Sprained Knee Treatment: RICE, Rehabilitation, and Surgical Indications

Knee sprain (ligament stretch/tear) management follows phased protocol:

Phase 1: Acute (0–72 hr) — Protect and Control Inflammation

• Rest: Crutches, weight-bearing as tolerated.
• Ice: 15–20 min q2–3h; barrier between ice and skin.
• Compression: Elastic wrap or sleeve; not too tight.
• Elevation: Above heart level.
• NSAIDs: Ibuprofen/naproxen for pain/inflammation (caution: may slightly delay ligament healing).

Phase 2: Subacute (3–14 d) — Restore Motion

• Passive/active-assisted ROM exercises.
• Isometric quadriceps sets, straight leg raises.
• Stationary bike (no resistance).

Phase 3: Rehabilitation (2–6 wk) — Strength and Proprioception

• Progressive resistance: mini-squats, leg press, hamstring curls.
• Balance: single-leg stance, wobble board.
• Functional: step-ups, lateral shuffles.

Phase 4: Return to Sport (>6 wk)

• Sport-specific drills, cutting, plyometrics.
• Bracing (functional) for Grade II/III MCL/LCL.

Surgical Indications

• Grade III ACL tear with instability (active patient).
• Multi-ligament injury (knee dislocation).
• Displaced bucket-handle meniscal tear.
• Failed nonoperative management.

Grade I (microscopic): 1–2 wk. Grade II (partial): 3–6 wk. Grade III (complete): 3–6 mo post-op.