Medial Collateral Ligament (MCL) Injury What is it? A medial collateral ligament or ‘MCL’ injury refers to a tear/ sprain in one of the ligaments inside the knee joint. There are four ligaments that provide stability to the knee; the two collateral ligaments run down either side of the knee. The medial collateral ligament is on the inner aspect of the knee joint. How does it happen? The MCL is injured when it is overstretched (sprained). This commonly occurs when an opponent or team mate falls across the outside of your knee when your foot is fixed on the ground. This causes the knee to bend inwards, overstretching and injuring the medial collateral ligament. Another way it can occur is while changing direction quickly and twisting the knee. How does it feel? The first sensation felt when the MCL is injured is pain along the inner aspect of the knee. There may also be an audible snap, crack or tear. Depending on the severity of the injury, the knee may swell and you may have difficulty walking due to pain. The knee may also feel weak and ‘unstable’. What should you do? To limit the severity of the symptoms it is advised that you stop your activity immediately and start initial treatment. Swelling is a necessary step in the healing process, however, too much swelling can delay healing and cause further tissue damage. To control the amount of swelling the RICE regime should be commenced. Rest involves ceasing your activity or sport; ice should be applied to the injured site for 15-20 minutes every 1-2 hours. Compression involved the application of a firm elastic bandage around the knee. Elevation involves lying with our knee resting comfortably on a chair or pillows so that it is above the level of our heart.
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You should avoid hot showers, rubs, the consumption of alcohol and excessive activity as these things increase blood flow to the area and can prolong bleeding and swelling around the ligament, potentially prolonging your recovery. If you think you may have damaged your MCL you should consult our physiotherapists. How is it managed? The assistance of a physiotherapist is important in the treatment of a MCL injury. Initially they can assist in confirming the diagnosis. Sometimes other structures in your knee are damaged at the same time as your MCL, and your physiotherapist will be able to determine this. This may require the use of imaging techniques such as an x-ray, CT scan or MRI. Treatment for MCL injury involves a process of rehabilitation which allows the damaged ligament to heal and for the muscles surrounding the ligament to be strengthened. This will facilitate your return to exercise/sport, limit long term effects as well as reducing your chance of re-injury. Rehabilitation involves performing a program of exercises, and seeing a physiotherapist on a regular basis. Your physiotherapist will be able to assist in reducing your swelling and pain, improve your joint flexibility, and strengthen the muscles supporting the knee joint. How long will it take to get better? Management for this injury varies depending on the severity of the injury. A mild to moderate sprain (grade I or grade II) will take a period of rehabilitation of around 3- 6 weeks. In a severe injury (grade III), all of the fibres of the MCL are ruptured completely. You do not need surgery for this injury as it is managed conservatively by wearing a limited range of motion knee brace, however, the rehabilitation process takes longer, up to 2-3 months. What can I do now that I’m receiving treatment? In the acute stage it is important to get rid of any swelling that has arisen in the knee joint because of the injury. This will involve regular icing. Your physiotherapist will give you some exercises to start strengthening the muscles around your knee, and get your knee moving. Any exercises your physiotherapist has given you should be performed at home.
Physio Professionals (07) 5438 9111
www.physioprofessionals.com.au
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