A medial collateral ligament (MCL) sprain is a tear of one of the four major stabilizing ligaments of the knee. The MCL helps maintain the normal relationship between the femur (thigh bone) and tibia (leg bone) along the inner side of the knee and prevents the knee from buckling inward.
The MCL is the ligament most commonly injured in sports. When torn, it usually heals, although it may heal in a lengthened, or slightly loose, position.
What Is an MCL Injury?
An MCL injury is a sprain or tear of the medial collateral ligament on the inner side of the knee.
MCL sprains are classified into three grades:
- First-degree sprain: The ligament is not lengthened but is painful.
- Second-degree sprain: The ligament is stretched but still functions.
- Third-degree sprain: The ligament is completely torn and does not function.
Causes and Risk Factors
MCL sprains occur when a force exceeds the strength of the ligament. Most commonly, the injury results from a direct blow to the outer side of the knee, usually while the foot is on the ground. An MCL sprain also may result from a non-contact injury.
Risk factors include:
- Contact sports such as football and rugby
- Sports requiring pivoting and cutting, such as soccer and baseball
- Poor physical conditioning, including strength and flexibility
- Improper equipment
Symptoms
Signs and symptoms may include:
- Pain and tenderness on the inner side of the knee
- A popping, tearing, or pulling sensation at the time of injury
- Swelling and bruising at the site of injury, often after 24 hours
- Ability to continue playing with lesser degrees of injury
- Knee stiffness
- Limping, often while walking with the knees bent
Treatment
Initial treatment includes medications and ice to relieve pain and reduce knee swelling. Walking with crutches until the patient can walk without a limp is often recommended, although full weight may be placed on the injured leg.
A hinged knee brace may be recommended to protect the MCL while knee motion is restored. Range-of-motion, stretching, and strengthening exercises may be performed at home, although referral to a physical therapist or athletic trainer usually is recommended.
Rehabilitation generally focuses on:
- Reducing knee swelling
- Regaining knee range of motion
- Regaining muscle control and strength
- A short period of bracing
When the MCL is injured by itself, it usually heals on its own with physical therapy and avoidance of aggravating activities. Rarely, an isolated severe MCL injury requires surgery. Surgery may be recommended for severe MCL sprains or injuries associated with other knee ligament injuries.
Nonsteroidal anti-inflammatory medications such as aspirin and ibuprofen, or other minor pain relievers such as acetaminophen, are often recommended as directed by a physician. Stronger pain relievers may be prescribed when necessary.
Cold can be used to relieve pain and reduce inflammation. It may be applied for 10 to 15 minutes every two to three hours and immediately after activities that aggravate symptoms. Heat may be used before stretching and strengthening activities prescribed by a physician, physical therapist, or athletic trainer.
Recovery and Outcomes
When the MCL is injured by itself, it usually heals on its own with physical therapy and avoidance of aggravating activities.
Rarely, isolated severe MCL injuries require surgery.
Potential complications may include recurrent knee giving way, instability and swelling, injury to the meniscus or articular cartilage, injury to other knee ligaments, and knee stiffness.
When to See Dr. Chudik
Contact Dr. Chudik’s office for evaluation if symptoms persist or worsen following an MCL injury.
Call 630-324-0402, request an appointment online, or email contactus@chudikmd.com.