Rehab for Sprained and Twisted Knee Injuries

Knee sprains can occur during sports activities or may result from trauma, such as a fall. Sprains affect the ligaments that hold your bones together. The cartilage that provides padding between the bones in your knee is also sometimes injured. Rehab after a knee sprain includes treatments to decrease pain, manual therapy, range-of-motion exercises and strengthening. Follow the specific instructions from your physical therapist or doctor if you have a knee sprain.

Man on grassy field holding his knee (Image: shakzu/iStock/Getty Images)

Initial Treatment

Doctor working on a wrapped knee (Image: KatarzynaBialasiewicz/iStock/Getty Images)

Initial treatment during rehab for a knee sprain focuses on decreasing pain and inflammation while improving blood flow to promote healing. Ice is often used to decrease swelling, pain and muscle spasms. Once your swelling has resolved, heat may be applied to your knee prior to exercise to increase blood flow and decrease stiffness. Ultrasound and electrical stimulation treatments also decrease pain and increase blood flow to your knee. In addition, neuromuscular electrical stimulation -- current that is strong enough to cause a muscle contraction -- may be used in conjunction with exercise to help strengthen your thigh muscles.

Manual Therapy

Doctor bending woman's knee (Image: KatarzynaBialasiewicz/iStock/Getty Images)

Manual therapy -- hands-on treatment -- is an important component of rehab after a knee sprain. Your therapist may bend and straighten your knee and move your kneecap to decrease stiffness and improve flexibility. Different types of massage may also be used. Retrograde massage -- strokes directed from your lower leg to your thigh -- can be used to decrease knee swelling. Muscle spasms and tightness may be treated with deep tissue massage -- firm pressure applied with strokes in multiple directions. Cross-friction massage may be performed directly on an injured ligament to increase blood flow to the area. Firm pressure is applied to the ligament, then massaged with a side-to-side motion.

Range-of-Motion Exercises

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Range-of-motion exercises may start in your first rehab session to reduce stiffness after your knee sprain.The goal is to improve bending and straightening. For example, you may sit with your leg stretched out in front of you with a towel hooked around the ball of your foot. As you bend your knee, you are able to bend your knee further by pulling the towel toward you. Full range of motion is expected within 2 to 4 weeks after injury.

Strengthening Exercises

Woman with taped knee doing leg lift (Image: kicsiicsi/iStock/Getty Images)

Strengthening exercises typically begin once you have full pain-free movement in your knee. Initially, you may perform these exercises while seated or lying down to reduce pressure on your leg. For example, you may straighten your knee from a seated position or bend your heel up toward your buttock while lying on your stomach. Ankle weights can be worn during these exercises to increase resistance as you become stronger. Stationary cycling and use of an elliptical trainer may be incorporated to increase your endurance. Balance activities such as standing on one foot and sports-specific training activities may also be incorporated in rehab, typically 6 to 8 weeks after injury.