Knee Injuries
Coronavirus / COVID-19 update
During the COVID-19 risk period, wherever possible we’ll be reducing face-to-face appointments and helping you manage your injury remotely. This means that, in accordance with the British Orthopaedic Association guidelines, your individual treatment and follow up plan may be different to what happens under normal conditions. An orthopaedic consultant or a member of the orthopaedic team will always review your notes and x-ray and decide if a face-to-face follow up is necessary.
If we haven’t asked to see you for a follow up, we may offer you an open appointment, where you can make an appointment to see someone at any time in the six months after your injury. If you’d like to book an appointment, please call 01736 758892.
Advice for a new knee injury
- rest your leg
- elevate it above hip level
- apply a cold pack regularly
- use crutches for walking or a support bandage
- Protect
- Rest
- Ice
- Compression
- Elevate
- Rehabilitation
Medication
The Emergency Department (ED) or a Minor Injury Unit (MIU) may have prescribed you with some pain relief. Take these as instructed to help manage the pain.
If you do not feel that this medication is helping, talk to us during your appointment in Fracture Clinic, or your GP, about an alternative option.
Cold packs
Ice is a great natural anaesthetic that helps relieve pain and controls swelling. Apply ice packs or a bag of frozen peas wrapped in a wet thin towel to your knee for up to 15 minutes every few hours.
- Do not place ice in direct contact with the skin.
- Do not leave the ice pack on for more than 20 minutes at a time in one hour.
Rest and elevation
It’s normal to experience swelling after your injury. Elevation reduces swelling, which in turn relieves pain and speeds up your healing. Keep your knee elevated as much as possible during the first 24 to 72 hours.
Raise your leg on a stool or cushions above the level of your hip to elevate it as much as possible.
Smoking
Medical evidence suggests that smoking prolongs fracture healing time. In extreme cases it can stop healing altogether. Stopping smoking during the healing phase of a fracture will help ensure optimal recovery from this injury.
For advice on stopping smoking and local support available, please discuss this with your GP or go to the NHS Smoke Free website.
Care plans for bone injuries in your knee
Click on the box with your injury to find information that will help you understand your injury, guide you through your rehabilitation and explain what you can do to maximise your recovery. Your diagnosis should have been made by an orthopaedic consultant or one of the team working under the supervision of the consultant team. The information in these care plans is to help you understand your diagnosis and is not exhaustive. Your consultant may give you a different, personalised care plan based on your injury and whether you need imaging (x-ray, CT scan, MRI or an ultrasound) or an operation.
Patella dislocation
What is your injury?
A patella dislocation is when your kneecap slides out of joint. You will have a T-scope brace or a patella stabilising brace to help manage this injury.
Healing
This injury will take up to 12 weeks to heal, but this may differ depending on your individual circumstances.
Follow up
A knee specialist will call you for a follow up after your injury. This usually takes place after around two weeks. They will tell you about the next stage of your rehabilitation. Please make sure we have your up-to-date contact details.
If you feel you’d like to see someone at any time in the six months after your injury, you can book an open appointment by calling 01736 758892.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow this rehabilitation plan
- you have any questions
- you’re struggling with your brace
- you experience pain or symptoms other than at the site of the original injury or surrounding area.
Wearing your knee brace
To protect your knee, you must wear the brace fitted by the Emergency Department (ED) or Minor Injuries Unit (MIU). Your brace is called a T-scope. We will set your brace at 0 to 90 degrees range of movement.
If this is the first time you have dislocated your knee cap, you need to wear the brace for 6 weeks. Put your full weight through your leg as you’re able.
You must wear your knee brace during the day and night for 6 weeks. Only take it off to wash or use a cold pack. You must keep your knee straight and put the brace back on when you finish washing or using your cold pack.
This video tells you how to fit your T-scope brace.
If this is not the first time you have dislocated your knee cap
Please use your patella stabilisation brace again. Put as much weight through your leg as you can. We’ll tell you when you no longer need the brace.
Walking
You can put weight through your leg. You may find it easier to use crutches in the early stages.
Exercises
It’s important to start exercises as soon as possible. Follow the instructions and pictures below.
