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How Do I Treat a Twisted Knee?

By Carol Francois
Updated Mar 03, 2024
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The most important thing to consider when trying to treat a twisted knee is to decide the extent of the damage. A twisted knee is also known as a sprained or strained knee. The knee is a major joint that attaches the thigh bone to the shin bone through a series of tendons and ligaments. Twisted knees are fairly common and can occur at any age or level of physical activity.

To determine the extent of the damage, there are three simple tests that can be done. First, feel the knee itself with your hands. The knee should feel cool to the touch, but slightly tender. Sitting down, move your leg up and down, and then move it from left to right. If the leg is able to move through the entire range of motion but is slightly sore, it is probably a twisted knee.

If the knee is hot to the touch, visibly swollen, bruised, discolored, and unable to accept any weight, go to the doctor or medical clinic. Apply an ice pack to reduce the swelling, but understand that this is a temporary measure to increase your comfort and is not a treatment. Do not wait to see if the knee improves, as the heat and swelling is an indicator of deeper damage.

To treat a twisted knee, there are three things you should do as soon as possible after the injury occurs: rest, ice, and elevate. Avoid putting any weight or pressure on the knee by using crutches or a cane when walking. Apply an ice compress for 30 minutes at least three times a day. Elevate your knee when sitting by using a stool or chair to keep the knee up. Avoid keeping it too straight, as this may strain the joint and make the knee feel stiff.

The three-step treatment plan should be followed for no more than five days. If the twisted knee is still sore after five days, it is best to see a doctor. There may be something else wrong with the knee. Once the knee is no longer sore, strengthening exercises are normally prescribed to strengthen the tendons and reduce the chance for repeated injury.

The first exercise to strengthen a twisted knee is to add a weight bag to the ankle and lift the foot straight up while in a seated position. Repeat this exercise 15 times at least three times a day. Alternate this exercise with a sweeping motion moving the foot from left to right. These two exercises together will strengthen the primary supporting tendons in the knee.

Can You Twist Your Knee?

To understand why knee twists and sprains occur, you need to know about the structure of the human knee. It's a hinge joint, which means it allows one of the attached bones to move back and forth. The knee joins together several bones:

  • Femur: the thigh bone
  • Tibia: also known as the shin bone
  • Fibula: running parallel to the tibia
  • Patella: the kneecap 

The knee also contains tendons and ligaments. It's easy to confuse the two, but a quick explanation can eliminate this confusion. Tendons are connective tissues that link muscles to bones. Ligaments, on the other hand, attach one bone to another. Tendons are vital for moving a joint, while ligaments provide stability to that joint.

Knee Ligaments and Tendons

Now that we know about tendons and ligaments in the knee, it's time to take a closer look at them. The anterior crucial ligament, commonly nicknamed the ACL, stops the femur from sliding backward on the tibia. The posterior cruciate ligament, also known as the PCL, prevents the femur from sliding forward. There are also two collateral ligaments, the medial and lateral. They inhibit any side-to-side motion of the femur.

Two important tendons are at work in the human knee. The quadriceps tendon attaches the thigh muscles to the kneecap. Meanwhile, the patellar tendon connects the kneecap to the top of the tibia. Because it's technically linking one bone to another, it's sometimes called the patellar ligament.

Three Types of Knee Sprains

As you now see, the human knee is a marvelous and complex structure. With this in mind, it's not surprising that a lot can go wrong. Sprains are only one type of injury that can impact the knee in serious ways. People commonly think of sprains as mild, but physicians classify them into three different categories:

  • Grade 1: mild damage and stretching of the ligament, but retained ability to stabilize the knee joint
  • Grade 2: stretched, torn and loose ligament
  • Grade 3: complete tearing of the ligament into two pieces

How Can You Twist Your Knee?

A knee sprain or twist can result from a few different causes. This type of injury usually happens suddenly. You may be running or walking as normal but end up on the floor with a twisted knee with seconds. The suddenness of the injury can feel scary and disconcerting. Yet with first aid and proper medical attention, you can avoid worsening the damage.

Many knee sprains come from strenuous physical activity, often while playing sports or exercising. Common movements that cause the sprains can include running, jumping and landing. Stopping and then quickly changing direction can also result in a knee sprain. You may commonly see such injuries in activities like American football, soccer, rugby, hockey, basketball and skiing.

Sometimes, direct impacts can lead to sprains. These can occur while playing sports, but they can also happen in everyday life from falls, bumping into large objects and other mishaps. Car accidents may produce knee sprains, especially with possible direct impacts to the knee during a collision. Occasionally, sprains occur when sudden excessive weight is placed on the knee joint.

How Long Does It Take a Twisted Knee To Heal?

