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Exercises for a sprained knee – perfect for swollen, painful knees
Exercises perfect for swollen and sprained knee
Maryke Louw
Maryke Louw
Aug 31, 2021
These two exercises work well to get your knee moving, reduce swelling, and activate your muscles after you’ve sprained your knee or torn a meniscus.

What happens when you sprain your knee?

You will only have swelling in your knee after you sprain it if you injure a structure that's located inside the knee joint.

When you sprain your knee, you usually injure more than just one structure. You may bruise the cartilage, over-stretch the ligaments, pull a muscle or even tear your meniscus.

Most sprained knees will have some swelling, but the amount will vary depending on what structures you’ve injured. If you’ve only injured the muscles and ligaments outside the knee joint, you’ll likely not have much swelling. If you’ve injured any of the structures inside the knee joint (e.g. cartilage, cruciate ligaments, menisci), you’ll likely have quite a bit of swelling.

What is the best treatment for a swollen knee?

Starting with the PRICE (Protect, Rest, Ice, Compression, Elevation) regime shortly after an injury is the best way to limit the amount of swelling that you get. You can continue with the PRICE regime for 3 to 5 days, depending on how bad your injury is, but if you want to reduce the swelling further you should also start with gentle movements and exercises that activate the muscles.

Why is movement important for swollen knees?

Your knee joint doesn’t have arteries or veins going into it. It relies 100% on the changes in pressure caused by movement to get fluid, nutrients, and oxygen in and out of the joint. So by doing gentle movements, you can help your knee get rid of the swelling while increasing the nutrients and oxygen available for healing.

If you keep your knee dead still, the swelling will accumulate and your knee will actually feel more painful. Have you ever noticed how a painful joint can feel at its worst when you wake up in the morning and try to move? Then after 3 or 4 repetitions of a movement, it starts to feel looser and more comfortable. That’s because you’ve helped the joint to get rid of the swelling and waste products that had accumulated while you were lying still in bed during the night.

Movement is important

By doing gentle movements, you can help your knee get rid of the swelling while increasing the nutrients and oxygen available for healing.

What are muscle activation exercises and why are they important?

The muscles that surround your knee (mainly the quads and hamstrings) provide support and stability to your knee joint. Research has shown that, when a knee is painful and swollen, these muscles actually switch off and don’t work as well. This can make your knee feel unstable and as if it wants to give way, even if your injury isn’t that severe. That’s why it’s important to start gentle activation exercises as soon as your injury has settled a bit.

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Exercises for a sprained knee

Important: These exercises may feel a bit uncomfortable to do, but they should not cause you more pain than what you already have. If you feel that they are aggravating your knee, rather than helping, you should stop them immediately and consult your doctor or physiotherapist.

Exercise and pain

Exercising may feel a bit uncomfortable to do, but it should not cause you more pain than what you already have.

Exercise 1: Leg slides

When to start: Usually from day 2 after injury.

Why do it? The gentle movement will help your knee joint to get rid of the swelling, reduce your pain, help feed your joint and improve your range of motion.

Frequency: You can do this exercise 2 to 3 times a day.

Number of repetitions: Do 10 to 20 repetitions per session.

Leg slide exercise for sprained knee

How to do it:

  1. Lie flat on your back or sit with your legs out in front of you.
  2. Flex your foot up so that your toes move towards your shin – this helps to activate your muscles and makes it easier to move your leg.
  3. Slowly bend your knee by sliding your heel towards your bottom.
  4. Don’t force it – only move it to where it is comfortable.
  5. Then slowly allow your knee to straighten out by sliding your heel away from your bottom.
  6. Rest for a moment if needed.
  7. Repeat this motion.

You will likely find that the first 1 or 2 repetitions feel really stiff and uncomfortable, but as you continue it eases off and feels more comfortable.

Finding this exercise hard? These tips may help:

  • Placing a plastic bag under your heel can help it slide with less friction; or
  • Hooking a towel around your thigh, so that you can gently tug on it and help your leg to move may be useful if it is too painful to move on its own.

Exercise 2: Knee extension over towel

When to start: From day 3 post-injury.

Why do it?: This exercise will activate your quad muscles and help to improve your knee’s ability to fully straighten. As a result, your knee will feel more stable when you walk.

Frequency: You can do it 1 to 2 times per day.

Number of repetitions: Start with what you can comfortably do and slowly build up to doing 10 repetitions per session.

Knee extension exercise for sprained knee

How to do it:

  1. Lie flat on your back or sit with your knees out straight in front of you.
  2. Place a rolled-up towel or foam roller under your knee.
  3. Flex your foot up so that your toes move towards your shin – this helps to activate your muscles and makes it easier to move your leg.
  4. Push the back of your knee gently into the rolled-up towel/foam roller while you attempt to lift your heel off the bed.
  5. Your aim is to lift your heel high enough so that your knee fully straightens out, but you will likely not be able to do this initially. Don’t worry – it will come with time.
  6. Hold the position for 5 seconds.
  7. Then rest it back down on the bed for 5 seconds.
  8. How many repetitions you start with, will depend on how difficult you find the exercise. Your aim is to build up to doing it 10 times but start with what feels comfortable and right for you.
  9. As you get stronger you can also increase the time you hold, so that you’re eventually holding the position for 10 seconds, resting 10 seconds, and doing 10 repetitions.

Important – the back of your knee should stay in contact with the towel/foam roller throughout the exercise. It is only your heel that should lift off the bed, NOT your whole leg.

Exercise program for meniscus tears

If you’ve torn your meniscus when you sprained your knee, you may benefit from the meniscus tear treatment plan we’ve created in the Exakt Health app. If you are suffering from kneecap pain, have a look at the patellofemoral pain syndrome treatment plan in our app.

The app is free to download and contains a step-by-step exercise treatment plan for meniscus tears, starting with easy low load exercises and slowly progressing to more advanced exercises as your knee recovers.

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Maryke Louw
Maryke Louw
Lead Physiotherapist at Exakt Health. Injury treatment doesn't have to be complicated - your body just needs the right combination of rest and exercise to allow it to heal. I love all sports but much prefer to exercise outside and off-road.
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