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Knee Sprain

“Ligaments” are made up of many individual fibers running parallel to each other and bundled to form a strong fibrous band. These fibrous bands hold your bones together. Just like a rope, when a ligament is stretched too far, it begins to fray or tear. “Sprain” is the term used to describe this tearing of ligament fibers.

Sprains are graded by the amount of damage to the ligament
fibers. A Grade I sprain means the ligament has been painfully stretched, but no fibers have been torn. A Grade II sprain means some, but not all of the ligamentous fibers, have been torn. A Grade III sprain means that all of the ligamentous fibers have been torn, and the ligament no longer has the ability to protect the joint. Knee sprains commonly involve one or more of your knee’s ligaments including: the medial collateral, lateral collateral, anterior cruciate, and posterior cruciate.

Most knee sprains begin as the result of a sudden stop, twist, or blow from the side or front. Some patients recall a “pop” or “snap” at the time of injury. Knee sprains cause pain and swelling within the joint. Your knee may be tender to touch, and some patients report a sensation of “giving way” or difficulty walking.

Most knee sprains can be successfully managed without surgery but will require some work on your part. Initially, a period of rest may be necessary in order to help you heal. Mild Grade I sprains may return to activity in a couple of days, while more severe injuries may take six weeks or longer to recover. You can help reduce swelling by elevating your knee and using an ACE wrap for compression. Applying ice or ice massage for 10 minutes each hour may help relieve swelling. Depending upon the severity of your sprain, you may need to wear a knee brace to help protect you from further injury. If walking is painful, crutches may be necessary.
Here is a brief description of the treatments we may use to help manage your problem.
Joint Manipulation
Your chiropractor has found joints in your body that are not moving freely. This can cause tightness and discomfort and can accelerate unwanted degeneration i.e. arthritis. Your chiropractor will apply a gentle force with their hands, or with hand held instruments, in order to restore motion to any “restricted” joints. Sometimes a specialized table will be used to assist with these safe and effective “adjustments”. Joint manipulation improves flexibility, relieves pain and helps maintain healthy joints.
Therapy Modalities
We may apply electrotherapy modalities that produce light electrical pulses transmitted through electrodes placed over your specific sites of concern. These comfortable modalities work to decrease your pain, limit inflammation and ease muscle spasm. Hot or cold packs are often used in conjunction, to enhance the effect of these modalities. Another available option is therapeutic ultrasound. Ultrasound pushes sound vibrations into tissues. When these vibrations reach your deep tissues, heat develops and unwanted waste products are dispersed.
Myofascial Release
Overworked muscles often become tight and develop knots or “trigger points”. Chronic tightness produces inflammation and swelling that ultimately leads to the formation of “adhesions” between tissues. Your chiropractor will apply pressure with their hands, or with specialized tools, in order to release muscle tightness and soft-tissue adhesions. This will help to improve your circulation, relieve pain and restore flexibility.
Therapeutic Exercise
Muscle tightness or weakness causes discomfort and alters normal joint function, leading to additional problems. Your chiropractor will target tight or weak muscles with specific therapeutic stretching and strengthening to help increase tissue flexibility, build strength, and ease pain. Healthy, strong, and flexible muscles may help prevent re-injury.
Foot Evaluation
Fallen arches and faulty foot mechanics are common problems that can perpetuate your condition. Our office will carefully evaluate your feet and consider the need for a change in shoe style, arch supports or even custom orthotics.
 
