MCL Tear | Sprain | Injury: Grades, Exercises & Treatment

 What is MCL Tear ?

Medial collateral ligament is one of the four MCL tearimportant knee’s ligaments that starts from femur (thigh bone) and ends at top of tibia (shinbone) i.e. inside part of the knee joint. The three other ligaments are ACL, PCL and LCL. MCL is made of tough fibrous tissues that are critical for the stability and strength of the knee joint.

MCL is extremely important part of knee wherein it resists the leg from over-extending inwardly. It also prevents the knee from opening up and allows it to rotate properly without any difficult.

MCL is usually damaged when knee receives sudden blow from outside, which makes the MCL to stretched too far resulting in tear or injury. Often, MCL tear is accompanied with either ACL tear or meniscus tear.


What are the Causes of MCL Tear?

MCL is torn only when knee receives blow directly from the outside, which pushes the knee sideways when the foot is planted firmly on the ground. Some of the common causes are:

  • Excessive Strain: When knee receives too much strain due to sudden twisting or valgus forces. When it stretched beyond its limits, then it will worn out similar to rubber band.
  • Contact Sports: Individuals and athletes involved in contact sports such as football, soccer, netball, basketball and skiing are often susceptible to MCL tear because it involves lots of running, pivoting, landing, sprinting, and kicking.
  • Repetitive Stressful Activities: Activities such as breaststroke kicking while swimming puts lots of stress on knee especially on Medial collateral ligament. Due to continuance involvement or perforating the abovementioned activity, MCL may incur injury or tear.
  • Poor Physical Conditioning: Weak muscles or aching muscles after performing minimal sporting There are also issues with strength and flexibility of body.
  • ACL Tear: It is common among athletes to suffer MCL tear when they have already suffering from ACL tear or Meniscus injury.

Diagnosis of MCL Tear :

During your appointment with your doctor, he or she will ask about the cause and symptoms of the injury such as swelling, tenderness and range of motion. Detailed medical history is also inquired and comprehensive physical test is conducted to analyze the injured knee.

Doctors conduct X-rays and MRI scan for checking whether any bone is broken and acquire the better pictures of soft tissues respectively for proper diagnosing.


MCL Tear: Grades, Symptoms, Treatment & Recovery:

torn-MCL

MCL tear ranges from small tear to complete rupture. Since symptoms, grades and treatment of MCL tear varies greatly according to the grades, we have described the grades individually:


MCL Grade 1 Tear – Minor Sprain

In this grade, only few fibres i.e. 10% are being damaged. The tear is incomplete and ligament is still connected. No loss of function.

  • Symptoms: Pain will be experienced upon putting pressure on the MCL. The point of injury will become tender and swollen.
  • Treatment:
    • With the usage of P.R.I.C.E. protocol, it will quickly heal in a matter of time. The acronym stands for
      • Protect: Protect and safeguard the knee from further damage or injury.
      • Rest: Resting is critical component of treatment because it will allow the tear to completely heal on its own.
      • Ice: Applying ice on the point of injury will reduce the swelling and pain.
      • Compression: Using an elastic bandage, the affected area will be constricted, which will provides relief.
      • Elevation: The knee should be positioned far above the ground or above the level of heart. This will make the MCL to heal properly and to help the leg in still position.
    • NSAIDs: Ibuprofen and other similar mediations are extremely effective in healing the pain and reducing the swelling. However, consult an experienced doctor before consulting any type of medication.
    • Knee Strengthening Exercises: Refer Grade 2 exercises.
  • Recovery: Minor strain can heal in a matter of few days i.e. couple of weeks and you can resume your normal activities. However, experts advise sportsmen not to participate in any sporting activities for about 3 weeks.

MCL Grade 2 Tear – Severe Sprain

Significant numbers of fibres are damaged but the ligament is still in continuity. It is also incomplete tear of MCL. Moderate loss of function.

  • Symptoms: Moderate pain can be experienced, which will appear along with bruising and swelling within 48 hours of injury. Patient will also feel instability in the knee. Significant amount of tenderness can be felt inside of the knee together with joint laxity.
  • Treatment:
    • R.I.C.E.: Protecting, resting, icing, compressing and elevating the knee joint will reduce the swelling, tenderness, bruising and pain.
    • Hinged Knee Brace: They are specially designed to increase stability for the ligament. It will also allows safe motion during any sporting activity along with comfort, support and protection. Even you can bend your knee with hinged knee brace.
    • Compression Bandage: They are specially designed elastic bandages that provides optimum comfort and support to the knee. It help reduce persistent pain and swelling. They are extremely easy to apply to the point of injury and even some bandages are reusable. However, don’t wear the bandages at night.
    • Therapeutic massage: Massage therapy helps in relieves stress and relaxes muscles. They improves the blood circulation along with flexibility and range of motion. They even assists in improving rehabilitation after MCL injury. Some of the therapeutic massages are Ultrasound treatment and deep tissue friction massage.
    • NSAIDs: Diclofenac/Voltaren or Ibuprofen/Motrin can be diagnosed to limit the pain and swelling in the injured area.
    • Exercises: Consult professional physical therapist before starting any MCL exercises. Some of the effective MCL exercises are: Static quads contractions, isometric quadriceps exercise, calf raises, leg curl, hamstring curl with resistance band, hip abduction, hip extension, half squats, lunges, leg press, step ups, bridge exercises, balance board exercises, plyometric exercises, agility drills
    • Crutches or Walker: Use crutches while walking in order to keep off putting weight on injured knee. Even walker can be beneficial in the treatment.

(Note: The remainder of treatment is the same as a Grade 1 injury)

  • Recovery: Grade 2 tear requires approximately one month to completely heal. Athletes can return to sporting activities after a period of one month or so after their injury.

MCL Grade 3 Tear – Complete Rupture

All the fibres are ruptured or torn and major loss of function. Along with complete rupture, meniscus or anterior cruciate ligament might have also injured or damaged.

  • Symptoms: Significant amount of pain, swelling and tenderness can be experienced. Knee will become unstable and wobbly. Pain can be felt while bending the knee and knee giving away sensation can be felt.
  • Treatment:
    • R.I.C.E. Formula: Protect, rest, ice, compress and elevate. Refer Grade 1 treatment section for more information.
    • Hinged Knee Brace: These braces support the knee and help prevent MCL tear to recur. They are comfortable and protect from any further injury.
    • Knee Immobilizer: They are usually used after surgery. However, they are extremely effective in preventing unnatural movement of the leg. It immobilize and covers entire knee joint i.e. from the shin bone to thigh bone.
    • Crutches: While walking, patient must use crutches for couple of weeks in order to avoid putting too much weight on the injured knee.
    • NSAIDs: Nonsteroidal anti-inflammatory drugs (NSAID’s) such Ibuprofen/Motrin are effective in easing pain and swelling.
    • Surgery: Surgery for MCL tear is extremely rare. If ever the surgery is performed, doctors will re-attach the ligament to the bone with the help of some of the flowing: stitches, metal screws and bone staple.
    • Exercises: Refer Grade 2 Treatment section.
  • Recovery: Since Grade 3 is severe injury, MCl takes 3-6 months for complete recovery.

Conclusion – MCL Tear:

The outlook is good. Individuals and athletes can return to sporting activities as soon as possible after the MCL heals completely. Avoid aggravating activities that can make the MCL tear to recur. Do proper exercise and stretches before sporting activity as your physical therapy suggests.