Knee Problems and Injuries
Table of Contents
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Topic Overview
Check Your Symptoms
Home Treatment
Prevention
Preparing For Your Appointment
Related Information
Credits
Topic Overview
Most people have had a minor knee problem at one time or another. Most of the time our
body movements do not cause problems, but it's not surprising that symptoms develop
from everyday wear and tear, overuse, or injury. Knee problems and injuries most often
occur during sports or recreational activities, work-related tasks, or home projects.
The knee is the largest joint in the body. The upper and lower bones of the knee are
separated by two discs (menisci). The upper leg bone (femur) and the lower leg bones
(tibia and fibula) are connected by ligaments, tendons, and muscles. The surface of the
bones inside the knee joint is covered by articular cartilage, which absorbs shock and
provides a smooth, gliding surface for joint movement. See a picture of the structures of
the knee.
Although a knee problem is often caused by an injury to one or more of these structures,
it may have another cause. Some people are more likely to develop knee problems than
others. Many jobs, sports and recreation activities, getting older, or having a disease
such as osteoporosis or arthritis increase your chances of having problems with your
knees.
Sudden (acute) injuries
Injuries are the most common cause of knee problems. Sudden (acute) injuries may be
caused by a direct blow to the knee or from abnormal twisting, bending the knee, or
falling on the knee. Pain, bruising, or swelling may be severe and develop within minutes
of the injury. Nerves or blood vessels may be pinched or damaged during the injury. The
knee or lower leg may feel numb, weak, or cold; tingle; or look pale or blue. Acute injuries
include:
• Sprains, strains, or other injuries to the ligaments and tendons that connect and
support the kneecap.
• A tear in the rubbery cushions of the knee joint (meniscus).
• Ligament tears, such as the anterior cruciate ligament (ACL). The medial collateral
ligament (MCL) is the most commonly injured ligament of the knee.
• Breaks (fracture) of the kneecap, lower portion of the femur, or upper part of the
tibia or fibula. Knee fractures are most commonly caused by abnormal force, such
as a falling on the knee, a severe twisting motion, severe force that bends the knee,
or when the knee forcefully hits an object.
• Kneecap dislocation. This type of dislocation occurs more frequently in 13- to
18-year-old girls.
• Pieces of bone or tissue (loose bodies) from a fracture or dislocation that may get
caught in the joint and interfere with movement.
• Knee joint dislocation. This is a rare injury that requires great force. It is a serious
injury and requires immediate medical care.
Overuse injuries
Overuse injuries occur with repetitive activities or repeated or prolonged pressure on the
knee. Activities such as stair climbing, bicycle riding, jogging, or jumping stress joints and
other tissues and can lead to irritation and inflammation. Overuse injuries include:
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Inflammation of the small sacs of fluid that cushion and lubricate the knee (bursitis).
Inflammation of the tendons (tendinitis) or small tears in the tendons (tendinosis).
Thickening or folding of the knee ligaments (plica syndrome).
Pain in the front of the knee from overuse, injury, excess weight, or problems in the
kneecap (patellofemoral pain syndrome).
• Irritation and inflammation of the band of fibrous tissue that runs down the outside
of the thigh (iliotibial band syndrome).
Conditions that may cause knee problems
Problems not directly related to an injury or overuse may occur in or around the knee.
• Osteoarthritis (degenerative joint disease) may cause knee pain that is worse in the
morning and improves during the day. It often develops at the site of a previous
injury. Other types of arthritis, such as rheumatoid arthritis, gout, and lupus, also
can cause knee pain, swelling, and stiffness.
• Osgood-Schlatter disease causes pain, swelling, and tenderness in the front of the
knee below the kneecap. It is especially common in boys ages 11 to 15.
• A popliteal (or Baker's) cyst causes swelling in the back of the knee.
• Infection in the skin (cellulitis), joint (infectious arthritis), bone (osteomyelitis), or
bursa (septic bursitis) can cause pain and decreased knee movement.
• A problem elsewhere in the body, such as a pinched nerve or a problem in the hip,
can sometimes cause knee pain.