Do each of these exercises 3 to 4 times a day. Start straight away. Do not push into pain.
Ankle exercises
Point your foot up and down. Repeat this 10 times.
Static quadricep exercises
Rest with your leg supported and straight. Gently tense the muscles in your thigh and try to straighten your knee further.
Hold for 5 seconds and repeat 7 to 10 times.
More information
You can find out more about your patella dislocation, and see demonstrations of the exercises in this video from Brighton and Sussex University Hospitals.
Undisplaced patella fracture
What is your injury?
It’s a fracture (break in the bone) to your kneecap. Undisplaced means that the bones have not moved.
Healing
This injury will take up to 12 weeks to heal, but this may differ depending on your individual circumstances. You may experience some ongoing pain and swelling for 3 to 6 months.
Follow up
You’ll be referred to our virtual fracture clinic and we’ll tell you whether you need to come to the Fracture Clinic for a see a clinician for a face to face appointment. If you don’t need to come in, but you feel you’d like to see someone at any time in the six months after your injury, you can still book an open appointment by calling 01736 758892. After the virtual clinic, we’ll also send you a letter explaining the next step in managing your injury.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow this rehabilitation plan
- you have any questions
- you’re struggling with your brace
- you experience pain or symptoms, other than at the site of the original injury or surrounding area.
Wearing your knee brace
To protect your knee, you must wear the brace fitted by the Emergency Department (ED) or Minor Injuries Unit (MIU). Your knee brace is called a T-scope.
Only remove the brace to wash your leg daily or apply a cold pack. Keep your knee straight while you wash and replace the brace afterwards.
How do I adjust my brace?
They will set your brace at 0 to 30 degrees range of movement. Keep it at this setting for two weeks.
You will then need to adjust your brace:
- 2 weeks after your injury adjust it to 0 to 60 degrees
- 4 weeks after your injury adjust it to 0 to 90 degrees
This video tells you how to adjust your T-scope brace.
Walking
You can partially walk on your leg for 6 weeks by putting about 50% of your bodyweight through your injured leg. Try standing on weighing scales and use crutches to assist you. These videos explain how to use crutches for partial weight bearing.
After 6 weeks, you can put your full bodyweight through your injured leg and gradually remove the brace and crutches. Try using one crutch until you can walk without them.
Early weight bearing (putting weight through your injured leg) helps increase the speed of healing. Try to walk as normally as possible. This will help your recovery.
Exercises
Follow the exercises below within the limits of your pain. These exercises will help the healing process.
Do each of these exercises 3 to 4 times a day. Start straight away. Do not push into pain.
Ankle exercises
Point your foot up and down. Repeat this 10 times.
Static quadricep exercises
Rest with your leg supported and straight. Gently tense the muscles in your thigh and try to straighten your knee further.
Hold for 5 seconds and repeat 7 to 10 times.
More information
You can find out more about your undisplaced patella fracture, and see demonstrations of the exercises in this video from Brighton and Sussex University Hospitals.
Proximal fibula fracture
What is your injury?
It’s a break to the bone on the outside of your leg below your knee.
Sometimes this injury is associated with an ankle injury. It’s important that you tell us if you have any associated pain, swelling or bruising around your ankle.
Healing
It can take up to 12 weeks for this fracture to heal, but this may differ depending on your individual circumstances. You may experience some ongoing pain and swelling for 3 to 6 months.
Follow up
We’ll tell you if you need a further follow-up.
If you feel you’d like to see someone, you can book an open appointment at any time in the six months after your injury. Please call 01736 758892 to make an appointment.
Please call the Fracture Clinic if:
- you still have significant pain or swelling after 6 weeks
- you’re struggling to remove the boot
- you’re unable to follow this rehabilitation plan
- you have any questions about it
- you experience pain or symptoms, other than at the site of the original injury or surrounding area.
Walking
You can put weight through your leg when wearing your boot. You may find it easier to use crutches in the early stages. You will need to pace your activity until your pain and movement is better.
Try to stop using the boot and crutches as soon as you can. You should have stopped using them by 6 weeks after your injury.
