The knee joint is a complex joint that relies heavily on ligaments and muscles for stability. Knee pain can be caused by various factors, not always originating from the knee, which makes the pain difficult to locate.
Common causes of pain are local causes such as, trauma and overuse, dysfunction of the lower limb, referred pain from low back, pelvis and hip. When pain is perceived as coming from the knee all the anatomical components need to be examined in addition to the joints that contribute to the biomechanics of the knee, i.e. low back, pelvis, hip and ankle and the foot.
One of the most common types of injury of the knee is damage to the ligaments. Ligaments are usually injured due to direct trauma to the knee and the amount of ligament injury caused is described as 1st, 2nd or 3rd degree sprain:
- 1st Degree Sprain – some tearing/over stretch of the fibres, no joint instability, mild pain, minimal swelling.
- 2nd Degree Sprain – Separation/tearing of fibres causing moderate instability and moderate to sever pain, swelling and stiffness.
- 3rd Degree Sprain – total rupture, gross instability, pain usually severe, profuse swelling, usually requires lengthy immobilisation and/or surgery.
Ligament injury will usually involve a certain amount of swelling directly over the location of the ligament.
Treatment of the sprain depends on the degree of injury. After the initial treatment, 1st and 2nd degree sprains can then be nursed at home with rest, ice, compression/elevation, massage and nutritional support of vitamin C / zinc. Once the ligament begins to heal gradual introduction of mobilisation and strengthening exercises can help and finally, proprioceptive training once ligament has healed. However, 3rd degree sprains are more serious and often require surgical repair.