I was out walking the dog and stepped off the curb wrong. I tweaked my knee but good. There’s swelling and tenderness along the inside joint line of my left knee. I know I’m not a candidate for surgery because I did this once before and the surgeon told me I’d have to lose 100 pounds before he would operate on me. What can I do to keep from hurting myself again?

From your description, it sounds like you may have just experienced a grade I or II (mild) injury to the medial collateral ligament (MCL). Taking a step wrong or moving in just a way that causes a sudden, sharp pain along the inside (medial side) of the knee can result in a strain to the MCL.

The MCL is made up of several layers of fibers. Some fibers are parallel. Others angle down from the lower end of the femur (thigh bone) to the upper part of the tibia (lower leg bone). The ligament is made up of multiple layers of fibers that cross the knee joint. It protects the knee from injury along the inside edge when a force is applied to the outside or lateral edge of the joint.

MCL injuries are among the most common knee ligament injuries. Most of the injuries to the MCL occur when the knee is slightly bent or flexed. Most of the time, people don’t even bother going to the doctor for this. They just take it easy for a few days until the pain goes away.

Being overweight does put you at increased risk for complications and problems linked with having ligamentous damage to the knee. If this is a re-injury of a previous injury, there may be added ligament, cartilage, or other soft tissue injuries. Combined injuries challenge treatment and recovery.

But before you jump to any conclusions, it may be best to get a proper diagnosis. Even if surgery is not indicated, a clear idea of what’s wrong can help guide conservative (nonoperative) treatment. You may be a good candidate for a rehab program. A physical therapist will guide you through joint range-of-motion and strengthening exercises.

You will also be shown how to work on retraining the knee’s proprioception. Proprioception refers to the joint’s sense of its own position. With proper training, it’s possible to restore your knee’s ability to recognize and respond to even tiny movements. Improving proprioception can also help prevent future reinjuries.

Losing weight is still important as well. Though difficult for many people, every effort should be made to take weight off slowly and steadily. Weight loss reduces the stress on joints — especially the hips and knees, but also the ankles and feet. It can go a long way to preventing future injuries, uneven wear and tear on the joints, and osteoarthritis.