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Medial Collateral Ligament (MCL) Tears

The medial collateral ligament, or MCL, is the most commonly injured ligament in the knee. It runs along the inner side of the knee and connects at the thigh bone and the shin bone. The MCL is responsible for stabilizing the knee and preventing it from overextending inward. Sometimes, an injury to the knee can result in stretching of the MCL that leaves the ligament intact, or the MCL can partially or completely tear.

Medial Collateral Ligament (MCL) Tears Hero Image 2

The medial collateral ligament, or MCL, is the most commonly injured ligament in the knee. It runs along the inner side of the knee and connects at the thigh bone and the shin bone. The MCL is responsible for stabilizing the knee and preventing it from overextending inward. Sometimes, an injury to the knee can result in stretching of the MCL that leaves the ligament intact, or the MCL can partially or completely tear.

MCL tears are classified by grades, depending on the severity of the injury:

• Grade I: The MCL is stretched, but not torn.
• Grade II: The MCL is partially torn.
• Grade III: The MCL is completely torn through.

What causes Medial Collateral Ligament (MCL) Tears?

Tears of the medial collateral ligament often occur due to getting hit on the outside of the knee, forcing it to overextend inwards.

MCL tears are common in these sports:

• Football
• Hockey
• Rugby
• Soccer
• Wrestling

Symptoms

Athletes who sustain MCL tears complain of pain on the inside of their knee. Usually, the knee does not swell with an MCL tear, but you may experience other symptoms such as:

• Pain on the inside of the knee with cutting movements
• Stiffness (inability to extend the knee/straighten the leg)
• Looseness or instability of the knee

When to see a doctor

If you experience an injury or trauma to the knee and have symptoms of an MCL tear, such as pain on the inside of your knee, make an appointment to see an orthopedic specialist. During your appointment, your doctor will examine the knee for damage to the ligament. If, upon examination, your doctor notices tenderness over the insertion points of the medial collateral ligament on the femur or tibia, this may indicate an MCL tear. He/she will also perform a valgus stress test to assess the severity of the injury.

In order to make a diagnosis, your doctor may prescribe the following imaging tests:

• X-rays to rule out fracture of the leg
• MRI to show the extent of damage and check for damage to other muscles and ligaments of the knee

Non-operative treatment

MCL tears are most often treated using conservative, non-operative treatments. Immediately following injury to the MCL, you will need to focus on reducing pain and swelling by:

• Resting the leg, sometimes using crutches and a knee immobilizer for a short period
• Icing periodically throughout the day
• Taking non-steroidal anti-inflammatory medications, like Ibuprofen

As your swelling resides, your doctor will recommend that you begin a physical therapy program to stretch and strengthen the knee. Working with a licensed physical therapist will help you to restore range of motion and stability to the knee. You will also be required to wear a brace to protect and stabilize the knee when active, until the ligament heals completely.

You can also try these exercises at home to stretch and strengthen the muscles surrounding the knee:

Medial Collateral Ligament Tears

Surgical Treatment

MCL tears rarely need surgery, because the ligament usually heals itself. Surgery is typically needed only when other ligaments or structures of the knee are also injured.

Recovery

The time it takes you to recover from an MCL tear will depend on the severity and grade of your injury:

• Grade I: Stretching of the MCL takes about three weeks to heal.
• Grade II: Recovery from partial tears of the MCL can take three to six weeks.
• Grade III: Complete tears of the MCL take from six weeks to three months to heal.

You can return to play when you have regained full range of motion and strength without any pain, and when instructed by your doctor. Once you recover from an MCL tear, you will most likely need to wear a brace to protect the knee and reduce the risk of another tear.

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