Early management of sprains and strains
Minor injuries to the knee, such as a mild sprain or strain should settle with time and can be managed at home.
A sprain or strain to the knee may result in the following:
- Pain
- Swelling
- Bruising
- Stiffness and loss of function
The pain can be particularly strong in the first three weeks as this is the inflammatory phase of your body healing itself. Typically, these injuries last 4 to 6 weeks depending on the severity.
Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet.
Up to date guidelines can be found on the NHS website:
Go to an urgent treatment centre or the emergency department if you:
- have severe pain or feel faint, dizzy or sick from the pain
- heard a snap, grinding or popping noise at the time of the injury,
- had a large amount of swelling which appeared instantly after the injury (within an hour)
- you are unable to weight bear because of the pain
These might be signs of a more severe injury which may need medical attention.
Speak to a GP or physiotherapist if:
- the pain is severe or stopping you doing normal activities
- the pain is getting worse and/or keeps coming back
- the pain has not improved in any capacity after treating it at home for 2 weeks
- you have ongoing symptoms of giving way or locking
- Click here to self-refer to a physiotherapist.
How to manage a sprain or a strain
DAY 1 – Early Management
Protect: Rest or restrict movement for 1 to 3 days after injury to minimise bleeding and prevent further injury.
Elevate: Elevate the injured limb above heart level to reduce swelling.
Avoid anti-inflammatories: Avoid non-steroidal anti-inflammatory drugs (NSAIDs), like Ibuprofen and Naproxen, as the inflammatory process is necessary for tissue repair. Icing a new injury can hinder the natural healing process so avoid this if you can. You can use pain medication like paracetamol. Take this regularly to control the pain and always follow the instructions on the packet.
Compression: Use an elastic bandage or wrap to help reduce swelling.
Education: Best practice advice now focuses on an active recovery, encouraging movement, and there is a recommendation to avoid passive treatments where you remain still and treatment is done to you. An active approach has been shown to improve recovery in the short and long term.
After the first few days, follow the L.O.V.E guide below
Load: Gradually reintroduce movement and normal activities. Optimal loading without increasing pain promotes tissue repair, builds tissue tolerance, and improves strength.
Optimism: Maintain a positive outlook. Psychological factors like depression, fear and worry regarding damage to tissues or getting moving again can hinder recovery.
Vascularisation: Engage in pain-free cardiovascular activity to increase blood flow to the injured area and promote healing.
Exercise: Restore strength, mobility, balance and coordination by incorporating specific exercises into the rehabilitation plan as soon as you feel able.
WEEK 1 – Early Mobilisation
After 72 hours is important to start using your knee as your pain allows. Start to do normal everyday activities. You should also try doing these exercises 3 – 4 times a day. Repeat each one 10 times.
Knee exercises
Hip exercises
WEEK 2 – Strengthening Exercises
You can start these when pain is starting to settle.
Knee exercises
a) moving the foot of your affected knee closer to you and then progress to
b) standing from a lower height.
Hip exercises
As you start to do these exercises you may feel there is some discomfort, however, this is okay and you should continue. If you have discomfort and pain for more than 2 hours after these exercises, then you should reduce the number and gradually build up again.
Recovery time and returning to activity
It usually takes 6 weeks to heal from simple soft tissue injuries to the hip or knee. However, everyone recovers from injuries at different rates. Some may be back in a few days however for some it can take a number of months.
Returning to work – Gradually build up your strength and function, practice doing similar tasks that you would do at work before returning. Start doing this little and often ensuring there is minimal pain or swelling.
Returning to hobbies or sport – it is advised not to return to these activities until you have full strength and range of movement without pain or swelling. Try to practice the specific movements of your hobby or sport in a controlled manner and build up the time and intensity that you do the movements before returning to your activity in full.