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MCL strain

I want to know more about MCL.

The medial collateral ligament (MCL) is located on the inner aspect, or part, of your knee, but it’s outside the joint itself. Ligaments hold bones together and add stability and strength to a joint.

It is a broad, flat, membranous band, situated slightly posterior on the medial side of the knee joint. It is attached proximally to the medial epicondyle of the femur immediately below the adductor tubercle; below to the medial condyle of the tibia and medial surface of its body. It resists forces that would push the knee medially, which would otherwise produce valgus deformity.

How did I injure my MCL?

An injury to the MCL is often called an MCL sprain. Ligament injuries can either stretch the ligament or tear it. MCL injury of the knee is usually caused by a direct blow to the knee. This type of injury is common in contact sports or falls

It’s usually the result of a hit or blow to the outer aspect of the knee, which stretches or tears the MCL.

Is my injury very bad?

It is important to know how bad your injury is as this determines where you start and progress on the MCL rehabilitation program.
MCL injuries can be grades 1, 2, or 3:

  • A grade 1 MCL injury is the least severe. It means that your ligament has been stretched but not torn.
  • A grade 2 MCL injury means that your ligament has been partially torn. This usually causes some instability in your knee joint.
  • A grade 3 MCL injury is the most severe type of ligament injury. It occurs when your ligament has been completely torn. Joint instability is common in a grade 3 MCL sprain.
What are the signs and symptoms?

The symptoms of an MCL injury may include:

  • a popping sound upon injury
  • pain and tenderness along the inner part of your knee
  • swelling of the knee joint
  • a feeling that your knee is going to give out when you put weight on it
  • locking or catching in the knee joint

Problems with knee stability typically indicate grade 2 or grade 3 injuries.

Can the MCL heal itself?

If you have a mild MCL strain, it can heal on its own with rest, ice, activity modification and other self-care. Not all ligaments have a good blood supply in order to create a healing response. But the MCL does have more of a healing capacity than most ligaments. If there are no other injuries to the meniscus, cruciate ligaments, or other soft tissues, you may expect a good recovery from this type of injury.

For more severe damage, you may need physical therapy to rehab your knee when your MCL pain begins to fade. Your physical therapist will give you exercises to strengthen the leg muscles around your knee so it works properly.

What kind of physiotherapy is effective for recovering from an MCL sprain?

Your physiotherapy treatment will aim to:

    1. Reduce pain and inflammation.
    2. Normalise joint range of motion.
    3. Strengthen your knee: esp quadriceps (esp VMO) and hamstrings.
    4. Strengthen your lower limb: calves, hip and pelvis muscles.
    5. Improve patellofemoral (knee cap) alignment
    6. Normalise your muscle lengths
    7. Improve your proprioception, agility and balance
    8. Improve your technique and function eg walking, running, squatting, hopping and landing.
    9. Guide return to sport activities and exercises
    10. Minimise your chance of re-injury.

A knee strengthening, agility and proprioceptive training program is the best way to reduce your chance of a knee ligament sprain.