Twisted knees - is that dangerous?
definition
A twisted knee is most common as a result of sports injuries. Sports in which the risk of such an injury is particularly high are skiing, football and martial arts (e.g. judo, wrestling). The athlete falls on the bent or extended knee, thereby placing it in an unphysiological position.
The enormous forces that act on the joint at this moment can lead to significant injuries to the structures inside and around the knee joint. The cross are particularly at risk-, as well as the inner and outer ligaments of the knee joint, the joint capsule, the menisci and the surrounding muscles.
What to do with a twisted knee Is that dangerous?
The result of the trauma is usually severe pain, swelling and overheating of the joint as well as blood and / or joint effusions. Based on the patient's acute symptoms, it is not possible to directly determine which structures in the joint have been damaged. However, this information is essential for choosing the correct therapy, which is why a detailed physical examination and often imaging (X-ray, MRI) are indicated.
If the knee joint has been twisted, the first thing to do is to stop physical activity and elevate and cool the affected joint. If severe pain occurs, a doctor should be consulted as a precaution. This is especially true if the joint swells or bruises develop. The doctor can determine if there has been a worse injury to structures of the knee joint. The respective therapy then depends on this.
A knee twist in which the ligaments have only been overstretched without damaging the ligaments, menisci or the joint capsule, can be treated conservatively and does not require an operation. The most important measure is then to continue cooling and elevating the affected knee to prevent further swelling. The cold also has a pain-relieving effect.
If the patient is in severe pain, they can take pain medication to bridge the gap. Suitable preparations are, for example, ibuprofen, paracetamol or, in the case of even more severe pain, Novaminsulfon®. If the knee joint cannot be put under strain due to pain, crutches can be used temporarily.
If the twisting of the joint has resulted in a more serious injury, for example a torn ligament, an injury to the inner or outer meniscus or damage to the joint capsule, an individual decision must be made as to whether a surgical procedure is necessary. Meniscal injuries are treated surgically if they are severe. Tears of the cruciate ligament also usually have to be operated on to ensure the stability of the knee joint in the future. The attending physician will decide what the right therapy is for each patient on the basis of the individual findings and the patient's clinical symptoms. Following an operation, physiotherapy is necessary to restore optimal mobility and stability in the knee joint. For some time, the patient has to use crutches and wear a splint so that the stress on the joint can slowly be increased again. Pain relievers help relieve pain after the procedure.
You might also be interested in this topic:
- Torn ligament in the knee joint
- Acute knee pain - that may be behind it
- Cruciate ligament overstretched
Who and how does the diagnosis?
If you twist your knee and suffer from severe pain, you should definitely consult a doctor to determine the extent of the injury. Various structures of the knee joint may have been damaged during the trauma. As a rule, it is advisable to present yourself with such an injury in a hospital emergency room, since the corresponding imaging can be done there directly (X-ray, MRI of the knee). The doctors who know best about such injuries are orthopedic surgeons, sports medicine specialists, and trauma surgeons.
In the hospital, one is usually presented directly to such a doctor after such an accident. He will explain the mechanism of the injury and examine the knee joint closely. In addition, an X-ray or an MRI of the knee is usually made in order to be able to show whether bones, ligaments or menisci have been damaged. The doctor will then suggest the further procedure and choose the appropriate therapy.
Appointment with a knee specialist?
I would be happy to advise you!
Who am I?
My name is dr. Nicolas Gumpert. I am a specialist in orthopedics and the founder of .
Various television programs and print media report regularly about my work. On HR television you can see me every 6 weeks live on "Hallo Hessen".
But now enough is indicated ;-)
The knee joint is one of the joints with the greatest stress.
Therefore, the treatment of the knee joint (e.g. meniscus tear, cartilage damage, cruciate ligament damage, runner's knee, etc.) requires a lot of experience.
I treat a wide variety of knee diseases in a conservative way.
The aim of any treatment is treatment without surgery.
Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.
You can find me in:
- Lumedis - your orthopedic surgeon
Kaiserstrasse 14
60311 Frankfurt am Main
Directly to the online appointment arrangement
Unfortunately, it is currently only possible to make an appointment with private health insurers. I hope for your understanding!
Further information about myself can be found at Dr. Nicolas Gumpert
Duration of complaints
The Duration of complaints following a twisting of the knee joint is mainly dated Extent of injury dependent. At a slight injury it quickly comes to an improvement and the patient becomes within a few days symptom-free again. Stronger strains and strains can be over complaints for a few weeks prepare.
