Sports Injury Focus: Knee Ligament

Signs and symptoms: 

Athlete likely to have landed awkwardly, twisted, or fallen causing pain, stiffness and immediate swelling of the knee joint, often on the inside. 

* Week 1 

Immediate ice, compression and elevation of the injured knee. Begin gentle walking ASAP. Strapping

Often 3-4 days post injury. 

Note: it is expected (and okay) to be painful. However, straight line walking only. 

None whatsoever twisting or turning of the knee joint can be tolerated in week 1. 

Swimming is encouraged when possible and if pain allows (Tip: Athletes will often use a float between the legs to keep the knee straight and limit pain). 

From a Physio point of view – deep friction massage and very gentle stretching and massage would begin after just 4-5 days. 

* Week 2 

Very gentle (but prolonged) walking on the flat is vital and is to be encouraged. Towards the end of week 2, the goal will be for gentle jogging on a treadmill. 

Swimming continues (not breast stroke), cycling and cross trainers are all ok. 

From a Physio point of view – massage continues of damaged knee ligaments and of the quads, ham- string and calf muscles. Specific quad and gluteal muscle activation is essential

Stretching of all muscle groups is a must and balance work is now added for both legs. 

* Week 3 

Exercise and CV work is increased. 

Straight line running is picked up and the athlete will aim to be at three quarter pace by the end of this phase. 

Slowly, but surely, uneven surfaces are introduced and twisting and turning begins to be allowed. 

From a Physio point of view – all deep massage work continues, muscles and knee joint are stretched to max and proprioception exercises are now top priority along with full movement of the knee joint. 

* Week 4 

Athlete returns to training and possibly performance. CV work increase and continues. 

From a Physio point of view – all massage treatment and stretching continues for approximately 3-4 weeks and athlete pays attention to strength and proprioception exercises. 

Review of recovery: 

Take it very easy early on. But in the case of nearly all knee ligament sprains, too much rest will be harmful. 

Stretch and mobilise the injury at just the right time and no knee ligament injury can ever recover fully with prolonged rest. 

Secret Tip(s): 

Too much rest in the first few weeks will increase the likelihood of re-injury and a recovery plateau will occur. 

No breast stroke in the swimming pool. 

Do not be fooled by lack of pain when walking straight – twisting and turning “pain free” must be achievable. 

Note: It’s not uncommon for knee sprains to feel not much better even 6 weeks down the line. And it’s often because of too much rest in the first few weeks. 

Stay off the beach and avoid uneven woods/hilly areas when running, for at least 3 months post knee injury. 

Don’t be fooled by the lack of pain after two weeks either. 

It does not mean you are fit to play or run and if you haven’t followed all of the Protocol listed above, you will damage the ligament again sometime soon – often when you least expect it on an uneven surface.

If you’d like more info on this, and some further easy, actionable tips on other sports injuries too. We have a free guide that we can send you. Connect with us on 01344 489398 or email us on bracknell@applephysio.com and tell us what’s going on. 

A member of the team can take your details and we can email you a copy.

About the Author: Leslie Abrahams and the Apple Physio team


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Leslie is a Physio, Pilates Educator and Rehab Specialist who has a special interest in Spinal Treatments, lower limb injuries, and has vast experience dealing with patients post injury or surgery. Every week, for over 20 years, 100’s of people aged 30-64+ have consulted the Apple Physio team looking for answers to concerning questions about, and for, a fast end to their health worries and physical pains and stiffness.

 Leslie is a Master Trainer for the world renowned Australian Physiotherapy and Pilates Institute(APPI). He is regular key note speaker at conferences and travels internationally to present on modified exercise for rehabilitation. Leslie is the Director of Apple Physio Clinics situated in Bracknell and Windsor. Berkshire’s Specialist Private Physiotherapy Practice for People in their 30’s. 40’s, 50’s and 60’s and above, who want to keep healthy and active.

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