A knee sprain is an injury to the ligaments, which are the strong, fibrous tissues connecting the bones of the knee joint. This damage occurs when a ligament is overstretched or torn due to a sudden movement, twist, or direct impact. The decision regarding mobility aids, such as crutches, depends entirely on the severity of this ligament damage and your ability to comfortably place weight on the injured leg. Using crutches serves as a temporary means of protection, preventing further stress on the healing tissues.
Determining Weight-Bearing Status
The primary factor in deciding whether crutches are necessary is the amount of pain experienced when attempting to bear weight on the injured leg. If you cannot stand or walk without a significant, sharp increase in pain, then crutches are strongly recommended to allow the joint to rest. The severity of a knee sprain is typically categorized into three grades, which directly correlate with the need for support.
A mild, Grade 1 sprain involves an overstretching of the ligament with only minimal tearing of the fibers. Individuals usually experience slight discomfort and swelling, but they can typically bear their full body weight and walk without a noticeable limp. Crutches are generally not needed in these cases, although limiting activity is still important.
A Grade 2 sprain indicates a partial tear of the ligament fibers, leading to moderate pain, swelling, and noticeable instability in the joint. Attempting to walk often results in the knee feeling loose or buckling under pressure, making it difficult to bear weight comfortably. Crutches are highly recommended for a Grade 2 sprain to reduce stress on the partially torn ligament and prevent the injury from worsening.
The most severe injury is a Grade 3 sprain, a complete tear of the ligament, leading to significant joint instability. Putting any weight on the leg is usually impossible due to severe pain and the knee’s inability to support the body. Crutches are mandatory for any movement, and immediate medical attention is required because a Grade 3 sprain may involve surgical repair.
Proper Use of Crutches
If crutches are necessary, proper fitting and technique are important to protect the injured knee and prevent secondary injuries. The top of the crutches should be positioned approximately one to one-and-a-half inches below the armpit when you stand upright. Weight should be supported by the hands, pressing down on the hand grips, not by resting the body weight on the pads under the armpits. Resting on the armpit pads can cause nerve damage in the arm, a condition known as crutch palsy.
The hand grip should be adjusted so the elbow is slightly bent, ideally at about a 30-degree angle, to ensure the arms can fully bear the body’s weight. The most common method of movement for non-weight-bearing injuries is the three-point gait. This technique involves moving both crutches and the injured leg forward together, then bringing the uninjured leg forward to step past the crutches. This sequence ensures that the injured leg remains off the ground.
Immediate Care
Initial management of a knee sprain focuses on reducing inflammation and pain, regardless of whether crutches are being used. This immediate care follows the R.I.C.E. methodology: Rest, Ice, Compression, and Elevation.
- Resting the joint means avoiding activities that cause pain and may involve using crutches to prevent weight bearing for at least the first 24 to 48 hours.
- Ice should be applied to the injured area for 15 to 20 minutes at a time, with a thin cloth barrier, and repeated every two to three hours during the first 48 to 72 hours. The cold application constricts local blood vessels, which helps limit swelling and provides temporary pain relief.
- Compression involves wrapping the knee with an elastic bandage to help decrease swelling and provide mild support. The wrap should be snug but not so tight that it causes numbness, tingling, or increased pain below the knee, which would indicate restricted circulation.
- Elevation requires raising the injured leg above the level of the heart as frequently as possible, especially during the first two days, using gravity to minimize fluid accumulation and swelling.
When to Seek Medical Attention
While the R.I.C.E. protocol manages mild sprains, certain symptoms require immediate professional medical assessment. If you heard a distinct “pop” or felt a tearing sensation at the moment of injury, this suggests a severe ligament or meniscal tear. Any visible deformity of the knee joint, which might indicate a dislocation or fracture, necessitates emergency care.
You should seek medical attention if you experience any of the following:
- Pain so severe that you cannot put any weight on the leg or move the knee joint at all.
- Signs of potential nerve or vascular damage, such as numbness, tingling, or paleness in the foot or leg below the knee.
- Swelling that rapidly increases within the first few hours.
- Pain and swelling that do not begin to improve after 48 hours of diligent R.I.C.E. treatment.