If in the course of the accident Torn ligaments If other structures in the joint are damaged, the healing process will take longer. Was a surgical intervention necessary, this is usually followed by a intensive rehabilitation period at, in particular physical therapy plays a big role. The load on the injured knee joint is then only allowed slowly increased again become. This process can be over 3-4 months until you can exercise carefully outside of physiotherapy. Until the knee has healed completely, there is no symptoms and you can again do unrestricted sport, up to a year pass away.
Concomitant symptoms
A twisted knee usually manifests itself as very severe pain that occurs immediately after the trauma. The knee can hardly be loaded or not at all because the pain is too strong. Often the knee swells and is reddened and overheated. When blood vessels are injured, bruises (hematomas) form. Joint effusion can also develop. If the menisci are also injured, broken cartilage fragments can lead to a joint blockage. The knee can then no longer be bent or straightened. Rubbing or cracking noises in the knee joint can also indicate an injury to cartilage tissue, as small pieces of cartilage then rub in the joint space when the joint moves. In general, the symptoms of a twisted knee depend on the extent of the injury and can vary greatly from person to person.
Read more on the topic: Cartilage damage in the knee
Knee pain
In the case of knee pain, particular attention should be paid to the exact localization. If pain occurs on the outside of the joint after twisting the knee, this may indicate an injury to the external meniscus or ligament. As a result of the trauma, the ligament structures of the knee joint are overstretched or compressed and can tear or even tear. The menisci can also tear as a result of the impact. This is very painful and should be clarified by a doctor. If the pain is more on the inside of the knee, it could be an injury to the medial meniscus or ligament. Here, too, the cause is the strain in the ligament apparatus and the force acting on the joint when it hits the ground.
Pain in the hollow of the knee after twisting the knee can also indicate a meniscus injury. In this case it is most likely that Back horn of a meniscus affected. If the pain in the hollow of the knee does not appear until later after the trauma, it may be a Baker cyst, for example. This is caused by a bulge in the joint capsule that fills with fluid, for example as part of a meniscus injury. Baker's cyst manifests itself as pain and a soft, palpable swelling in the hollow of the knee.
If pain occurs in the calf after twisting the knee, it could be, for example, a crushed nerve or a torn muscle fiber as part of the accident. When you fall, great forces act on the knee joint and the whole leg, which can cause painful injuries. As a precaution, persistent and severe complaints should be clarified by a doctor in order to exclude injuries requiring therapy.
You can read detailed information on this topic in the next article: Knee pain - what do I have?
Knee swelling
Knee swelling after twisting may indicate joint effusion. If blood vessels were affected during the injury, bleeding into the joint capsule can occur. The joint swells. If the menisci are injured, an effusion is also common. As a result of the trauma, the tissue around the knee joint also swells, as blood and lymph vessels also run in the soft tissue. When these are damaged, fluid leaks into the tissue and the tissue swells. However, joint effusion does not occur every time the knee is twisted. So swelling is not an obligatory symptom of this type of injury. If there is swelling in the hollow of the knee after a knee injury, it may be a Baker cyst.
This occurs when the joint capsule bulges and increasingly fills with fluid. A swelling can then be felt in the hollow of the knee, which can also be accompanied by pain in the hollow of the knee.
Read more on the topic:
- Increasing knee swelling
- Swollen hollow of the knee
Cracking knee
If it's following a Twisting of the knee in the knee joint cracksso this can be done on a Injury to the cartilaginous articular surface Clues. Due to the trauma, great forces act on the joint, which lead to a compression or strain of the structures there. The Menisci, from Cartilage tissue exist, can tear, small fragments can peel off and float freely in the joint space. When the corresponding knee moves, it comes to friction the pieces of cartilage in the joint space, which can be noticeable as a cracking. Under certain circumstances, such cartilage fragments can also lead to a Joint blockage lead if they get trapped in an inconvenient place in the joint space. Suddenly the knee can no longer be bent or straightened. At a Cartilage injury in the knee joint it often comes in addition to one Joint effusion, which is through a swelling of the affected joint. Such symptoms should necessarily clarified by a doctor so that the extent of the injury can be determined and the appropriate therapy selected. This is the only way to avoid subsequent injuries, as otherwise free pieces of cartilage or bone will close further damage in the joint.
causes
A twist in the knee joint occurs most often in the context of sports accidents. Sports that require a lot of physical activity with stopping movements and changes of direction carry a particularly high risk. Examples of such sports are, for example, soccer, handball, basketball, skiing and martial arts.The twist occurs when the athlete falls on his bent or straight knee and the force exerts it into an unnatural position that does not correspond to his normal range of motion.
