Some Basics...

• There are many ways that people can injure their knees. 
• There are also many types of knee injuries. There are bones, tendons, ligaments, cartilage, and muscles in the knee. These can all be injured.
• Treatment depends on the type of injury.

Types of Injuries

• Abrasion: This is the medical term for scraped skin. This happens when an injury scrapes off the top layer of the skin. A person may say that he or she "skinned" their knee. Pain is usually mild. This can usually be treated at home. Making certain the wound is clean is the most important thing.
• Contusion: This is the medical term for bruise. It is caused by a direct blow to the skin and muscles. The skin is not broken, there is no cut. The bruised skin may first look red, then purple, and finally orange-yellow. These skin color changes are from blood that leaked from tiny torn blood vessels in the bruised area. The skin may also be swollen. Pain is usually mild to moderate. Bruises are tender to touch. Most often this can be treated at home. A cold pack can help reduce the pain and swelling.
• Cut - Superficial: Superficial cuts (scratches) only extend partially through the skin and rarely become infected. A scratch is an injury to the skin made by a sharp edge. For example, scratches can be caused by fingernails, a sharp nail, a piece of metal, or a branch of a tree or bush. This can usually be treated at home. Making certain the wound is clean is the most important thing.
• Cut - Deep: Deep cuts (lacerations) go through the skin. A laceration is caused by cutting the skin with the sharp edge of an object. Lacerations longer than 1/2 inch (12 mm) usually need sutures.
• Dislocation: This is when a bone comes out of the joint. The joint always looks crooked or deformed. The pain is severe. A person with a knee dislocation will not be able to walk. This is serious and admission to the hospital is always needed. A doctor will treat this by putting the bone back into the joint socket.
• Dislocation of patella: This is when the kneecap slips off the top of the knee joint. The knee joint will look funny or deformed. A person with a patella dislocation will not be able to walk. The pain is moderate to severe. A doctor will treat this by pushing the patella bone back into right place.
• Fracture: This is the medical term for a broken bone. It means the same thing as a break or crack in the bone. The pain is severe. A person with a knee fracture usually cannot walk. Surgery may be needed.
• Patellar tendon rupture: This is a tear of the tendon just below the knee cap. Often a person cannot lift that foot and completely straighten the knee. Surgery is often needed.
• Quadriceps tendon rupture: This is a tear of the thigh muscle just above the knee cap. Often a person cannot lift that foot and completely straighten the knee. Surgery is often needed.
• Sprain: A sprain is the medical term used when ligaments are torn or over-stretched. Ligaments are the bands of tissue that connect bones to each other. This is the same thing as a "twisted knee." Knee sprains are very common. They happen most often while playing sports. Pain and swelling can range from mild to severe. Most knee sprains heal themselves with time and rest. Crutches and a knee brace are usually needed.
• Strain: A strain is the medical term used when muscles are torn or over-stretched. A more common term for this is a "pulled muscle". These are common injuries from falling, heavy lifting, and sports. Strains may heal themselves with time and rest. Surgery is rarely needed for a muscle strain.

Pain Scale

• None: No pain. Pain score is 0 on a scale of 0 to 10.
• Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
• Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
• Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

1. What You Should Know:
   • There are many ways that people can injure their knees.
   • There are also many types of knee injuries. There are bones, tendons, ligaments, cartilage, and muscles in the knee. These can all be injured.
   • You can treat a minor bruise, sprain, or strain at home.
   • Here is some care advice that should help.
     
2. Treatment of Bruise (direct blow to knee area):
   • Cold Pack: For pain or swelling, use a cold pack or ice wrapped in a wet cloth. Put it on the sore area for 20 minutes. Repeat 4 times on the first day, then as needed.
   • Heat Pack:
     • If pain lasts over 2 days, apply heat to the sore area. Use a heat pack, heating pad or warm wet washcloth. Do this for 10 minutes, then as needed.
     • For widespread stiffness, take a hot bath or hot shower instead. Move the sore knee under the warm water.
   • Rest the injured knee as much as possible for 48 hours.
3. Treatment of Sprains and Strains of Knee:
   • FIRST AID: Wrap with a snug elastic bandage. Put an ice pack on the knee to reduce bleeding, swelling, and pain. Wrap the ice pack in a moist towel.
   • Treat with rest, ice, compression, and elevation (R.I.C.E.). Do this for the first 24 to 48 hours.
     • REST the injured leg for 24 hours. You can then return to normal activity if it is not too painful.
     • Keep using ICE packs for 10-20 minutes every hour for the first 4 hours. Then use ice for 10-20 minutes 4 times a day for the first 2 days.
     • Apply COMPRESSION by wrapping the injured part with a snug, elastic bandage for 48 hours. If you feel numbness, tingling, or more pain, the bandage may be too tight. Loosen the bandage wrap.
     • Keep injured leg ELEVATED and at rest for 24 hours. Put your leg up on a pillow. Stay off your feet as much as you can.
4. Pain Medicines:
   • You can take one of the drugs listed below if you have pain.
   • They are over-the-counter (OTC) pain drugs. You can buy them at the drugstore.
   Acetaminophen (Tylenol):
   • Regular Strength Tylenol: Take 2 pills (650 mg) every 4-6 hours. Each pill has 325 mg of acetaminophen.
   • Extra Strength Tylenol: Take 2 pills (1,000 mg) every 8 hours. Each pill has 500 mg of acetaminophen.
   • Do not take more than (3,000 mg) of this drug per day.
   Ibuprofen (Motrin, Advil):
   • Motrin and Advil: Take 2 pills (400 mg) every 6 hours. Each pill has 200 mg of ibuprofen.
   • A second choice is to take 3 pills (600 mg) every 8 hours.
   Naproxen (Aleve):
   • Aleve: Take 1 pill (220 mg) every 8 hours. Each pill has 220 mg of naproxen.
   • A second choice is to take 2 pills (440 mg) every 12 hours.
   Extra Notes:
   • Use the lowest amount of a drug that makes your pain feel better.
   • Your doctor might tell you to take more than what is shown above. That is because your doctor knows you and your health problems.
   • Acetaminophen is safer than ibuprofen or naproxen in people over 65 years old. Acetaminophen is in many OTC and prescription drugs. It might be in more than one drug you are taking. Be careful how much you take. Too much of this drug can hurt the liver.
   • Caution- Acetaminophen: Do not take it if you have liver disease.
   • Caution- Ibuprofen and Naproxen:
     • Do not take ibuprofen or naproxen if you are pregnant.
     • Do not take these drugs if you have stomach problems or kidney disease.
     • Do not take these drugs for more than 7 days without checking with your doctor.
   • Read all package instructions.
5. What to Expect: Pain and swelling most often start to get better 2-3 days after an injury. Swelling is most often gone in 7 days. Pain may take 2 weeks to go away.
6. Call Your Doctor If:
   • Pain becomes severe
   • Pain is not better after 3 days
   • Pain or swelling lasts more than 2 weeks
   • You get worse