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Twisted Knee: Problems & Solutions

A twisted knee is a painful, debilitating condition with symptoms ranging from mild to severe. The degree of pain is determined by the extent of the injury and the damage to the knee joint.

Twisted knee refers to two different types of injuries. A sprained knee occurs when the ligaments surrounding the knee joint are injured. A strained knee is an injury to the muscles and/or tendons that surround the knee joint.

A twisted knee is a common condition that can harm the ligaments and cartilage in the knee. It frequently causes pain and swelling. Furthermore, it causes instabilities and functional limitations.

Twisted Knee Pain

Twisting your knee frequently leads to the development of joint pain. Typically, this type of injury affects the knee ligaments or meniscus. It can also cause damage to a wide range of other structures.

Paying attention to your specific symptoms and where they occur can assist you in determining what is causing your pain.

Twisting injuries are the most common type of sports injury. This occurs when a combination of sudden changes in direction, speed, and contact tackles causes injury. This is especially true when wearing cleats/studs, such as in rugby/football or skiing, because the foot can remain locked to the ground while the leg rotates, extending and twisting the knee.

Twisting the knee can injure one or more of the four ligaments, as well as pinch and tear the cartilage/meniscus.

Knee Anatomy

The knee is made up of a number of vital structures. When you twist your knee, many of these structures can be damaged.

The patella (kneecap) sits on top of the joint that connects the tibia (shin bone) and the femur (thigh bone). The meniscus is a pair of C-shaped cartilage pieces located between the femur and tibia. It aids in the absorption of forces that pass through your leg.

Articular cartilage, a smooth, slippery covering that aids in shock absorption and joint movement, coats the bone ends.
Several important ligaments connect the femur to the tibia. They keep your knee stable while you move. These are some examples:

  • On the inside, the medial collateral ligament (MCL)
  • On the exterior, the lateral collateral ligament (LCL)
  • The anterior cruciate ligament (ACL) is a ligament that connects the knee to the ACL
  • The posterior cruciate ligament (PCL) is a ligament that runs through the middle of the joint.

Diagnosing Knee Pain When Twisting (By Location)

It can be difficult to pinpoint which anatomical structure was injured as a result of a knee twist. This is due to the variety of anatomical structures crammed into a small space. Fortunately, knowing where your pain is coming from can assist you in determining the source of your symptoms.

Inside the Knee

Meniscus Tear: This is one of the most common causes of pain on the inside of the knee after a twisting injury. This type of acute cartilage injury frequently causes medial knee pain.

This is followed by swelling between 24 and 48 hours after the incident. The condition can also cause the knee to lock or give way. As a result, you are unable to fully straighten the leg.

MCL Sprain: This is frequently accompanied by pain and swelling on the inside of the knee. Depending on the severity of the damage, a popping sensation and leg instability may occur.

Osteoarthritis: Twisting your knee in an awkward way may aggravate pre-existing conditions such as osteoarthritis.

Knee arthritis is caused by the breakdown of the knee cartilage. This can occur as a result of, among other things, aging, obesity, or injury.

Knee Cap

Patellar Dislocation: The kneecap partially or completely slips out of the groove where it normally resides. This type of injury, which causes pain in the front of the knee, is most common in teenagers.

When straightening or bending the leg, it is also accompanied by swelling and apprehension.

Synovial Plica Syndrome (SPS): This condition is caused by inflammation of the synovial plicae (inward folds in the tissue that lines the knee joint). SPS, also known as an overuse injury, can occur after trauma and cause pain on the inside of the kneecap.

Activities requiring repetitive knee bending or straightening (such as running or biking) aggravate the syndrome's symptoms.

Outside of Knee

Acute Tear of the Lateral Meniscus: It causes pain around the outside joint, knee locking or giving way, and difficulty fully extending the leg. Swelling can occur anywhere between 24 and 48 hours after a tear.

The LCL Sprain or Tear after a Twist: This occurs when the leg moves into a bow-legged or various position.

This illness is characterized by pain and discomfort on the exterior of the joint, increased swelling, and instability when bearing weight through the leg.

Osteoarthritis in the Outer/Lateral Portion of the Knee: After a twist, patients may experience a flare-up of their disease.

This could result in generalized knee pain, stiffness after inactivity, and soreness and swelling after prolonged periods of movement. This is a condition similar to medial knee osteoarthritis.

Treatment of Twisting Knee Injuries

Following an acute twist injury, the RICE (Rest-Ice-Compression-Elevation) principle can be used to help reduce pain and inflammation:

  • Begin by regularly raising your leg above your heart and refraining from any activity that aggravates your symptoms.
  • Ice can also be applied to the affected area three or more times per day for 10 to 20 minutes at a time.
  • Finally, if the knee is swollen, a compressive bandage or sleeve can be applied to help with swelling relief.

When your knee pain has been properly evaluated by a healthcare provider, the following conservative treatments may be beneficial:


Acetaminophen and NSAIDs are two medications that can help you manage joint pain. After an osteoarthritis flare-up, a cortisone injection is usually recommended for short-term pain relief. Your healthcare provider may also advise you to wear a knee brace following a ligamentous injury.

Physical Therapy

This therapy can help reduce pain and impairment in a variety of disorders, including ligament sprains, osteoarthritis, meniscal tears, lumbar radiculopathy, and SPS.

To provide stability and support to the injured area, exercises aimed at strengthening the hip and knee muscles as well as increasing balance are frequently used. Gentle stretching exercises may be required to improve the strength and flexibility of your legs.

Surgical Intervention

Surgical intervention may be required following a more serious injury or one that cannot be adequately treated using the treatments listed above. In the case of a meniscal tear, this usually entails repairing or removing the injured section of cartilage.

An arthroscopically inserted graft may be required to add support to the affected area in the case of significant ligament tears or recurring patellar dislocations. Finally, in severe cases of osteoarthritis, a total knee replacement may be required to remove and replace the damaged parts of the joint.

When Should You See a Doctor?

It is critical to seek medical attention as soon as possible following an acute knee injury. This is especially important if your knee pain or swelling is worsening, or if it is accompanied by limb weakness or instability.

A thorough examination, as well as, on rare occasions, an X-ray or MRI, may be required to fully diagnose your problem. If you follow these procedures, your healthcare professional will be able to explain the various options and develop an effective treatment plan for you.

The Bottom Line

A twisted knee can cause severe pain in your joint and make movement difficult. While many of the symptoms associated with this type of injury can be aggravating and debilitating, it is critical to maintaining a positive attitude.

Many of the illnesses listed above can be successfully treated without requiring surgery. Working with your healthcare provider gives you the best chance of returning to your normal routine as soon as possible.

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