The ligament structures, the joint capsule as well as the muscles, nerves and blood vessels are overstretched or compressed. It can crack and bleed. But you can twist your knee in other situations too. For example, when falling from a great height, traffic accidents or twisting ankle. If the pain is severe and does not improve, a doctor should be seen to determine the extent of the injury.
Ligament stretch
Typical signs that suggest ligament stretching in the knee area are pain when moving the knee joint, as well as severe swelling and a noticeable loss of strength.
Compared to other injuries to the ligaments, pain from overstretching the ligaments usually only becomes apparent when the patient is exerted. If the knee is relieved and rested, the pain will decrease significantly. Compared to a ligament rupture, if the ligament is overstretched, standing and walking are basically still possible, even if only with severe pain. Restricted movement should in principle still be possible with pain.
You can easily find out whether you have a bath stretch in our appropriate article Ligament stretch in the knee read.
Capsule irritation as the cause of the complaints
An irritation of the knee capsule can have a wide variety of causes and therefore also bring with it a wide variety of accompanying symptoms. The usual symptoms of irritation of the knee joint capsule can include pain, redness and swelling. These are already present at rest, but increase during exercise.
Within the knee capsule there are several bursa, two menisci and the cruciate ligaments. Due to increased stress, all elements within this capsule can initially be irritated and eventually also become inflamed. Depending on which structure is affected, the pain can occur in either the anterior, posterior, upper or lower area of the knee.
Menicus contusion
The menisci are responsible for cushioning in the knee joint. Squeezing this connection can be very uncomfortable and painful. However, they are not essential for the knee, so that the mobility in the knee works even without menisci.
The pain of a meniscus squeeze usually does not occur at rest, but only when the patient is exerted. The knee can no longer be straightened without significant pain. The pain can radiate into the hollow of the knee. In addition, patients with meniscus bruises often feel an uncomfortable feeling in the knee area, but this is not particularly painful. A contusion occurs more often in the inner meniscus, i.e. in the inner knee area, than in the outer meniscus. Redness and swelling do not usually occur if the meniscus is squeezed alone. You can read about the symptoms here: inner meniscus lesion or outer meniscus lesion
Everything else on this topic can be found in the article Meniscal contusion or meniscus lesion
Meniscal tear
The meniscus connects the thigh bone to the shin bone. It forms an articular surface through which the two bones are in contact. If the meniscus tears, this can cause severe pain in the knee area. This pain is especially pronounced when the knee moves. Depending on whether the inner or outer meniscus is affected, the pain is more likely to appear on the outside of the knee or inwards.
With an internal meniscus tear, the pain becomes more pronounced when the knee is rotated inward. In addition, there are pressure pain in the inner joint space. This can easily be felt between the thigh and lower leg bones when the leg is bent. Pain is also evident when crouching and stretching the leg.
With an external meniscus tear, the pain is particularly pronounced when the knee is rotated outwards. Pressure pain within the joint space is more localized in the outer area. In addition, there is pain with an external meniscus tear when straightening up from the squatting position.
You can read everything about meniscus injuries here: List of contents Meniscus
Cruciate ligament stretch
The cruciate ligaments ensure the stability of the knee joint in a healthy state and are of essential importance during the movement of the knee.
Overstretching the ligaments can cause pain and swelling in the knee area. In spite of everything, the overstretching of the ligaments can be distinguished from a tear in the cruciate ligaments in that if the knee joint is overstretched, it is largely still stable. In principle, both standing and walking are still possible without assistance. The pain occurs depending on the load.
A cruciate ligament stretch is difficult to identify externally. Usually there are no bruises at all. Small swellings can be seen on the way.