• Osteochondritis dissecans causes pain and decreased movement when a piece of
bone or cartilage or both inside the knee joint loses blood supply and dies.
Treatment
Treatment for a knee problem or injury may include first aid measures, rest, bracing,
physical therapy, medicine, and, in some cases, surgery. Treatment depends on the
location, type, and severity of the injury as well as your age, health condition, and activity
level (such as work, sports, or hobbies).
Check your symptoms to decide if and when you should see a doctor.
Check Your Symptoms
Do you have a knee injury or other knee problem?
Yes
No
How old are you?
Less than 5 years
5 years or older
Are you male or female?
Male
Female
Have you had knee surgery in the past month?
If a cast, splint, or brace is causing the problem, follow the instructions you got about
how to loosen it.
Yes
No
Have you had a major trauma in the past 2 to 3 hours?
Yes
No
Do you have severe bleeding that has not slowed down with direct
pressure?
Yes
No
Do you have symptoms of shock?
The symptoms in an adult or older child are different than the symptoms in a young
child.
Yes
No
Is the leg blue, very pale, or cold and different from the other leg?
If the leg is in a cast, splint, or brace, follow the instructions you got about how to
loosen it.
Yes
No
Is there any knee pain?
Yes
No
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is
the worst pain you can imagine?
Signs of pain in a baby or toddler are different than signs of pain in an older child.
5 to 10: Moderate to
severe pain
1 to 4: Mild pain
Has the pain:
Gotten worse?
Stayed about the same
(not better or worse)?
Gotten better?
Do you have any pain in your knee?
Yes
No
How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is
the worst pain you can imagine?
8 to 10: Severe pain
5 to 7: Moderate pain
1 to 4: Mild pain
How long has the pain lasted?
Less than 2 full days (48
hours)
2 days to 2 weeks
More than 2 weeks
Has the pain:
Gotten worse?
Stayed about the same
(not better or worse)?
Gotten better?
Have you had a knee injury in the past month?
Yes
No
Are you having trouble moving your knee normally?
Yes
No
Can you move the knee at all?
Yes
No
Have you had trouble moving your knee for more than 2 days?
Yes
No
Did the knee or kneecap get twisted out of shape or pop out of its
normal position?
This is called dislocation.
Yes
No
Is the knee still out of place?
Yes
No
Is this the first time the knee has ever popped out of place?
Yes
No
Does the knee feel loose or unstable when you try to walk?
Yes
No
Is there any swelling or bruising?
Yes
No
Did you have swelling or bruising within 30 minutes of the injury?
Yes
No
Has swelling lasted for more than 2 days?
Yes
No
Do you have trouble moving your knee?
Yes
No
Is it very hard to move or somewhat hard to move?
"Very hard" means you can't move it at all in any direction without causing severe
pain. "Somewhat hard" means you can move it at least a little, though you may have
some pain when you do it.
Very hard
Somewhat hard
How long have you had trouble moving your knee?
Less than 2 days
2 days to 2 weeks
More than 2 weeks
Has the loss of movement been:
Getting worse?
Staying about the same
(not better or worse)?
Getting better?
Is there any swelling?
Yes
No
Has the knee been swollen for more than 2 full days (48 hours)?
Yes
No
Do you think that the knee problem may have been caused by
abuse?
Yes
No
Do you think the problem may be causing a fever?
Some bone and joint problems can cause a fever.
Yes
No
Are there any symptoms of infection?
Yes
No
Are there red streaks leading away from the area or pus draining
from it?
Yes
No
Do you have diabetes, a weakened immune system, peripheral
arterial disease, or any surgical hardware in the area?
"Hardware" includes things like artificial joints, plates or screws, catheters, and
medicine pumps.
Yes
No
How long have you had knee symptoms?
Less than 1 week
1 to 2 weeks
More than 2 weeks
Home Treatment
Home treatment may help relieve pain, swelling, and stiffness.
• Rest and protect an injured or sore area. Stop, change, or take a break from any
activity that may be causing your pain or soreness. When resting, place a small
pillow under your knee.