Practice walking without your boot and crutches around your home first. Build up to longer walks outside.
Remove your boot to wash, dress and do your exercises.
Exercises
It’s important to start exercises as soon as possible. Follow the instructions and pictures below. Do each of these exercises 3 to 4 times a day. Start straight away. Do not push into pain.
Ankle exercises
Point your foot up and down. Repeat this 10 times.
Static quadricep exercises
Keep the leg straight and supported. Gently tense your thigh muscle and try to straighten your knee further. Hold for 10 seconds and repeat 7 to 10 times.
Inner range quads exercise
Place a rolled up towel or small pillow under your injured knee.
Tense your thigh muscle and try to straighten your knee. Keep the back of your knee in contact with the towel or pillow.
Repeat 10 times. Try to hold your knee straight for 5 seconds.
Knee flexion and extension
Sit or lie with your legs outstretched.
Bend and straighten your injured leg. Go as far as you feel comfortable.
Repeat 7 to 10 times.
Seated knee flexion and extension
Bend and straighten your knee while sitting as comfort allows. Repeat 10 times.
If you can, hold your leg straight for up to 5 seconds.
More information
You can find out more about your proximal fibula, and see demonstrations of the exercises in this video from Brighton and Sussex University Hospitals.
Tibial plateau fracture
What is your injury?
You have fractured the top of your tibia (shin bone). This area is called the tibial plateau. It’s part of your knee joint.
Healing
This injury will take up to 12 weeks to heal, but this may differ depending on your individual circumstances.
Some people with a tibial plateau fracture may need surgery.
Follow up
You’ll be referred to our virtual fracture clinic. We’ll tell you when you need to come to the Fracture Clinic for a see a clinician for a face to face appointment. After the virtual clinic, we’ll also send you a letter explaining the next step in managing your injury.
If you feel you’d like to see someone at any time in the six months after your injury, you can book an open appointment by calling 01736 758892.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow this rehabilitation plan
- you have any questions about it
- you experience pain or symptoms, other than at the site of the original injury or surrounding area.
Wearing your knee brace
You will have been given a T-scope brace at the Emergency Department (ED) or Minor Injuries Unit (MIU) to help you manage your injury. You can take this off to wash and check your leg but keep your knee straight as you do it.
Keep the brace on when doing your exercises. Try to bend and straighten your knee as much as your brace allows you to and within pain limits, as shown below.
You should repeat this 10 to 15 times, 4 to 5 times a day.
How do I adjust my brace?
They will set your brace at 0 to 30 degrees range of movement. Keep it at this setting for two weeks.
You will then need to adjust your brace:
- 2 weeks after your injury adjust it to 0 to 60 degrees
- 4 weeks after your injury adjust it to 0 to 90 degrees
This video tells you how to adjust your T-scope brace.
Walking
You must not put any weight on your affected leg for at least 6 weeks and possibly up to 12 weeks. You can walk using crutches by putting weight through your non affected leg.
Exercises
To recover movement it’s important to start exercises as soon as possible.
Follow the instructions and pictures below.
Do each of these exercises 3 to 4 times a day.
Knee flexion and extension
Bend and straighten your injured leg as far as you feel comfortable and only as far as the brace allows. Repeat 7 to 10 times.
Strengthening exercise
Keeping the leg straight and supported, gently tense your thigh muscle and try to straighten your knee further. Hold for 10 seconds and repeat 7 to 10 times.
Care plans for soft tissue knee injuries
What is a soft tissue knee injury?
You may have torn any of the four ligaments in your knee, or damaged other areas inside your knee such as cartilage.
Soft tissue knee injuries are graded according to severity:
-
Grade 1:
a few fibres are damaged or torn. This will usually heal naturally. It is often referred to as a sprain.
-
Grade 2:
more fibres are torn but the ligament is still intact. This may be referred to as a severe sprain.
-
Grade 3:
the ligament is completely disrupted. The knee joint is unstable and you may need an operation. This is a significant soft tissue injury.
