Managing a knee sprain the right way, means faster healing, stronger healing and you get back to what you love faster – how could you say no to that!
Following on from the first post in this knee sprain series, where I outlined what you must do in the first 72 hours, I want to outline the knee sprain treatment and rehab exercises that will fully rehab your knee, the right way.
Knee Sprains Rehab with Non-Operative Treatments
The medial collateral ligament (MCL) is the most frequently injured ligament of the knee, so it is important that YOU have the know-how, to rehabilitate it right from the start.
It is important for you to know and have peace of mind that knee sprains (when other structures aren’t also injured) do respond very well to non-operative treatment and rehab.
As Phisitkul et al state: “Nonoperative care has been proposed as the mainstay treatment for the majority of isolated MCL injuries regardless of severity”.
Treatment with early protected range of motion exercises and progressive strengthening has been shown to produce excellent results and a high rate of return to sports”
So let’s go through what your knee sprain (LCL or MCL) rehab involves and what the exercises are that will get you back faster and stronger.
Knee Sprain Treatment
Effective knee sprain treatment must include:
- RICE – for the first 72 hours
- Brace (for high-grade tears)
- Proprioceptive re-training
- Range of motion exercises
- Strengthening exercises
If one of these aspects are missed or ignored, you could be left with ongoing, nagging pain or heal weaker, leading to future injury. Not ideal right?
Your rehab needs to be gradually progressed so that you body has time to adapt and get stronger. Our body is continually adapting to the forces that we put through it – So if you put the right controlled forces though your injured leg, it will get stronger and stronger.
We have talked about the first two components of sprained knee rehab and treatment in our earlier posts. For this post we will talk about the other three aspects, starting with Proprioception Re-Training.
1. Proprioception Re-Training:
Proprioception is the ability for you brain to know where you body is in space. If this is decreased, you have poor balance and increased chance of re-injury.
If you aren’t sure what proprioception is – extend one arm out to the side, close your eyes and mirror it exactly with the other arm – you could do this with your eyes closed because of proprioception.
Single leg standing (SLS):
Begin by standing on one leg on a solid surface (you can put one finger on the wall if you need to start with). When you can do this for 60 seconds, you can progress it by:
- SLS on a folded up towel, layers of towels are great to use as you can easy progress this by adding layers and then finally rolling it up, tighter and tighter. Progressing each time when you can easily do it for 60 seconds. NOTE: Have a bench in front or to the side to grab onto if need be – but only if you have to!
- You can also use Wobble boards, Bosu balls and balance boards when towels become to easy (or boring!) – Bosu ball are fantastic rehab tools if there is one available to you!
Continue to progress this through all phases.
2. Range of motion (ROM)
We recommend performing multiple exercises in a couple of phases to regain range of motion and strengthening of muscles.
Phase one (first 1-2 weeks)
Due to pain, inflammation and limping, we lose range of motion (flexibility) very quickly and it is important to get this back as soon as possible to normalize movement and prevent secondary injury.
Note: continue to ice after use if there is pain, discomfort or swelling.
– Heel slides
– Heel slides- Lying on your back or sitting
- slide your heel up and down (bending knee up)
- Do not push into pain
- 3 sets, 10 reps
- Do not push through pain
– Straight leg raise
– Straight leg raise- Keeping leg straight
- Lift leg 5-6 inches off the surface
- 3 sets, 10 reps
– Quads setting
– Quads setting- Roll a towel up and place under your knee
- pushing your knee down into the towel
- Lifting the feel up as shown
- hold for 5 seconds, 10 reps
Progress to phase 2 when you can complete phase 1 exercises with little or no pain or swelling
Phase 2 of ROM and Strengthening:
*Continue to ice as needed
– Calf stretch
– Calf stretch- Hang your heel off the edge of a step, hold for 30 seconds
- Do not push into knee pain – you should just feel a calf stretch
– Quads stretch
- Hold for 30 seconds
- As pain allows
– Hamstring stretch
– Hamstring stretch- Hold for 30 seconds
- A little pain is OK, no more
– Single leg squats
- Quality, not quantity here – control it
- 3 sets, 10 8 reps
- Hold onto a pole/broomstick if needed
- Don’t push into pain, just go down in a comfortable range
– Bridges
- Bend your knees up, place feet on the ground
- push through your heels and lift your bottom up
- 3 sets, 12 reps
Progress this to single leg bridges when this is easy and pain-free:
- 3 sets, 12 reps
– Begin walking/jogging program
Want more?
More more detailed information, advice and a step by step rehab guide that makes you your own Physical Therapist, check out our downloadable knee rehab guide HERE
Fore more detailed information, for those of you that enjoy research articles, have a read of this good review of anatomy, biomechanics and management
Persevere with this knee sprain treatment until your knee is 100% and remember, physio treatment can help speed up recovery by reducing swelling, muscle spasm and increasing ROM.
If you have any questions, make use of the comments section and don’t forget to like and share!