• Ice will reduce pain and swelling. Apply ice or cold packs immediately to prevent or
minimize swelling. Apply the ice or cold pack for 10 to 20 minutes, 3 or more times
a day.
◦ For the first 48 hours after an injury, avoid things that might increase swelling,
such as hot showers, hot tubs, hot packs, or alcoholic beverages.
◦ After 48 to 72 hours, if swelling is gone, apply heat and begin gentle exercise
with the aid of moist heat to help restore and maintain flexibility. Some
experts recommend alternating between heat and cold treatments.
• Compression, or wrapping the injured or sore area with an elastic bandage (such
as an Ace wrap), will help decrease swelling.
◦ Don't wrap it too tightly, since this can cause more swelling below the affected
area. Loosen the bandage if it gets too tight. Signs that the bandage is too
tight include numbness, tingling, increased pain, coolness, or swelling in the
area below the bandage.
◦ Don't expect the bandage to protect or stabilize a knee injury.
◦ Talk to your doctor if you think you need to use a wrap for longer than 48 to
72 hours. A more serious problem may be present.
• Elevate the injured or sore area on pillows while applying ice and anytime you are
sitting or lying down. Try to keep the area at or above the level of your heart to help
minimize swelling.
• Reduce stress on your sore knee (until you can get advice from your doctor):
◦ Use a cane or crutch in the hand opposite your painful knee.
◦ Use two crutches, keeping weight off the leg with the sore knee. You can get
canes or crutches from most pharmacies. Crutches are recommended if a
cane causes you to walk with a limp.
• Gently massage or rub the area to relieve pain and encourage blood flow. Do not
massage the injured area if it causes pain.
• Try the following exercises to maintain flexibility:
◦ Hamstring stretch
◦ Knee-to-chest exercise
• Avoid high-impact exercise, such as running, skiing, snowboarding, or playing
tennis, until your knee is no longer painful or swollen.
Do not smoke. Smoking slows healing because it decreases blood supply and delays
tissue repair. For more information, see the topic Quitting Smoking.
Medicine you can buy without a prescription
Try a nonprescription medicine to help treat your fever or pain:
• Acetaminophen, such as Tylenol
• Nonsteroidal anti-inflammatory drugs (NSAIDs):
◦ Ibuprofen, such as Advil or Motrin
◦ Naproxen, such as Aleve or Naprosyn
• Aspirin (also a nonsteroidal anti-inflammatory drug), such as Bayer or
Bufferin
Talk to your child's doctor before switching back and forth between doses of
acetaminophen and ibuprofen. When you switch between two medicines, there
is a chance your child will get too much medicine.
Safety tips
Be sure to follow these safety tips when you use a nonprescription
medicine:
• Carefully read and follow all directions on the medicine bottle and box.
• Do not take more than the recommended dose.
• Do not take a medicine if you have had an allergic reaction to it in the
past.
• If you have been told to avoid a medicine, call your doctor before you take
it.
• If you are or could be pregnant, do not take any medicine other than
acetaminophen unless your doctor has told you to.
• Do not give aspirin to anyone younger than age 20 unless your doctor tells
you to.
Symptoms to watch for during home treatment
Call your doctor if any of the following occur during home treatment:
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Signs of infection develop.
Your knee becomes hard to move or swelling lasts for more than 2 days.
Your knee, lower leg, or foot becomes pale or cool or looks blue.
Symptoms do not improve with home treatment.
Symptoms become more severe or frequent.
Prevention
The following tips may prevent knee problems.
General prevention tips
• Wear your seat belt in a motor vehicle.
• Don't carry objects that are too heavy. Use a step stool. Do not stand on chairs or
other unsteady objects.
• Wear knee guards during sports or recreational activities, such as roller-skating or
soccer.
• Stretch before and after physical exercise, sports, or recreational activities to warm
up your muscles.
• Use the correct techniques or positions during activities so that you do not strain
your muscles.
