ADVICE AND EXERCISES FOR ACUTE KNEE PAIN OR INJURY
- FRANK GILROY- Senior Physiotherapist MSc MCSP
- COLIN WALKER- Consultant Orthopaedic Surgeon MB ChB, FRCS
- KELSEY BRETHOUR- MSc Physiotherapist Student
There are many reasons why patients will visit our clinics in Glasgow with a swollen knee. This may be as a result of injury or often just from an irritation within the joint itself which can occur as you get older. This joint pain and swelling will very often settle with time by doing the right things at the right time.
There are some medical conditions which will cause your knee to suddenly swell and become painful for no obvious reason and in this case you should consult your medical practitioner for an assessment.
The following advice is what we give to our patients if they are experiencing a flare up of acute knee joint pain and swelling:
APPLY ‘P.OL.I.C.E’ PRINCIPLE
- PROTECT Pain is your body’s signal that something is wrong. It is important to give your knee some rest to reduce pain and prevent further damage. If severe enough an assistive device like crutches or a brace may be necessary to use when walking to protect your knee from further damage and delayed healing.
- OPTIMUM LOADING While protecting your knee is important in the immediate short-term (<48 hours), immobilising your knee for too long can lead to deconditioning of the tissues, joint stiffness, muscle weakness and impaired balance. Therefore, gentle exercise needs to be incorporated slowly and gradually as your pain allows. Remember nature is protecting you from doing any more harm. These exercises will involve simple range of motion exercises like bending your knee to your chest while lying on your back to promote blood flow circulation. Exercise advice we recommend is available on this website HERE.
- ICE Place an ice pack on your knee 3 to 4 times a day for 20 Cover the ice pack so that it is not directly against your skin to prevent ice burns. We encourage patients to do this until the pain and swelling subsides.
- COMPRESS Use an appropriately sized compression bandage to reduce swelling. Apply bandage evenly around the affected area ensuring it is not too tight and remove at night to avoid disrupting blood flow.
- ELEVATE Keep your knee elevated as much as possible during the day, even at work. This will help flush out excess fluid from the knee and therefore reduce swelling due to gravity.
- BEGIN NON-LOADING ACTIVITIES Once you feel ready to start exercising again try non-loading activities like hydrotherapy or low resistance settings on an exercisebike for short periods initially. This exercise will mobilise the synovial fluid found within your knee joint that will help to lubricate your joint reducing the stiffness and pain being felt.
- PUT PAINFUL ACTIVITIES ON HOLD If you know that certain activities are causing discomfort, then you should stop doing them. For example, if movements such as squatting and lunging are causing pain and swelling, then these activities should be avoided.
- WEAR SUPPORTIVE FOOTWEAR
Supportive trainers help reduce the forces going through your knee whilst nature is trying to heal itself. No brand fits all, but shoes that are comfortable and provide stability will help keep the foot in a neutral position and reduce the stress placed on the knee joint.
Keep hydrated as joints that are well lubricated will heal more quickly. Your body will be able to eliminate waste and toxins that are contributing to the inflammation and painful state.
- BE REALISTIC ABOUT TIMESCALES FOR RECOVERY
Last but definitely not least, be realistic about timescales for your injury. A simple joint irritation may settle in a few days/weeks but a significant issue can often take up to 12 weeks to recover. The human body is extremely good at healing itself when given the timeso don’t be tempted back to loading activities too soon as this will prolong the recovery process.
The climb to recovery, it’s like a game of snakes and ladders…
Gilroy-Brethour Model, 2020
The aim of your rehabilitation is to climb up the ladder and avoid the snakes. The snakes involved in this process are the unexpected setbacks such as a flare up in symptoms along with unrealistic expectations you create for yourself such as climbing the ladder too quickly. It is important to understand that nature will heal itself and injuries will have different time scales of healing. Your physiotherapist will be able to discuss the time scale for your injury in order to guarantee you are climbing up the ladder and not sliding down the snake.
These are some simple tips for an acutely swollen knee. The ‘Knee Injury Self Treatment’ exercise programme which we previously wrote for use within the hospital is available on this website HERE.
If you any issues with your knee or any other ailments you can see Frank or any of the team at Hampden Sports Clinic…