I have just sprained my knee and hope to follow your advice. Looks great. I’ll keep you posted. Do you have any advice for future knee stretches – before squats etc.? Thanks
Brilliant Ian, keep at it and then once comfortable doing body-weight one and double leg squats and lunges, you can then start adding weight or more plyometric exercises as able
Hi,
Thank you for your rehab program.
I’m 64. I have a MCL sprain and now into my second week of rehab. I do a lot of lap swimming and biking ( relaxed, upright rides on my beach cruiser). After 10 days of nothing but RICE, I just got back into the pool and I’ve been working my knees in a variety of positions using dive fins. I’ve also started riding 10 – 15 miles and staying conscious not to put any heavy torque on the bad knee. After my workouts, I apply ice and elevation (even though there is no longer any swelling). I’m also wearing a ACE knee support sock and only wear tennis shoes when walking, no flip flops. It appears to be working very well as I can finally plant my heel pretty well now when I step (instead of limping on the ball of my foot). The knee is still sore in the morning until I get it moving. But it’s much, much better after only 2 weeks!
Thanks again!
Dan
Hi Dan, that is good to hear – It sounds like you are starting to get that extension back if you can get the heel down now. Great start for the first 2 weeks but Keep at it until it is 100%!
I slipped and fell down on the road my knee got sprained. Sfter 2 months suffering I googled and found this rehab your knee exercise. I started the 5 steps today. I have a high hope to get healed with this rehab exercise program.
Tha is great to hear Dan, keep at it until it is 100%!
How often can you do this exercise a day?
Hi Ken, aim for two times per day but listen to your body and add in rest days and skip sessions if you need to.
I have been struggling with a sprained knee… Although mild it’s taking a long time to heal I was wondering when it’s safe to know when to start doing some sports again I am afraid of reiniury or setting myself back
Thanks
Hi there
Once you can single leg squat etc comfortably, build into some sports specific training by yourself such as running intervals, practicing changes of direction, jumping and ladder-work, as well as some training so build back up your confidence and ease in.
Is it bad to still work for uo to 6hours @a time when recovery from a knee injury …my swolleness has gone down &im still limping ..i been elevating my knee &using rubbing ointments. ..i feel better but still get moments of discomfort &some small pain ..this sunday will bee3weeks since my knee pop out of socket …
Hi Miguel
Yes, it is just important to remember not to push into pain with the exercises in this case. Such as if the one leg squats hurt then don’t go as low or step it back to some wall squats.
Kind regards, Shaun
I have recently had a knee sprain about 5 weeks ago in football and came back (without doing any rehab ) today but planted my right foot , when that happened I felt a pop and fell and starting limping . How long should I wait until I could play again ?
Hi Julio
As with all injuries, there is no set or exact time and secondly, don’t wait to play again. Rehab the knee until it is feeling great and training great and then get back to playing.
I sprained my knee ice skating two weeks ago. I can walk fine but am still unable to fully bend my knee without feeling any pain. Would I simply just need to give it time until it fully heals? It it okay for me to walk on it? Thank you.
Hi there, that is great to hear you are doing well and can walk fine. You are only two weeks into your rehab so stick at it and slowly start stretching the knee now to get more bend and if it isn’t improving in range in a couple of weeks, see a local physio for some manual therapy.
Thanks for your rehab! I sprained my knee and just litltle over a week the swelling is down and complete ROM is back. I am so glad I started this program the fourth day after my injury instead of waiting!
I sprained my knee and ankle a week ago and they aren’t really painful anymore but my knee feels not very strong when I do SLS. It feels almost wobbly all around it (just a weak feeling compared to my healthy knee) and my front thigh muscle feels the strain. I’ve stopped wearing a bandage but should I actually be supporting my knee when I do SLS? Thanks for your advice!
Hi there – That sound just right, the reason we do the SLS exercise os to get the neuromuscular control and strength back again and if is a bit wobbly it is being challenged and will improve. Keep it up!
Thank you very much! Should I be concerned that across the top of my knee still looks a little swollen and that there is slight pain in that area as well as around the back of my knee, a week and a half later? How soon should I expect to start feeling improvements in my strength and balance? I’m an avid walker (an hour or so a day) and I’m afraid of walking too much too soon with this injury.
My other question is, should I avoid doing any thigh stretches until I’m better at SLS? I ask because there is a stretch that I do for my back when I kneel
on the floor and stretch out in front – it’s good for my whole back and neck, but I’m concerned that stretching my thigh that way (and kneeling) could harm my injured knee.
Thank you very much for any advice!
– HoneyB.
Many thanks for the wise words and advice. I followed this programme for my left knee sprain 2 years ago (which worked fine after 6 weeks), and am just about to complete rehabilitation of my right knee (!) following a similar sprain almost 5 weeks ago now. Maybe I’ll try more strengthening exercises from now on!
Hi Jim. That is brilliant to hear, well done – The perfect patient! Absolutely, now try and keep a few exercises going.