How we will help you manage your injury
This will depend on your injury. For mild injuries such as sprains, PRICER (Protect, Rest, Ice, Compression, Elevation and Rehabilitation) plus time will allow your injury to heal.
More severe injuries may need further imaging such as an MRI scan. You may or may not need an operation.
To maximise your recovery, we’ll help you:
- manage your pain
- minimise your knee swelling
- maintain the range of movement in your knee joint
- keep your front thigh (quadriceps) muscles working and stop your hamstring muscles at the back of your thigh taking over too much.
Physiotherapy
Physiotherapy is an integral part of managing knee injuries, regardless of whether you’re having an operation. In more major soft tissue injuries, where we suspect you’ve injured one of the major ligaments or cartilages, one of our specialist physiotherapists will follow up with you to talk about how to manage your injury and whether you need further imaging (such as an MRI or CT scan, or an x-ray).
Mild soft tissue injury / knee sprain
What is your injury?
It’s a sprain to your knee. This can range from mild to severe. You may have been fitted with a knee support to help with initial swelling. If so, remove it at night.
Healing
Mild soft tissue knee injuries can take up to 12 weeks to heal, but this may differ depending on your individual circumstances and the severity of your injury.
Follow up
These injuries do not normally need a follow up, but we may decide you need to be referred to a physiotherapist. We’ll let you know if you do.
If you feel you’d like to see someone, you can book an open appointment at any time in the six months after your injury. Please call 01736 758892 to make an appointment.
Please call the Fracture Clinic on 01872 253091 if:
- you experience a sensation of giving way, locking or instability in your knee
- you’re unable to follow this rehabilitation plan
- you have any questions about it
- you experience pain or symptoms, other than at the site of the original injury or surrounding area.
Walking
You may walk on your leg as comfort allows. Use crutches and/or a support if you were given them at the Emergency Department (ED) or Minor Injuries Unit (MIU).
Gradually use your crutches and support less as pain and swelling eases.
Exercises
Follow the exercises below within the limits of your pain. These exercises will help the healing process.
Do each of these exercises 3 to 4 times a day. Start straight away.
Do not push into pain. Adjust your activity level until your movement returns and your pain has resolved.
Ankle exercises
Point your foot up and down. Repeat this 10 times.
Static quadricep exercises
Rest with your leg supported and straight. Gently tense the muscles in your thigh and try to straighten your knee further.
Hold for 5 seconds and repeat 7 to 10 times.
Inner range quads exercise
Place a rolled up towel or small pillow under your injured knee.
Tense your thigh muscle and try to straighten your knee. Keep the back of your knee in contact with the towel or pillow.
Repeat 10 times. Try to hold your knee straight for 5 seconds.
Knee flexion and extension
Bend and straighten your injured leg as far as you feel comfortable. Repeat 7 to 10 times.
Seated knee flexion and extension
Bend and straighten your knee while sitting as comfort allows. Repeat 10 times.
If you can, hold your leg straight for up to 5 seconds.
More information
You can find out more about your soft tissue knee injury, and see demonstrations of the exercises in this video from Brighton and Sussex University Hospitals.
Suspected anterior cruciate ligament (ACL) injury
What is your injury?
You have torn or sprained your ACL. It’s one of the 4 major ligaments in your knee that keeps your knee joint stable.
ACL injuries usually happen during sports. You may have pain, swelling, difficulty walking or feelings of instability (such as your leg giving way).
Healing
An ACL is a serious injury and it’s rare for it to heal completely by itself.
Depending on your injury and lifestyle, you may be able to manage your injury with physiotherapy and by changing the way you do things.
Some people, particularly younger people and those with active lifestyles, may be offered reconstructive surgery. ACL surgery fully restores the functioning of the knee in more than 80% of cases.
After the operation, it typically takes 9 to 12 months before you can return to sport, as long as you meet your rehabilitation goals with the physiotherapy team.
Having an operation on your ACL
ACL reconstruction uses a graft from your hamstring or patella tendon graft.
If surgery is an option, a knee surgeon will discuss this with you to help you understand the risks and benefits so you can make an informed decision.
You can find out more about knee surgery on the NHS website.
Find out more about having surgery for a soft tissue injury.
