Causes of a Medial Collateral Ligament (MCL) Injury
The most common cause of an MCL injury is when someone gets hit on the outer side of their knee. This type of impact will naturally strain the MCL on the inner side of the knee, causing it to tear or become strained. Medial collateral ligament injuries are very common among athletes and those with physically demanding jobs.
Types of MCL Injuries
MCL injuries fall into three different categories, depending on the severity of the injury.
Grade I: A grade I injury is the most minor type of MCL injury, generally indicating an MCL sprain. There’s usually tenderness and manageable pain. A person with a grade I injury will have a generally short recovery time. Within a few days to a few weeks, they will probably be fully healed and able to return to work, school, or sports with a full range of motion.
Grade II: With a grade II MCL injury, you may notice knee joint instability. In other words, your knee feels like it might give out when you try to walk on it. You’ll probably feel major pain and tenderness along with some swelling. You can expect to get back to your normal activities within two to four weeks after a grade II injury.
Grade III: Grade III is the most severe type of injury, and usually indicates an MCL tear. Patients will generally notice intense pain and swelling around the knee joint. There’s generally lots of knee instability with a grade III injury as well. Recovery time for a torn MCL generally takes four to eight weeks. However if your ACL tore as well (which is common with a torn MCL), then the healing process will take even longer.
Symptoms of an MCL Sprain
If you sprain your MCL, you may have these symptoms:
- Feeling like you can’t walk or stand on your injured knee because you’re afraid it will give out
It’s worth noting that knee instability, or feeling like your knee will give out, generally indicates a torn MCL, not a sprained MCL.
How is an MCL Sprain or Tear Diagnosed?
When it comes to diagnosing an MCL tear or sprain, a doctor at SPORT Orthopedics + Physical Therapy will first perform a physical exam of your knee. They will check for swelling and instability by bending and placing pressure on your knee. Additionally, your doctor will generally check the range of motion of your knee to help determine the severity of the tear or sprain.
Imaging Tests and Scans
Next, your doctor may suggest an X-ray or an MRI in order to get a clear picture of the injured ligament. An X-ray will generally show all the tissues and bones in your knee. Meanwhile, an MRI will show injured muscles, ligaments, and bones in the knee.
Treatment Options For an MCL Sprain or Tear
There are many treatment options out there for MCL sprains, but they can generally heal quickly with nonsurgical treatment. The best at-home treatment for any kind of sprain is the RICE method, which stands for rest, ice, compression, and elevation. This method is pretty self-explanatory. Just rest, ice, and elevate your knee for a few days. For compression, it’s best to get a knee brace or an elastic bandage from the drug store, such as an ACE bandage. This method, along with pain medication, will greatly reduce pain and swelling while your sprain heals.
Most MCL tears generally heal with nonsurgical treatment as well. In fact, only a very severe MCL tear will require MCL surgery. Your doctor may suggest for you to wear an elastic or hinged knee brace for a few days. Then you will likely undergo rehabilitation with a SPORT physical therapist in order to strengthen your muscles and restore your knee’s range of motion.
MCL surgery is only necessary for very severe MCL tears that can’t heal on their own. Additionally, surgery is necessary if the MCL isn’t the only ligament that’s torn. For example, maybe your surgeon needs to reconstruct the ACL too.
Your surgeon may start with an arthroscopy to get a good look at the knee damage. During this procedure, your surgeon will insert a small camera into a tiny incision in your knee. After the arthroscopy, your surgeon will then repair the torn MCL along with any other torn ligaments. They may reattach the ligaments to either your shin bone or your thigh bone with these tools:
However, if the MCL tear happened in the middle of the ligament, then your surgeon will simply stitch it back together.
MCL surgery recovery can take three months or longer, depending on the severity of the tear as well as how many ligaments were torn and repaired. But you can expect to wear a brace and use crutches for approximately six weeks after surgery.
Basic Physical Therapy Exercises for MCL Injuries
Physical therapy is very important following MCL sprains and MCL tears because you need to strengthen those muscles while getting your range of motion back. Your physical therapist at SPORT will likely instruct you to do these exercises every day until you’re functioning as well as you did before your injury. Remember, you should only begin these exercises once you’ve spent several weeks recovering from your MCL tear surgery. Always follow the professional medical advice from your healthcare provider because everyone’s recovery time looks different.
Riding a stationary bike is pretty self-explanatory. This exercise will assist in bending the knee joint and increasing knee flexion. It’s best to ride the bike for 30 to 30 minutes every day.
For this exercise, you can either lay flat on your back or sit up straight with your legs straight out in front of you. All you have to do is contract and hold the quadricep muscles above the injured knee. This action will make the leg lay straighter and flatter on the floor. You’ll know that you’re doing this right if your kneecap moves up when you contract your thigh muscles. Hold each contraction for five seconds. It’s best to do this exercise 20 times a few times a day.
Sit on a chair with your heel propped on a stool in front of you. Make sure the stool doesn’t elevate your foot. Instead, try to make sure that your foot is the same height as the chair. All you have to do in this position is relax the knee and the leg until it’s fully straight. If it won’t fully straighten out, then put a small weight on your thigh, just above the knee. You can do this exercise for about five minutes a few times a day.
Lay on your back and slide the heel that corresponds with your injured knee forward and backward across the floor. You want to slide the heel away from you until you feel a nice stretch on the front side of your knee. You want to do this exercise a few times daily until your injured knee bends the same as your uninjured knee.
Standing Hamstring Curl
Stand up straight and face a table or a chair. Hold onto the table or chair in front of you while you stand on your uninjured leg. Then lift the foot of your other leg towards your buttock. Lift your leg 20 times.
Standing Toe Raise
Similarly to the last exercise, you will need to stand up straight and face a table or a chair for the standing toe raise. Keep your legs and knees straight and then raise your heels off the floor until you’re on your tip-toes. Hold for a few seconds and then lower your heels back down. Repeat 20 times.
Lay down on the uninjured side of your body with your legs fully straight. Raise the injured leg up as high as you can, hold for a few seconds, and then release. Do this 20 times.
Stand up straight with your back flat against a wall. Make sure your feet are about a foot apart from each other and about 6 inches away from the wall. Slide your body down the wall until your knees bend at a 45-degree angle. This exercise is not the same as wall sits, where you slide down the wall until your knees bend at a 90-degree angle. Your knees should only be slightly bent. Hold this position for a few seconds and do it 10 to 15 more times.
Short Arc Lift
Lay on the floor or bed and prop yourself up on your elbows. Put a rolled-up towel or blanket under your injured knee. Then lift your foot as high as you can until your knee and leg are fully straightened. Hold this position for a few seconds and then release. Repeat 20 times.
Call SPORT Orthopedics & Physical Therapy Today
If you or someone you love is suffering from an MCL tear, sprain, or any other knee injury, a healthcare provider at SPORT Orthopedics + Physical Therapy wants to make sure your recovery time is as blissful as possible. For more information, call us today at 469-200-2832.