Acute Knee Injuries

Acute injuries happen all the time, but recently the 15-24 age group has had the highest injury rate in a study of emergency room visits. Approximately 2.5 million sports-related knee injuries occur each year amount adolescents in the United States. The most common diagnoses are the following:

• Ligaments: Sprains or tears of the ACL, MCL, PCL or LCL
  • Since 2007 we have seen an increase in ACL tears in children and teens by 26%
• Fibrocartilage: Injury to the medial / lateral meniscus
• Bone: Bruises or non-displaced fractures
• Cartilage Injury: Osteochondral defects

How to Manage the injury:

Decrease pain and swelling, but also increase range of motion.

• Over the counter medications such as Ibuprofen, naproxen or acetaminophen
• Ice therapy and compression
• Gentle range of motion exercises with the following exercises:
  • Ankle Pumps & Circles
  • Quadriceps Sets
  • Heel Slides (Hip & Knee Flexion)
  • Lying Kicks
    • Lie on your back with a padded 3-pound coffee can or rolled blanket under your knee. Straighten your knee. Hold for 5 seconds. Slowly lower your leg down and relax. The back of your knee should stay in contact with the can/blanket during the exercise. Repeat with opposite leg
  • Straight Leg Raises
  • Knee Bending (Seated Knee Flexion)
    • Sit on a chair. Bend your knee back as much as you can. You may use the other leg to push the leg back. Hold for 30 seconds. Return to the starting position and relax. Repeat 5 times.
  • Sitting kicks
    • Sit in a sturdy chair. Lift your foot, straightening your knee as much as possible. Try to keep your knees level, as if you were holding a tray on your lap. Hold for 5 seconds. Slowly lower your leg down and relax. Return to the starting position and repeat with opposite leg.
  • Knee straightening stretch
    • Work on straightening your knee for 10 minutes. Sit on a sturdy chair with your heel up on another chair, or a footstool, in front of you. You should feel a stretch on the back of your knee. You can do thigh squeezes while you sit in this position to increase the stretch.

Next Steps:

Given the mechanism of injury, symptoms and physician examination, an MRI has to be ordered to evaluate internal derangement. A Forté staff member associated with your physician will contact you usually 48 - 72 hours after the MRI has been completed to review the results and develop a personalized treatment plan. Physical therapy is an integral part of the recovery process and can be initiated before the MRI scan to help with the range of motion.

Resources:

• S.K. Yasen: Common knee injuries, diagnosis and management
• L.S. Butler, J.J. Janosky, D. Sugimoto: Pediatric and adolescent knee injuries: risk factors and preventative strategies
• V. Minjares: Analysis: Serious knee injury among teen athletes grows 26%; National ACL Injury Coalition