• Use equipment appropriate to your size, strength, and ability. Avoid repeated
movements that can cause injury. In daily routines or hobbies, look at activities in
which you make repeated knee movements.
• Consider taking lessons to learn the proper technique for sports. Have a trainer or
person who is familiar with sports equipment check your equipment to see if it is
well suited for your level of ability, body size, and body strength.
• If you feel that certain activities at your workplace are causing pain or soreness
from overuse, call your human resources department for information on other ways
of doing your job or to talk about using different equipment.
Tips specific to the knee
• Keep your knees and the muscles that support them strong and flexible. Warm up
before activities. Try the following stretches:
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◦ Hamstring stretch
◦ Knee-to-chest exercise
◦ Calf stretch
◦ Straight-leg raises
Avoid activities that stress your knees, such as deep knee bends or downhill
running.
Wear shoes with good arch supports.
Do not wear high-heeled shoes.
When playing contact sports, wear the right shoes that are made for the surface
you are playing or running on, such as a track or tennis court.
Replace running shoes every 300 to 500 miles (480 to 800 kilometers). Experts
recommend getting new athletic shoes every 3 months or after 500 miles of wear.
Tips specific to female athletes
Sports trainers recommend training programs that help women learn to run, jump, and
pivot with knees bent to avoid knee injuries. In sports such as soccer, basketball, and
volleyball, women who bend their knees and play low to the ground have fewer knee
injuries than women who run and pivot with stiff legs.
Knee brace use
Some people use knee braces to prevent knee injuries or after a knee injury. There are
many types of knee braces, from soft fabric sleeves to rigid, metal hinged braces, that
support and protect the knee. If your doctor has recommended the use of a knee brace,
follow his or her instructions. If you are using a knee brace to help prevent problems,
follow the manufacturer's instructions for use.
Keep bones strong
• Eat healthy foods such as milk, cheese, yogurt, and dark green, leafy vegetables
like broccoli. For more information, see the topic Healthy Eating.
• Exercise and stay active. Talk to your doctor about exercises and activities that are
right for you. Begin slowly, especially if you have been inactive. For more
information, see the topic Fitness.
• Don't drink more than 2 alcoholic drinks a day if you are a man, or 1 alcoholic drink
a day if you are a woman. Drinking alcohol increases your chances of having weak
bones (osteoporosis). It also increases your chances of falling.
• Do not smoke or use other tobacco products. Smoking increases your chances of
having osteoporosis. It also causes problems with the blood supply in your legs and
slows healing. For more information, see the topic Quitting Smoking.
Possible abuse
Knee injuries such as bruises, burns, fractures, cuts, or punctures may be caused by
abuse. Suspect possible abuse when an injury cannot be explained or does not match
the explanation, repeated injuries occur, or the explanations for the cause of the injury
change. You may be able to prevent further abuse by reporting it and seeking help.
Preparing For Your Appointment
To prepare for your appointment, see the topic Making the Most of Your
Appointment.
You can help your doctor diagnose and treat your condition by being prepared to answer
the following questions:
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What are your main symptoms?
How long have you had your symptoms?
What were you doing when your symptoms started?
Have you had this problem in the past?
◦ What was the diagnosis?
◦ How was it treated?
How and when did an injury occur? How was it treated? Were illegal drugs or
alcohol involved in your injury?
Have you had any injuries in the past to the same area? Do you have any
continuing problems because of the previous injury?
Have you ever had knee surgery?
What activities, related to sports, work, or your lifestyle, make your symptoms
better or worse?
Do you think that activities related to your job or hobbies caused your symptoms?
What home treatment measures have you tried? Did they help?
What nonprescription medicines have you taken? Did they help?
Do you have any health risks?
Related Information
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Animal and Human Bites
Burns and Electric Shock
Chest Problems
Cuts
Leg Injuries
Leg Problems, Noninjury
Puncture Wounds
Scrapes
Credits
By Healthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Kathleen Romito, MD - Family Medicine
Specialist Medical Reviewer Adam Husney, MD - Family Medicine
Current as of March 20, 2017
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