What should I do after a knee injury?
This advice is for people who have already been assessed and is based on the best available evidence. If you have been given specific advice about a brace, limiting movement or how much weight you can put through your leg, follow that advice too.
1. Control pain and swelling — the golden rule
Pain and swelling can limit movement and switch the leg muscles off. Keep moving, but avoid things that clearly increase pain or swelling during the activity or over the following 24 hours. Elevate the leg when resting to let gravity help move swelling back up the leg so it can be cleared by the body. Regular ankle, calf and thigh movements can also help to remove swelling¹˒².
For the first 48–72 hours, avoid HARM: Heat, Alcohol, Re-injury and vigorous Massage. These can increase blood flow, bleeding or swelling early after injury.
What about ice?
Ice can help pain and, if used soon after injury, may also help limit early bleeding. Current evidence suggests it is most useful within the first 6–12 hours after injury, rather than being used repeatedly for days. However, ice does not remove swelling³.
What about painkillers?
Use pain relief if needed to help you move, sleep and walk more normally. Be careful that pain relief does not mask your symptoms and lead you to do too much, causing more pain or swelling and breaking the golden rule. If possible, avoid routinely using anti-inflammatory medicines such as ibuprofen in the early stages after injury. They do not appear to provide better pain relief than simple painkillers, and there is still uncertainty about whether they may negatively affect tissue healing⁴. Speak to your GP or pharmacist about the safest pain relief for you.
2. Regain or maintain knee range of movement
Prioritise getting the knee fully straight, while gradually improving bending as pain and swelling allow. Keep the kneecap moving normally unless you have been told otherwise.
3. Keep the muscles working
Regular muscle contractions help maintain activation and can also help remove swelling¹˒².
4. Get back to normal walking
If you are allowed to put full weight through the injured leg, gradually return towards a normal walking pattern. Being able to fully straighten your knee and having thigh (quadriceps) muscles that are working well is important for this.
Important
This is general information and does not replace advice from the healthcare professional who assessed you. Seek further advice if your symptoms worsen or you are concerned about your recovery.
Written by: Richard Norris
References
1. Palmieri-Smith RM, Villwock M, Downie B, Hecht G, Zernicke R. Pain and effusion and quadriceps activation and strength. Journal of Athletic Training. 2013;48(2):186–191.
2. The Effect of Physiotherapy on Arthrogenic Muscle Inhibition After ACL Injury or Reconstruction: A Systematic Review. 2024.
3. Racinais S, Dablainville V, Rousse Y, et al. Cryotherapy for treating soft tissue injuries in sport medicine: a critical review. British Journal of Sports Medicine. 2024;58(20):1215–1223.
4. Solaiman RH, Dirnberger J, Kennedy NI, et al. The effect of nonsteroidal anti-inflammatory drug use on soft tissue and bone healing in the knee: a systematic review. Annals of Joint. 2024;9:3.