If you need an operation, prehabilitation exercises will help you prepare for and recover from surgery. It’s important to help you get the best outcome from your operation, so you must follow your physiotherapist and surgeon’s advice.
Follow up
We’ll refer you to a physiotherapist for rehabilitation or prehabilitation if you need an operation. We will discuss this in person when we discuss your injury in the fracture clinic. If you’d like to see someone at any time in the 6 months after your injury, you can book an open appointment by calling 01736 758892.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow your rehabilitation or prehabilitation plan
- you have any questions
- you’re struggling with your brace
- you experience pain or symptoms other than at the site of the original injury or surrounding area.
Wearing your knee brace
You may have been given a knee brace in the Emergency Department (ED) or Minor Injuries Unit (MIU). The brace is called a T-scope and we’ll have set it to a specific range of motion to protect your knee.
We’ll tell you how long you need to wear the brace for. It’s usually at least 6 weeks but could be longer depending on the severity of your injury.
If your injury is severe, we’ll tell you whether you need to wear your knee brace during the day and night. If you do, only take it off to wash or use a cold pack. You must keep your knee straight while the brace is off and put the brace back on afterwards.
Watch this video to find out how to remove and replace your brace.
Walking
You may have crutches to help you walk. Depending on your individual injury, we’ll discuss how much weight you can put through your leg when walking.
If you notice increased pain or swelling after walking, it can be a sign that you’re overdoing it. Please reduce the amount of walking you do and rest your leg. Elevate it to help reduce swelling.
Exercises
You can find exercises to help you recover from an ACL injury, or to prepare for an operation (prehabilitation) on your ACL here.
Suspected posterior cruciate ligament (PCL) injury
What is your injury?
You have torn or sprained your PCL. It’s one of the ligaments in your knee that keeps your knee joint stable.
You may have a few or no symptoms and might not realise that you have this injury. You might be able to walk normally and only experience some pain and mild swelling.
You may feel more generalised knee pain if you don’t treat the injury and feel discomfort when running, walking distances and down stairs.
A PCL injury might happen:
- during direct contact while playing sports, for example to your shin
- falling on your bent knee
- twisting your knee
- your knees hitting the dashboard in a car accident.
Healing
This injury will take approximately 6 to 12 months to heal. It may heal on its own over time by wearing a knee brace. You may need an operation if your knee remains unstable after we remove the brace.
You can find out more about knee surgery here:
Follow up
We’ll refer you to a physiotherapist for rehabilitation, or prehabilitation. You may also need a follow up for further x-rays such as an MRI, or to talk to a knee surgeon if you need an operation.
We’ll inform you of this after your face-to-face appointment in the Fracture Clinic. If you’d like to see someone at any time in the 6 months after you have been discharged, you can book an open appointment by calling 01736 758892.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow your rehabilitation or prehabilitation plan
- you have any questions
- you’re struggling with your brace
- you experience pain or symptoms other than at the site of the original injury or surrounding area.
Having an operation on your PCL
If surgery is an option, a knee surgeon will discuss this with you to help you understand the risks and benefits so you can make an informed decision.
You can find out more about knee surgery on the NHS website.
Find out more about having surgery for a soft tissue injury.
If you need an operation, prehabilitation exercises will help you prepare for and recover from surgery. It’s important to help you get the best outcome from your operation, so you must follow your physiotherapist and surgeon’s advice.
Wearing your knee brace
To protect your knee, you must wear the brace fitted by the Emergency Department (ED) or Minor Injuries Unit (MIU). It’s called a Rebound PCL Brace.
You need to wear the brace for 12 to 16 weeks.
Keep the brace on all the time except for washing. Remember to keep your leg straight when you take your brace off.
Watch this video to find out how to fit your brace.
Walking
You may have elbow crutches to help you walk.
These videos show you how to use your crutches.
You can put weight through your injured knee but you must be guided by your pain and swelling. Walk little and often, pace yourself and follow the PRICER (Protect, Rest, Ice, Compression, Elevate and Rehab) principles.
Exercises
You can find exercises to help your injury below in the section named ‘Exercises for your significant soft tissue knee injury’.
