Health

Knee sprains are injuries that occur frequently, especially during sports activities such as football, tennis or skiing. They always require a consultation in order to establish the severity of the trauma.

WHAT IS A KNEE SPRAIN?

A knee sprain is a distension or tear of one or more ligaments.

The knee is stabilized by 4 main ligaments:

• The two lateral ligaments (internal and external), located on each side of the knee.
• The two cruciate ligaments (anterior and posterior), located in the center of the joint.

Simplified representation of the knee:

Injury to these ligaments can be accompanied by more or less intense pain, swelling of the joint (immediately after the injury, several hours or several days after it) and difficulty walking.

HOW DOES A KNEE SPRAIN OCCUR?

A sprain results from excessive tension on a ligament. It generally occurs when playing sports where the knee is used for sudden changes in direction, such as football, tennis, skiing, rugby, combat sports, etc. called pivot sports. A shot into the air can also lead to a sprain by hyperextension.

WHAT IS THE DIFFERENCE BETWEEN A MILD SPRAIN AND A SERIOUS SPRAIN?

A mild sprain corresponds to a distension or partial injury of the ligaments that heals spontaneously, while a severe sprain is characterized by a complete rupture of the ligaments and may require surgery. At the knee level, damage to the lateral ligaments is most often benign, while damage to the cruciate ligaments, particularly the anterior cruciate ligament, is generally more serious.

WHAT ARE THE SIGNS OF SEVERITY?

Pain is not a sign of severity. A mild sprain can be much more painful than a serious sprain. However, certain symptoms should alert you:

• If you have heard or felt a cracking sound in the joint.
• If your knee buckles or dislocates.
• If your joint swells very quickly.
• If you can no longer walk.

WHAT CAN I DO IF I SUSPECT A KNEE SPRAIN?

You should use your joint as little as possible. You can apply ice and keep your knee elevated to reduce swelling and inflammation. If necessary, take a painkiller to relieve the pain. You should then consult a doctor who will determine, by examining the movements of your joint, whether it is a serious sprain. If necessary, he will prescribe additional tests (X-ray, MRI) and refer you to a specialist to assess the condition of your ligaments and assess the associated injuries.

WHAT TREATMENTS ARE AVAILABLE?

The treatment depends on the severity of the injury but also on your age, your professional activity and the sports you practice.

Functional treatment combines medical treatment (analgesics, anti-inflammatories, possibly puncture to evacuate a blood effusion, multiple daily icing), partial immobilization (wearing a knee brace or removable splint) and muscular, joint and proprioceptive rehabilitation. Proprioceptive rehabilitation consists of performing balance exercises to improve control of your knee. Your doctor will refer you to a professional to carry out this rehabilitation.

Functional treatment is the only one considered for mild sprains. It may also be sufficient to treat a serious sprain or be a first step before surgical treatment.

If one or more of your ligaments are torn and you wish to resume a demanding professional activity or a pivot sport, your doctor may suggest surgery to replace the torn ligament with part of another of your tendons (autograft or ligamentoplasty) followed by several months of rehabilitation.

WHEN TO RESUME SPORT?

Your doctor will advise you on resuming your sporting activity, which depends on the type of sprain, the sport you practice, your fitness level and possibly the surgical technique used. In the event of surgery, you will be able to gradually resume a pivot sport 8 to 9 months after the operation.

HOW TO AVOID RECURRENCE?

The risk of recurrence depends on the severity and management of your sprain. Preventing recurrences involves treating the sprain promptly and practicing muscle and proprioceptive rehabilitation to increase the stability of your knee. Muscle strengthening particularly concerns the hamstrings located at the back of the thigh. You can also wear a knee brace when you return to your sport.

It is important to consult and treat a sprain. Neglecting a sprain runs the risk of instability (the knee gives way, it "gives way") and degeneration of the joint (osteoarthritis).