However, various injuries to the ligaments are possible. To learn more about this, also read: Ligament injuries in the knee joint
Cruciate ligament tear
A cruciate ligament tear is often associated with other knee injuries. For example, a frequently combined injury is
- anterior cruciate ligament
- inner sideband
- inner meniscus
The tear in a cruciate ligament can often be clearly felt and you may have heard a cracking noise in your knee when it was torn. A cruciate ligament rupture quickly leads to severe pain and swelling of the entire knee. In addition, patients report, in addition to limited mobility and exercise capacity, an uncomfortable feeling of displacement within the knee.
A build-up of fluid under the kneecap is also one of the typical symptoms. This can be diagnosed using what is known as the "dancing patella", a phenomenon in which the kneecap appears to dance on the bruise when you stroke the knee. A bruise in the area of the knee or certain restrictions on extension and flexion can also indicate a torn cruciate ligament.
Please read our articles accordingly:
- Anterior cruciate ligament tear
- Posterior cruciate ligament tear
- Torn ligament on the knee
Collateral ligament tear
The knee is stabilized by the inner band and the outer band. Either of these ligaments can tear, but the likelihood of an outer ligament tear is much less likely than an inner ligament tear. A tear in the outer ligament occurs only in very rare cases as the sole injury. Often, other structures on the knee are injured when the outer ligament is torn, making it difficult to isolate the symptoms of an outer ligament tear. However, they are usually associated with pain, swelling, and bruising on the outside of the knee.
In the case of an inner ligament tear, however, the accompanying symptoms are easier to isolate. This often occurs without further knee injury. The inner ligament tear is associated with severe pain both at rest and under load. In addition to the pain, there is usually swelling on the inside of the knee. In addition, if the inner ligament ruptures, nearby blood vessels are often injured, which can ultimately lead to a bruise on the inside of the knee.
Both the inner ligament tear and the outer ligament tear lead to a feeling of instability in the knee. Due to the torn ligaments either on the outside or inside, the thighbones can no longer be connected to the shinbone on the respective side, which means that the knee can easily bend to the corresponding side. You can test this phenomenon by fixing the thigh bone and then bending the lower leg inwards or outwards. If the lower leg can be bent extremely strongly outwards, there is an inner ligament tear. If the lower leg bends inward with an unusual degree, an outer ligament tear is likely. However, this examination should by no means be carried out lightly and only by medical staff, as other structures in the knee can also be affected.
However, there are other ligaments on the knee that can tear or overstretch. To learn more, also read: Torn ligament in the knee or stretched ligament in the knee
Free joint body in the knee
Free joint bodies within the knee joint lead to increased irritation of the joint. The free joint bodies represent foreign bodies for the knee joint and, in extreme cases, can also cause inflammatory reactions in the knee.
Typical symptoms of such free joint bodies are pain caused by the increased irritation and severe swelling. In addition, the foreign bodies can become acutely trapped, which can ultimately lead to a so-called “blocking phenomenon”. This can lead to very painful and mobility-restricting pain within the knee. Patients describe the typical symptom of free joint bodies as the fact that blockages often occur, which then subside a short time later.
Tendonitis on the knee
Typical symptoms of knee tendonitis are pain in the area above the kneecap. In particular, severe flexion of the knee and internal rotation of the knee can lead to severe pain. If the inflammation persists, the pain can increase even with light exertion or at rest. A common symptom of tendinitis is swelling and reddening in the knee area, which can usually be seen above the kneecap.
You can find everything else under: Tendonitis in the knee or tendinitis in the hollow of the knee
Dislocated kneecap
A sudden, severe pain is typical of a dislocated or dislocated kneecap. In addition, the affected person can usually clearly feel how the kneecap slides out of its normal position. As a result of a dislocated kneecap, there is complete instability within the knee, so that it is almost impossible to stand on the affected leg. It is not uncommon for the holding apparatus of the kneecap to be affected as a concomitant phenomenon. This means that even after the kneecap has been reduced, it can quickly become dislocated again.
For how to treat a dislocation, see: Therapy of kneecap dislocation
Water in the knee - the joint effusion as the cause
If there is water in the knee, this can also be viewed as a form of knee joint effusion. A typical symptom is severe swelling, especially when compared to the other knee, as water in the knee is often only isolated on one side. In addition, there is reddening in the knee area and pain, which occurs especially during exercise. Another accompanying symptom is the increasing stiffness of the knee joint as well as difficulty in bending and extending the knee.
With the help of the so-called examination of the “dancing patella” it can be checked whether fluid has actually accumulated behind the kneecap.
Read on this topic too: Joint effusion- how dangerous is it?