Suspected medial collateral ligament (MCL) injury
What is your injury?
You have torn or sprained your MCL. It’s one of the ligaments in your knee that keeps your knee joint stable.
An MCL injury is one of the most common knee ligament injuries. It usually happens by twisting your knee or receiving a direct blow to the outside of your knee, often during sports.
It’s common to injure one of your cruciate ligaments, or your meniscus, at the same time as your MCL.
Healing
This injury will take approximately 3 to 9 months to heal. It may heal on its own over time or you may need an operation.
Follow up
We will refer you to a physiotherapist for rehabilitation, or prehabilitation. You may also need a follow up for further x-rays such as an MRI, or to talk to a knee surgeon if you need an operation.
We’ll contact you to book these in so please make sure we have your up-to-date contact details.
If you’d like to see someone at any time in the 6 months after you have been discharged, you can book an open appointment by calling 01736 758892.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow your rehabilitation or prehabilitation plan
- you have any questions
- you’re struggling with your brace
- you experience pain or symptoms other than at the site of the original injury or surrounding area.
Having an operation on your MCL
Your individual circumstances will guide whether we recommend having an operation to reconstruct your MCL. The MCL heals better when the torn ends are in contact. Maturation of the scar occurs from 6 weeks to up to one year.
If surgery is an option, a knee surgeon will discuss this with you to help you understand the risks and benefits so you can make an informed decision.
You can find out more about knee surgery on the NHS website.
Learn more about having an orthopaedic operation at Royal Cornwall Hospital.
If you need an operation, prehabilitation exercises will help you prepare for and recover from surgery. It’s important to help you get the best outcome from your operation, so you must follow your physiotherapist and surgeon’s advice.
Wearing your knee brace
To protect your knee, you must wear the brace fitted by the Emergency Department (ED) or Minor Injuries Unit (MIU). Your brace is called a T-scope. We will set your brace at 0 to 90 degrees range of movement.
You need to wear the brace for 6 to 12 weeks, depending on the severity of your injury. We will see you in the Fracture Clinic and confirm the actual time needed for your particular injury.
You must wear your knee brace during the day and night for 6 weeks. Only take it off to wash or use a cold pack. You must keep your knee straight and put the brace back on when you finish washing or using your cold pack.
Watch this video to find out how to fit your brace.
Walking
You may have elbow crutches to help you walk.
These videos show you how to use your crutches.
You can put weight through your injured knee but you must be guided by your pain and swelling. Walk little and often, pace yourself and follow the PRICER (Protect, Rest, Ice, Compression, Elevate and Rehab) principles.
Exercises
You can find exercises to help your injury below in the section named ‘Exercises for your significant soft tissue knee injury’.
Suspected lateral collateral ligament (LCL) injury
What is your injury?
You have torn or sprained your LCL. It’s one of the ligaments on the outside of your knee that keeps your knee joint stable.
An LCL injury may happen from a direct blow to the inside of your knee, or stress on the knee from twisting the side of your foot.
You might feel:
- pain and swelling
- tenderness along the outside of your knee
- instability such as your leg giving way
- locking or catching when you move your knee
- numbness or weakness in your foot
Healing
This injury will take approximately 3 to 12 months to heal. Grade 1 and 2 LCL injuries usually heal well on their own over time. Some grade 2 and grade 3 injuries need an operation. This may happen in the first few weeks after your injury or at a later stage depending on your individual circumstances.
It’s important to follow a pre and postoperative physiotherapy programme to help your recovery.
Follow up
We’ll refer you to a physiotherapist for rehabilitation, or prehabilitation if you need an operation. You may also need a follow up for further x-rays such as an MRI, or to talk to a knee surgeon.
If you’d like to see someone at any time in the 6 months after you have been discharged, you can book an open appointment by calling 01736 758892.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow your rehabilitation or prehabilitation plan
- you have any questions
- you’re struggling with your brace
- you experience pain or symptoms other than at the site of the original injury or surrounding area.
