow your doctor's instructions. Instructions are supplemental

The doctor usually applies a splint from the ankle to the groin to immobilize the sprained knee. If the doctor does not apply a cast ,tape or elastic bandage:

• Continue using an ice pack 3 or 4 times a day. Place ice chips or cubes in a plastic bag. Wrap the bag in a moist towel, and place it over the injured knee. Use for 20 minutes at a time.
• Wrap the injured knee with an elasticcized bandage.
• After 72 hours , apply heat instead of ice, if it feels better.Use heat lamps, hot soaks, hot showers, heating pads or heat liniments and ointments.
• Take whirlpool treatments, if available
• Massage gently and often to provide comfort and decrease swelling.

MEDICATION

Ask your doctor if you have any questions about using medications. Drugs that are commonly used to reduce pain and inflammation include:

• Ibuprofen (Motrin, Advil)
• Naproxen (Aleve, Naprosyn)
• Acetaminophen (Tylenol)
• Aspirin

Home Diet

During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Prevention Tips

• Build your strength with a conditioning program appropriate for your sport.
• Warm up before practice or competition.
• Take a break from sports or exercise when you feel tired.
• Tape vulnerable joints before practice or competition.
• Do exercises that strengthen the leg muscles.
• Wear proper protective shoes. A twist or injury to the foot can affect the knee.
• Learn the proper technique for exercise and sporting activities. This will decrease stress on all your muscles, ligaments and tendons, including those around your knee.