Minor knee sprains can heal within six weeks. Severe sprains, however, can require several months or more than a year for recovery. Care and healing for a knee sprain can include immobilization, physical and occupational therapy, at-home exercises and surgery. Individual treatment plans vary according to the severity of the injury. A grade 1 knee sprain might require you to just wear a brace and do at-home exercises, while a grade 3 sprain almost always calls for surgery. As with any injury, you should follow your healthcare provider's directions and ask questions about anything you don't understand.

First Aid for a Knee Sprain

You must take a twisted knee seriously for the injury to properly heal. Even if your sprain doesn't feel overly painful or serious, you must still seek immediate medical attention. First aid is an important initial step that can aid in healing.

You've probably heard of RICE, which stands for "rest, ice, compression and elevation," a first aid method for treating a knee injury. Immediately after being injured, you must avoid moving your knee. Apply an ice pack for 15 minutes to the injured area, waiting at least 40 minutes between applications. Bandage your knee snugly, but not too tight, and extend the wrap both slightly above and below your knee. Finally, keep your knee elevated above your heart until you can get to a doctor or hospital.

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Discussion Comments
By anon305142 — On Nov 24, 2012

@anon304629: You likely don't need surgery, but see a doctor anyway. Your kneecap may have slid out of place, or the damage to the ligament may be more severe than you think. At the very least, take some anti-inflammatories and watch the swelling. If the knee feels abnormally warm to the touch, or if the leg is crooked, see a doctor right away.

By anon304629 — On Nov 20, 2012

I was balancing on one leg, (in high heels) and moved my body to one side a little too much and my standing leg popped, I felt a sharp pain, and I fell to the ground. My knee doesn't hurt when I don't move it, but it hurts to bend, straighten and walk on it and it's pretty swollen. Can I recover with ice and rest or is surgery a must?

By anon301536 — On Nov 05, 2012

I twisted the knee on my left leg and pulled a hamstring on my right. I'm having a lot of trouble using crutches because I have no 'good' leg to put the weight on. Any recommendations?

I've already seen a doctor; they gave me crutches and a brace for my left leg and sent me on my way. They didn't tell me anything about this RICE thing, or that I might need to treat my right leg.

By anon291271 — On Sep 13, 2012

I hurt my knee more than 7months ago,and went for an X-ray to see if it was broken. It wasn't broken, but the swelling in my knee never went down. I am in constant pain, and I was told that it could take up to nine months for the knee to get better, but I'm worried, as I can't move my knee from left to right because it is really painful. Any ideas?

By anon141383 — On Jan 10, 2011

I twisted my knee. I actually heard (and felt) the ligaments pop over and out of position. I sat down and moved the knee around and they slid back after 15 minutes. I had swelling and pain, etc. In addition to ice and elevation (and some rest) the best thing, I found, was getting deep-tissue massage. One hour just on my knee/leg helped a ton. but you need to strengthen the muscles/ligaments to get them more secure or you'll likely twist it again soon (I did!).

By googlefanz — On Dec 30, 2010

Nice article. When I was little I had a twisted knee ligament, which might not sound so serious, but it was incredibly painful! You know how it is when you turn your ankle and it's not really swollen, but you just hear that "pop" when you move it?

Well, that's what happened to my knee. I tried to keep going on it for a week or so since it wasn't swollen, but when the pain didn't go away I went to the doctor, where I learned that I had actually twisted a ligament.

It wasn't too terribly hard to treat, but the doctor said it was a good thing that I had come in when I did, before the ligament got too seriously damaged.

Have you guys ever had anything like that? If so, you know just how crazy painful it can be!

By pharmchick78 — On Dec 28, 2010

Excellent article! I really like how you guys' medical articles are so factually based, yet easy to read. I think that a lot of medical sites on the web are written either to cause paranoia or confusion -- at least that's the two responses that my patients give me after reading them!

What you said here is great though -- with a twisted knee, pain is your main indicator, though of course a little swelling might be evident as well. It is also very true that if your knee is hot and swollen, then you really need to see a doctor ASAP -- the last thing you want is to let some lasting damage set in!

I knew of one patient who actually sprained her knee badly, then kept trying to walk on it for a few weeks -- she eventually did so much damage to herself that she had to get some knee arthroscopy procedures done.

So, anybody reading this, remember, follow the three steps for how to heal a twisted knee -- rest, ice, and elevate -- and make sure that it really is a twisted knee (no swelling, etc) before you try to treat it at home. If there's any doubt, go to a doctor. The knee is incredibly complex, and can be very difficult to repair if you don't care for it properly.

By Planch — On Dec 27, 2010

Thank you for this article -- I was out running a few days ago and fell, and afterwards I had the worst pain in my knee. I was worried that I had sprained it or torn a ligament or something because it really was quite painful, but since it wasn't hot, I let it go for a few days.

Now after reading this I'm pretty sure that I just twisted it, especially since there's almost no swelling now, just tenderness.

Is there anything else that I should be doing besides resting it and keeping it elevated? I put ice packs on it two or three times a day, but I just didn't know if there was something else I should be doing.

Could you give me some more information about this?

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