Different types of knee therapy include following "RICE" guidelines, physical therapy and knee exercises, sports massage, steroid injections, and, in the worst cases, surgery. The specific type of knee therapy usually depends on the severity of the injury as well as the activities that the patient wishes to return to. Surgery is commonly used as a last resort, although there are certain injuries that may require an immediate operation.
The RICE (rest, ice, compression, and elevation) guidelines apply to any acute knee injury. Icing the knee helps to reduce inflammation in the joint, and rest allows the knee to recover from the initial injury. As the knee is a weight bearing joint, it is susceptible to repetitive strain injuries such as tendinitis and iliotibial band syndrome. These injuries require an extended period of rest from the activity that caused the injury.
Knee physiotherapy for the knee usually involves strengthening the muscles that move the joint and increasing flexibility. Physiotherapy is a conservative type of knee therapy, and can have good results if the initial injury is diagnosed correctly. Knee problems are often caused by a muscular imbalance, and a physiotherapist will be able to recognize which muscles are causing the problem. Knee exercises often involve strengthening of the muscles of the thigh and hip, and can be effective in reducing pain from minor injuries.
Other types of conservative knee therapy include massage, acupuncture, and ultrasound. Deep tissue massage is useful for breaking down scar tissue in the joint, while acupuncture, usually with a dry needle, can assist in activating certain muscles. Ultrasound is commonly used to control inflammation.
If long-term inflammation or scar tissue is present in the joint, then an injection of cortisone, which is a type of steroid, is often used. For some injuries, this provides relief, while for others it is a short-term fix. An inflamed fat pad, which is a shock absorber at the bottom of the knee, is one example of an injury that can sometimes be permanently treated with an injection. There are, however, potential side effects to cortisone injections, especially if required on a regular basis, such as weakening of the surrounding tissue and cartilage.
Surgery is a type of knee therapy that's usually used when non-invasive treatment fails. A knee arthroscopy, or keyhole surgery, is the most common type of operation, and is used for less severe injuries such as a plica inflammation, fat pad scar tissue, or cartilage damage. There are numerous potential risks with knee surgery as the joint is very complex, but in some situations there is no alternative.
Some acute knee injuries require surgery for best results. For example, if the patella tendon, which attaches to the bottom of the knee, becomes ruptured then surgery is nearly always needed to repair the damage. A quadriceps tendon rupture also requires surgery.