 
After this initial course of treatment we will reassess your progress. We will determine the need for any additional care after your reassessment.
Sleep Posture
Your mattress and the position you sleep in may affect your condition.
Choose a mattress that provides medium or firm support, such as a traditional coil spring or adjustable airbed. Avoid waterbeds, thick pillow tops and soft, sagging mattresses.
Always sleep on your back with a pillow either underneath your knees or on your side with a pillow between your knees. Avoid sleeping on your stomach.
Keep your neck and back covered while sleeping to avoid drafts that could cause potential muscle spasms.
Workstation Ergonomics
Ergonomics is the science of adjusting your workstation to minimize strain in the following ways:
Maintain proper body position and alignment while sitting at your desk - Hips, knees and elbows at 90 degrees, shoulders relaxed, feet flat on floor or footrest.
Wrists should not be bent while at the keyboard. Forearms and wrists should not be leaning on a hard edge.
Use audio equipment that keeps you from bending your neck (i.e., Bluetooth, speakerphones, headsets).
Monitors should be visible without leaning or straining and the top line of type should be 15 degrees below eye level.
Use a lumber roll for lower back support.
Avoid sitting on anything that would create an imbalance or uneven pressure (like your wallet).
Take a 10-second break every 20 minutes: Micro activities include: standing, walking, or moving your head in a “plus sign” fashion.
Periodically, perform the “Brugger relief position” -Position your body at the chair’s edge, feet pointed outward. Weight should be on your legs and your abdomen should be relaxed. Tilt your pelvis forward, lift your sternum, arch your back, drop your arms, and roll out your palms while squeezing your shoulders together. Take a few deep cleansing breaths.
RICE
The acronym RICE can help you remember what to do after a new injury:
Rest – Limit stress to the injured area for at least the first 48 hours.
Ice – Apply for 10-15 minutes. Break for 30 minutes. Reapply. (Alternatives to the ice pack include Ziploc bags filled with ice, or a bag of frozen vegetables.)
Compression – Wrap the injured area with an elastic ACE bandage if possible.
Elevation – Elevate the injured area to limit swelling.
Standing
To avoid extra stress on your spine while standing:
Avoid high-heeled shoes or boots
Use a footrest measuring 10% of your height
To decrease stress on your back and feet consider leaning on a tall chair.
If excessive standing can’t be avoided, consider shock-absorbent shoes or an anti-fatigue mat.
When transitioning from a sitting workstation to a standing desk, begin gradually by standing 20 minutes per hour and not necessarily in a continuous period. Add an extra 10 minutes per hour each day as long as there is no prolonged stiffness or discomfort.
Footwear
Improperly supported feet can affect the alignment of all of the structures above. To improve your overall comfort:
Choose shoes with good arch support.
Avoid going barefoot or wearing shoes that lack support (i.e. flip-flops). The following brands of sandals provide better than average arch support: Naot, Fit Flops, Orthoheels, Abeo, Vionic and Yellow box.
Avoid high-heeled shoes or boots (keep heels to a maximum of 1½ inches, especially if you are going to be doing a lot of walking).
“Cross-trainer” athletic shoes tend to provide the best all around support and shock absorption for daily activities.
Patients with fallen arches should consider adding arch supports or orthotics.
Repair or replace shoes with worn soles or heels.
Running Shoes
Running shoes need to be replaced every 250 miles. There are three basic options:
Motion Control Shoes – Designed for people with low or no arches, these shoes are for runners who strike the ground on the outer edge of their foot. Avoid overly stiff shoes as these decrease you perception of ground strike and lead to new injuries.
Stability or Neutral Shoes – Designed for people with normal or average arches and running mechanics. The shoe contains some cushioning to absorb shock and prevent injuries and some rigidity to avoid pronation.
Cushioned Shoes – Designed for people with high arched feet. Their footprint will typically leave a thin band along the foot’s edge. As they run weight is distributed from heel strike to the outer edge of the foot and small toes that bear the brunt of “lift off.” This shoe is more flexible and absorbs the shock created by the lack or rotation (under-pronation) created by their running style.
Exercise- Water Aerobics
“Water Aerobics” simply means that you are exercising in the pool. Water exercise adds resistance but reduces the effect of gravity, and is usually less stressful on your joints. Water Aerobics are better tolerated by people who have joint problems like arthritis.
You do not need to be a swimmer to exercise in the water - most classes are held in chest-deep pools. Check with your gym or local YMCA to inquire about classes.
Working out in a group class can help with motivation.
As with all aerobic exercise, you should start gradually and don’t exceed the “talk test”- meaning you are still able to talk while exercising.
Sports Cream
Sports creams come in a variety of styles that produce either a sensation of heat or cold. These creams do not speed healing, but may provide temporary relief. Their effect is to pleasantly irritate the skin by stimulating the highly sensitive surface nerves, so that your brain can temporarily "forget" about your underlying deeper pain.
Sports creams have no known side-effects when applied in small amounts but do not apply more than a 2-3 of times per day unless otherwise directed.
Racquet Sports
Here are a few pointers for selecting your racquet:
Improper grip size is a known contributor to elbow problems. When you grip the racquet, you should be able to snuggly slide the index finger of the other hand between the tips of your fingers in the base of your palm.
A good grip overwrap can help prevent slipping and decrease the amount of force required to hold the racquet. (Factor the extra wrap into grip size, though)
Players should quickly release their grip tightness after ball-to-racquet strike in order to reduce stress on the elbow.
Increasing the size of your racquet head can help to reduce arm stress.
Avoid choosing “longer” or “heavier” racquets that will increase the amount of stress on your elbow.
Graphite is a light racquet but does not absorb vibration well. When possible, choose a more flexible frame that helps to absorb some of the shock of the ball’s impact.
Avoid playing with old or wet tennis balls as the additional speed and mass of the ball increases stress on your elbow. “Softer” or “stage 2” tennis balls weigh less than standard tennis balls which will produce less stress on your elbow when you strike the ball. These balls can also slow down the game slightly.

 

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