Wearing your knee brace
To protect your knee, you must wear the brace fitted by the Emergency Department (ED) or Minor Injuries Unit (MIU). Your brace is called a T-scope. We will set your brace at 0 to 30 degrees range of movement.
You need to wear a brace for 2 weeks.
You must wear your knee brace during the day and night for 2 weeks. Only take it off to wash or use a cold pack. You must keep your knee straight and put the brace back on when you finish washing or using your cold pack.
Watch this video to find out how to fit your brace.
Walking
You should be able to fully weight bear unless you’re told not to by one of our consultants.
Exercises
You can find exercises to help your injury below in the section named ‘Exercises for your significant soft tissue knee injury’.
Suspected meniscal injury
What is your injury?
You have bruised or torn the thick pads of cartilage tissue (menisci) in your knee. The menisci act as shock absorbers to absorb body weight and help smooth movement and stability of the knee. Each knee joint contains a medial and lateral meniscus (inner and outer meniscus).
Injuring your meniscus often happens during sport through twisting your knee while your foot stays on the ground.
Meniscal injuries also happen through repeated small injuries, or wear and tear of the cartilage in older people. Severe meniscus injuries may damage other parts of your knee so you may have also sprained or torn a ligament.
Healing
Depending on your injury, it could take between 2 weeks to 12 months to heal.
If you have bruised your menisci or have a small tear, the injury should heal on its own in time.
If you have a larger tear, ongoing pain, or your knee locks or gives way, you may need an operation. This is because meniscal cartilage does not heal very well once it is torn. It’s mainly because it does not have a good blood supply.
If you have an operation and follow the advice from your doctor and physiotherapist you should fully recover.
What symptoms can you expect?
Your symptoms will depend on the type and position of the tear.
If your injury is because of wear and tear, your knee may feel slightly swollen for several months, but you may also not experience any symptoms.
You may find pain is worse when you straighten your leg. If the pain is mild you may still be able to walk. If the pain is severe, you may have a torn fragment of meniscus caught between your tibia and femur. You will need an urgent operation.
You may notice a clicking or catching feeling when you walk or be unable to straighten your knee fully.
If your knee locks (it gets stuck when you bend it and you can’t straighten it without moving the leg with your hands), please call us on 01872 253091 as we’ll need to see you urgently. You can also see your GP for an urgent referral.
Follow up
We’ll refer you to a physiotherapist for rehabilitation, or prehabilitation. You may also need a follow up for further x-rays such as an MRI, or to talk to a knee surgeon if you need an operation.
We’ll contact you to book these in so please make sure we have your up-to-date contact details.
If you’d like to see someone at any time in the 6 months after you have been discharged, you can book an open appointment by calling 01736 758892.
Please call the Fracture Clinic on 01872 253091 if:
- you’re unable to follow your rehabilitation or prehabilitation plan
- you have any questions
- you’re struggling with your brace
- you experience pain or symptoms other than at the site of the original injury or surrounding area.
Walking
If you have mild pain, you can walk and put weight through your knee and leg as you’re able to tolerate.
If your injury is more severe, you may not be able to walk without a lot of pain. If this is the case, you may need one or more of the following:
- walking aids
- a knee brace
- physiotherapy
- cortisone injections.
See your GP for a referral to physiotherapy or the Fracture Clinic. Their team will assess you and decide on the best treatment depending on the severity of your injury.
Exercises
You can find exercises to help your injury below in the section named ‘Exercises for your significant soft tissue knee injury’.
Exercises for your significant soft tissue knee injury
Start doing these exercises straight away. You must do these exercises 3 times daily. Do 10 to 15 repetitions.
Take painkillers 30 minutes before starting. Use ice after exercising where needed.
Static quadriceps
Keep the leg straight and supported. Gently tense your thigh muscle and try to straighten your knee further.
Hold for 10 seconds.
Inner range quads exercise
Place a rolled up towel or small pillow under your injured knee.
Tense your thigh muscle and try to straighten your knee. Keep the back of your knee in contact with the towel or pillow.
Try to hold your knee straight for 5 seconds.
Knee flexion and extension
Bend and straighten your injured leg as far as your brace allows you to.
