Diagnosis Explanation:

A knee sprain occurs when the ligaments that stabilize the knee joint are stretched or torn due to twisting, sudden stops, awkward landings, or direct impact. The most commonly affected ligaments are:

• MCL (Medial Collateral Ligament) – Inner knee, injured by side impacts.
• LCL (Lateral Collateral Ligament) – Outer knee, injured by twisting or blows to the inside of the knee.
• ACL (Anterior Cruciate Ligament) – Injured by sudden stops, pivoting, or hyperextension.
• PCL (Posterior Cruciate Ligament) – Injured by direct blows to the front of the knee.

Severity Classification:

• Grade 1 (Mild): Ligament is stretched but not torn, slight swelling, minimal instability.
• Grade 2 (Moderate): Partial tear, noticeable swelling, difficulty bearing weight.
• Grade 3 (Severe): Complete tear, significant instability, possible need for bracing or surgery.

Specific Work Modifications:

• If your job requires standing or walking: Wear a knee brace for support and take frequent seated breaks.
• If your job involves lifting: Avoid sudden twisting, deep squats, or heavy lifting that puts stress on the knee.
• If your job is desk-based: Keep your leg elevated when sitting and perform gentle mobility exercises.
• Avoid: Prolonged standing, excessive stair climbing, squatting, and movements that cause knee instability.

Specific Activity Modifications:

• If you play sports: Avoid running, jumping, and pivoting until fully healed. Try swimming or cycling instead.
• If you hike: Stick to flat terrain, avoid steep inclines, and use trekking poles for stability.
• If you do weightlifting: Avoid deep squats, lunges, and leg presses. Instead, focus on controlled strength exercises for the hips and quads.
• Avoid: Cutting movements, sudden direction changes, and high-impact activities.

Recommended Supplements:

• Collagen Peptides – 10g daily for ligament and cartilage repair.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Vitamin C – 500mg daily to aid collagen production.
• Calcium & Vitamin D – 1000mg/800 IU daily for bone and joint support.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support ligament repair.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain joint lubrication.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to keep joints hydrated.

Home Exercise Prescription (Rehabilitation for Knee Sprain)

Early Phase (0-2 Weeks, Reducing Pain & Swelling):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression (brace or knee sleeve), Elevation.
• Quadriceps Sets – Tighten thigh muscles, hold for 5 seconds, repeat 10 reps, 3x/day.
• Heel Slides – Gently slide heel toward buttocks to improve mobility, 10 reps, 2x/day.
• Ankle Pumps – Move ankle up and down to improve circulation, 10 reps, 3x/day.

Strengthening Phase (2-6 Weeks, Regaining Strength & Stability):

• Straight Leg Raises – Keep knee straight, lift leg, hold 5 seconds, repeat 10 reps, 2x/day.
• Clamshells (Hip Strengthening) – Lie on side, open and close knees, 10 reps, 2x/day.
• Mini Squats (No Deep Bending) – Slight knee bends while keeping weight on heels, 10 reps, 2x/day.
• Glute Bridges – Lie on back, lift hips while keeping knees bent, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Improving Stability & Return to Activity):

• Step-Ups – Step onto a low platform, push through the heel, repeat 10 reps, 2x/day.
• Lateral Band Walks – Step sideways with a resistance band around thighs, 10 steps each way, 2x/day.
• Stationary Cycling – Low resistance for 10-15 minutes/day to maintain knee mobility.
• Balance Exercises – Stand on injured leg for 10-20 seconds, increase as tolerated.

Helpful Books:

1. The Knee Injury Bible: Everything You Need to Know About Knee Pain, Prevention, and Treatment – Kevin R. Stone, MD.
2. Heal Your Knees: How to Prevent Knee Surgery and What to Do If You Need It – Robert Klapper, MD, and Lynda Huey.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.