Is that knee injury going to heal on its own?

You twist your knee playing pickleball. It starts aching after a long day in the yard. Maybe there wasn’t an obvious injury at all, but the pain has been hanging around. How long should you give it before getting it checked?

Many minor knee injuries can improve with time and basic care. Other injuries need medical attention, even if you can still walk. The severity of your symptoms, how long they last, and whether they interfere with your normal activities can help you decide what to do next.

“A lot of it is pain that doesn’t go away, especially after you’ve given it a little time,” says Robert D. Jamieson, DO, an orthopedic surgeon affiliated with Intermountain Health St. George Regional Hospital. “When it starts to affect your ability to do what you want to do, or you’re having to take medications for it, it’s time to have somebody take a look.”

What knee injuries can heal on their own?

“There are certainly injuries that our bodies have the ability to heal,” says C. Dain Allred, MD, an orthopedic sports medicine surgeon affiliated with Intermountain Health Utah Valley Hospital and American Fork Hospital.

Some examples include:

• Bruises: A fall or direct hit to the knee can injure the soft tissue without damaging the bones or other structures inside the joint.
• Strains: A strain affects a muscle or tendon around the knee. It can happen when the tissue is stretched or overworked.
• Sprains: A sprain affects a ligament, the strong tissue that connects bones and helps keep your knee stable.
• Some MCL sprains: The medial collateral ligament, or MCL, runs along the inside of your knee. Mild injuries may heal with time and proper support.
• Some partial ligament or tendon tears: With a partial tear, some of the tissue remains intact.
• Arthritis flares: If you already have arthritis, doing more activity than usual can temporarily increase knee pain. Dr. Allred says these flares often return to their usual level over the next week or two with rest, ice, activity changes, and appropriate anti-inflammatory medication.

Some meniscus tears may also improve without surgery. The meniscus is cartilage that cushions your knee joint. In fact, you can have a meniscus tear without knowing it.

“There are many people walking around with meniscus tears who don’t even know they have one because it doesn’t hurt,” Dr. Allred says. “Sometimes it flares up here or there, but then the pain goes away and is tolerable.”

When should you see a doctor for knee pain?

Some knee symptoms need prompt medical attention. Lingering symptoms also deserve attention when they aren’t improving.

Watch for:

• You can’t put weight on your leg: Severe pain that prevents you from standing or walking after an injury should be evaluated promptly.
• Your knee is red, hot, or significantly swollen: Dr. Jamieson recommends seeking acute care for these symptoms rather than waiting for them to improve at home.
• You’ve had a major injury or knee dislocation: Some fractures require surgery. A knee dislocation can also injure nearby blood vessels and needs immediate evaluation.
• Your pain isn’t improving: “If you’ve had continued pain for more than three to four weeks that doesn’t go away or seem to be getting better, that’s a good time to come in,” Dr. Allred says.
• Pain is changing your daily activities: Pay attention if you’re limping, regularly taking medication for pain, skipping exercise, or avoiding things you normally do because of your knee.

A medical evaluation can help determine what’s causing the symptoms and whether it’s safe to give the knee more time.

Can you still walk with a serious knee injury?

Yes. Walking doesn’t tell you how serious a knee injury is.

Your knee has several muscles, tendons, and ligaments working together. When one structure is injured, the others can sometimes compensate enough to keep you moving.

An anterior cruciate ligament, or ACL, tear is one example.

“Some things won’t heal on their own, like an ACL tear, because of the blood supply,” Dr. Jamieson says. “But some people live with an ACL tear and get by okay.”

Dr. Jamieson has even seen patients with chronic ACL tears who don’t remember injuring the knee. Being able to walk, then, isn’t a reliable way to judge the injury.

That makes your overall function important. Notice whether you’re limping, your knee feels unstable, or you’re changing how you move. Pain or instability that limits work, exercise, or everyday activities is worth discussing with a provider.

Do specific knee diagnoses require surgery?

“Not everybody who has arthritis needs a knee replacement. Not everybody who tears their ACL needs it repaired, and not everybody who has a meniscus tear needs it fixed,” Dr. Jamieson says. “Can you do the things you want to do?”

That question is one Dr. Jamieson often asks his patients because surgery is one possible treatment for some knee problems, while others can be managed with nonsurgical care.

Imaging is also one piece of that picture. Dr. Jamieson says he sometimes sees patients whose X-rays show severe arthritis even though the knee doesn’t bother them much. Other people may have less dramatic imaging but symptoms that significantly affect their lives.

How are knee injuries treated without surgery?

“We do a lot of non-operative care,” Dr. Jamieson says. Depending on the injury, treatment can include rest, ice, compression, elevation, bracing, injections, physical therapy, medication, and lifestyle changes.

A brace, for example, may give a sprained MCL support while it heals. Other causes of knee pain, such as irritation of the patellar or quadriceps tendon, may respond to different nonsurgical treatments.

An orthopedic exam can also provide answers without automatically leading to advanced testing. Dr. Jamieson says providers can identify many soft-tissue problems through a physical exam and may use X-rays or an MRI when needed.

“There’s no harm in having information,” Dr. Allred says. “If you know it’s nothing to worry about, you know you can live with it and manage it. That’s good knowledge to have.”

Get help for knee pain that keeps you from moving freely

Pain that persists, gets worse, or changes the way you move is worth checking out.

“Get it checked out whenever it starts to bother you, especially if it limits you from getting out and doing things,” Dr. Jamieson says. “We can figure out what’s going on and help you get back to those activities without pain.”

You can start with your primary care provider or an orthopedic specialist, depending on your needs and insurance plan. Primary care providers can evaluate many knee problems, order imaging, begin nonsurgical treatments, and refer you to an orthopedic specialist when needed.

Intermountain Health orthopedic specialists across Colorado, Idaho, Montana, Nevada, and Utah treat knee injuries and other bone, muscle, and joint conditions. From conservative care and rehabilitation to specialized orthopedic treatment and surgery, Intermountain can help you understand your options and take the next step.

As Dr. Jamieson puts it, “Our goal is to help people keep moving.”

Whether moving means hiking, biking, skiing, gardening, playing pickleball, or simply getting through your day comfortably, taking care of a knee that keeps bothering you can help you get back to it.

To learn more or find a provider, visit the Intermountain Health Orthopedics page on our website.