Straight leg raise
Mini squats
Stand up with your arms across your chest.
Slowly lower your bottom into a squat position as if you are sitting on an imaginary chair.
Stand up again.
Using your knee braces and crutches
Advice for how to fit, wear and adjust your brace is different for each type of injury. Please read the information for your injury above. You must keep your brace on for all your exercises for at least 6 weeks.
How to use crutches
These videos show you how to use your crutches.
What should I do with my brace and crutches when I no longer need them?
- We can not use the brace again. You should not return it to the hospital.
- You can return crutches to the Fracture Clinic or your local physiotherapy department.
Preventing complications
Caring for your wound
If you’ve had an operation on your knee, you’ll need to keep your stitches dry and clean. You should also look out for any redness or signs of swelling, bleeding or pus as these can be signs of an infection.
You can find information about how to care for your stitches, if/when they need to be removed and signs of an infection on our orthopaedic surgery page.
Blood clots and Deep Vein Thrombosis (DVT)
Because your lower limb is immobilised and you’ll be moving less than normal, you’re at higher risk of developing a blood clot or Deep Vein Thrombosis (DVT). This can be life threatening if left untreated.
Symptoms of DVT in the leg are:
- throbbing or cramping pain in 1 leg (rarely both legs), usually in the calf or thigh
- swelling in 1 leg (rarely both legs)
- warm skin around the painful area
- red or darkened skin around the painful area
- swollen veins that are hard or sore when you touch them.
These symptoms can also happen in your arm or tummy if that’s where the blood clot is.
More information about DVT
- Watch this video about how to prevent DVT
- Learn more about DVT including symptoms, who is at risk and how to treat it on the NHS website
- Find out how to reduce the risk of blood clots when you have an immobilised lower limb (PDF, 108KB).
Preventative medication for DVT
If you have been told not to put any weight through your leg, you should have been assessed in ED or MIU and told if you need to take preventative medication. If you haven’t had this conversation please call your GP for an urgent appointment.
Pressure Sores and Ulcers
Wearing a brace and not moving your limb can lead to pressure sores or ulcers. These are injuries to the skin and underlying tissue caused by prolonged pressure, rubbing or tension.
They often develop gradually, but can sometimes form in a few hours.
Signs and symptoms of a pressure sore include:
- skin discolouration – red patches for people with pale skin, purple or blue patches for people with dark skin
- discoloured patches that do not turn white when pressed
- a patch of skin that feels warm, spongy or hard
- pain or itchiness in the affected area.
Take your brace off every day to check your skin. Make sure it’s not rubbing.
More information about pressure sores and ulcers
- Watch this video about how to prevent pressure sores
- Read more about pressure sores on the NHS website
If you think you have a pressure sore or ulcer
Call the Fracture Clinic straight away on 01872 253091. For out of hours advice please call 01736 758909.
Sepsis
Sepsis (also known as blood poisoning) is a serious infection that can be life threatening. There is no one sign for sepsis so it can be hard to spot.
Call 111 immediately if you develop any of the following:
- Slurred speech or confusion
- Extreme shivering or muscle pain
- Passing no urine in a day
- Severe breathlessness
- It feels like you’re going to die
- Skin is mottled or discoloured.
Find out more about the symptoms of sepsis on the NHS website.
These videos also explain what Sepsis is and how to spot the early signs.
Living with your injury
Driving
If you have an injury to your knee, you can return to driving when you:
- are no longer using your brace or crutches
- can walk comfortably
- can perform an emergency stop pain free.
Always test your ability to drive with the ignition off and in a safe environment.
If you have a follow up appointment with us, please wait until your consultant or physiotherapist has given you clearance to drive. If you are in any doubt, do not drive until you have spoken to our team.
Work
Decisions to return to work are made on a unique basis and should be discussed with the Fracture Clinic, your GP and your employer.
You may need time off work and when you return, you may need light or amended duties. When you should return to work will depend on your profession and your injury.
You can get a fitness for work statement or a sick note from your GP.
Sport
You should not do any sports for 6 weeks.
You must avoid contact sports and heavy lifting for 12 weeks.
