What is a knee sprain and how to treat it?
by Kevin Maniet
Kevin Maniet, sports physiotherapist and Performance Coach at Uperform Brussels Sports Performance gives us more information on knee sprain.
1) What is a lateral knee sprain?
The lateral sprain of the knee corresponds to damage to the ligaments (internal lateral ligament and
external) ensuring the medial and lateral cohesion of the thigh bone (femur) with those of the leg (tibia and fibula). It can turn out to be a mild trauma (simple elongation) or represent a more significant trauma, sometimes going as far as the rupture of the ligament or the injury of other structures of the knee.
2) What is the mechanism of injury? What structures are affected?
Most often, it is an accident occurring during sports practice (pivot sport and/or
contact: football, handball, rugby, skiing, etc.).
However, this type of lesion can be found in injuries occurring following road accidents.
The lesion mechanisms most often encountered are:
– The valgus-flexion-rotation-external (VFE) movement, causing damage to the internal capsulo-ligamentous plane (postero-internal angle point and LLI), but also, depending on the severity, the internal meniscus and the cruciate ligament anterior (ACL).
– The internal varus-flexion-rotation movement causes damage to the external capsulo-ligamentous plane (posterior external corner point and LLE) but also, depending on the severity, to the ACL and the external meniscus.
– Varus movement close to extension is a rare mechanism. When it occurs, it is responsible for serious lesions of the external compartment, it can lead to the rupture of the LLE, the popliteal tendon, the postero-external angle point and the posterior cruciate ligament.
– The valgus movement close to extension causes, depending on the extent of the trauma, a lesion of the internal compartment of the knee (LLI, postero-internal angle point).
3) Is it serious?
The most common injuries can range from partial tears to complete rupture of the lateral ligaments (LLI and LLE). These lesions are classified by degree of severity, the classification being generally defined according to the pathological laxity.
The clinical examination as well as the medical imaging therefore make it possible to determine the seriousness of the problem and the choice of treatment to be considered.
4) Is surgery an option?
Internal compartment lesions are usually treated orthopedically, regardless of the degree of injury.
On the other hand, lesions of the external compartment are rarer and often more serious (due to the anatomical and biomechanical complexity of this compartment). A grade 1 lesion is generally treated orthopedically, but in the presence of a higher degree lesion, a complex lesion of the LLE, the popliteal tendon and/or other ligamentous structures must be feared.
This type of injury should be the subject of a consultation in a specialized environment, because, very often, surgical treatment in deferred emergency is necessary.
5) How to deal with this problem? How is rehabilitation going?
Treatment also varies depending on the severity of the injury.
Initially, it usually consists of immobilizing the knee in a removable splint, for the purpose of pain relief and healing. The immobilization lasts between four and six weeks, the time necessary for the healing of the ligament.
At the same time, and as soon as possible, the physiotherapy treatment can start. It consists first of all in finding normal articular amplitudes, and in improving the sliding planes between the different structures of the knee.
Then, the treatment focuses on global and progressive muscle strengthening of the lower limb, in order to improve parameters such as strength, neuromuscular control and joint stability. Finally, the therapist prepares the individual to resume his sporting activity through re-athleticization sessions. A sort of rehabilitation that is more sporting than medical, this essential step in treatment brings athletes, professional or amateur, back to their best level of practice, in order to avoid any risk of relapse.
6) Can I continue to train?
Regardless of the severity of the injury, it is essential to stop sporting activity in order not to aggravate the injury.
Consult a health professional to determine the procedure to follow in order to return to your sports practice as soon as possible in complete safety.
7) Will I get back to my pre-injury level?
Depending on the severity of your injury, the recovery time will be longer or shorter. However, provided you follow the instructions given by your doctor/therapist, you will more than likely find your level… or even better!
8) What can I do to speed up the process?
In order to speed up the healing process, be sure to follow the recommendations of the health professionals you work with as much as possible. Laziness or, on the contrary, overzealousness, will be your enemies.
Conversely, discipline, rigor, perseverance as well as a positive and voluntary state of mind will help you get back in top shape as soon as possible!