Soft Tissue Injury: Knee

  • Reference Number: HEY-248/2016
  • Departments: Orthopaedics

Introduction

This leaflet has been produced to give you general information about your injury.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is a knee soft tissue injury?

The knee is a complex joint which is designed to withstand large stresses. Its stability relies mainly on:

  • Ligaments – which are strong bands of tissue that connect one bone to another and help hold the knee joint together.
  • Meniscus – This is the cartilage tissue which acts as a shock absorber in the knee joint.
  • Muscles – which surround the knee joint.

Any one or a combination of these structures can be injured.

What are the symptoms?

Symptoms can vary depending on the structure that is injured. Acute knee injuries may cause:

  • Pain, swelling and/or bruising.
  • Locking (an inability to straighten the knee).
  • Giving way.

What if I need pain relief?

To manage your pain it is advised that you regularly take simple pain relief, which can be bought over the counter from a pharmacist. If you have allergies or conditions which prevent the use of pain relieving or anti-inflammatory medication, please seek advice from your General Practitioner (GP) or a pharmacist.

What should I do in the first 72 hours after the injury?

The most important initial treatment is aimed at controlling the pain and swelling by following the principles of RICE:

R – Rest

Complete rest is not advisable but it is important that you prevent putting the knee under strain in the very early stages of healing. If necessary you will be given crutches to help you take some weight off the injured knee.

I – Ice

There are many different ways in which ice can be applied. Whatever method you choose, it is important that you wrap the ice in a damp towel to prevent burning the skin. Ice should be applied for 20 to 30 minutes every two hours.

Please note:

Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold.
Do not apply over an open wound.
Do not apply an ice pack to an area that has poor circulation.
During ice application check the skin every 5 minutes and discontinue its use if:

  • the area becomes white, blue or blotchy.
  • the area becomes excessively painful, numb or tingles.

C – Compression

If you have been given a tubigrip to wear it is important this is removed if you develop any signs of poor circulation, pins and needles or numbness. In addition it should be removed when you go to sleep.

E – Elevation

The ankle should be elevated above the level of the heart as much as possible as this will reduce and prevent swelling.

What should I do in the first 72 hours after the injury - E - Elevation Carry out circling movements of the ankle, while the leg is elevated, may help to reduce any swelling further.

What not to do

Consuming alcohol, massaging the injured area and applying heat can all be detrimental in the early stages of healing and therefore should be avoided.

Rehabilitation and recovery

If you follow this basic advice your injury should take around 6 weeks to heal. However, everyone recovers from injuries at different rates and it is dependent on the severity of the injury, the soft tissue that was involved and the presence of any other medical problems.

After 72 hours it is important you try to practice the following exercises which will help you to regain full function, flexibility and strength. These will also reduce the risk of the injury occurring again.

1. Find a friction free surface, for example a wooden floor or a tea tray placed on your bed, so that your foot can slide easily.

Rehabilitation and recovery - 1A Sit down and stretch your legs straight out in front of you. Now slide your foot up towards your bottom by bending your knee.

You may want to wrap a scarf around your heel so that you can assist by pulling with your hand to bend your knee further.

2. Sit on the floor or bed with your legs straight in front of you.

Rehabilitation and recovery - 2A Tighten your thigh muscle by pushing the back of the knee downwards and raising your heel slightly.

Hold for 5 seconds.

Each exercise should be repeated 10 times, 3 – 4 times per day.

As the knee improves you will find that you are able to stand and walk for longer. At this stage you should add in the exercises below.

1. Lean against a wall with your feet hip width apart.

Rehabilitation and recovery - 1B Now bend both knees so that you slide down the wall.

When you feel that your heels begin to lift off the floor, stop, hold 5 seconds and then return to the starting position.

2. Stand facing a wall and hold on for support.

Rehabilitation and recovery - 2B Keep your knees together; lift the heel of the injured leg up behind you towards your bottom.

Hold for 5 seconds and gently lower.

3. Stand facing a step and hold on to a firm support if required.

Rehabilitation and recovery - 3 Place the foot of the injured leg on the step and step up

Now place the foot of the uninjured leg on the floor and step down.

4. Stand on your injured leg and balance. To begin with you may need to hold on to something solid to prevent you from falling over.

Rehabilitation and recovery - 4 As you improve try doing functional activities such as washing the dishes or cleaning your teeth while you are standing on the one leg.

Try to hold your balance for up to 30 seconds.

Once you can do this comfortably try closing your eyes while you continue to balance on your injured leg.

Each exercise should be repeated 10 times, 3 times per day.

When can I return to normal activities?

If you participate in an active hobby then it is advisable that you do not return to this until you have full strength, full range of movement and you can walk briskly, run and turn without experiencing pain and swelling.

If you play a sport, practice specific activities like dribbling or jumping to prepare the knee and build this up gradually before returning to full training sessions and competition.

When to seek further help

You will normally be offered a referral to physiotherapy following this type of injury, unless your symptoms are minimal on your initial appointment.

If 10 days following your injury you are unable to weight bear and the knee remains painful and swollen, despite following the advice above, please contact your physiotherapist.

If you have not yet started your physiotherapy treatment at this stage please contact the physiotherapy team on telephone number (01482) 608939. If there is no answer, please leave a message and clearly state your full name, address and telephone number and we will get back to you as soon as possible.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

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We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

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