Pikes Peak Orthopaedic Surgery and Sports Medicine

2925 Professional Place STE 110, Colorado Springs, 80904   |  P. 719-445-0344   |  F. 719-445-0357   |   Email Us

 

P. 719-445-0344     |    Email Us

MCL Injuries

The medial collateral ligament (MCL), a band of tissue present on the inside of your knee joint, connects your thigh bone and shin bone. The MCL maintains the integrity of the knee joint and prevents it from bending inward.

Your MCL may get sprained or injured while twisting, bending or quickly changing direction. The sprain is classified into three degrees:

  • First-degree sprain: Ligament fibers may be injured, but with no significant tear and no loss of integrity.
  • Second-degree sprain: Not all ligament fibers are torn. Ligament remains intact overall.
  • Third-degree sprain or a tear: Complete rupture of ligament and loss of overall integrity.

Injuries to the MCL commonly occur because of a pressure or stress on the outside part of the knee or from sudden impact from the outside of your knee. Rarely, the MCL can get injured when the knee is twisted or following a quick change in direction. However, the anterior cruciate ligament (ACL) may be torn along with an MCL injury.

Symptoms

The symptoms of MCL sprain include:

  • Tenderness and pain in the inner side of the knee
  • Swelling and bruising
  • Stiffness of the knee
  • Difficulty walking
  • Bleeding and inflow of fluid into the joint

The symptoms of an MCL tear include:

  • Knee pain
  • Swelling
  • Locking or catching sensation in the knee during movement
  • It may also feel like the knee may ‘give out’ suddenly or buckle

Diagnosis

Regardless of a sprain or a tear, your doctor will review your symptoms and medical history. A physical examination will be performed where your doctor checks the range-of-movement of your legs by exerting pressure on the outside of your knee while your knee is bent to 25 degrees. This will determine the looseness of your knee. An X-ray or MRI scan may be ordered to determine soft tissue injury, confirm the extent of damage, and assess the integrity of your knee.

Treatment

Sprain

MCL sprains are commonly treated by conservative procedures. You will be advised to take adequate rest and not to strain yourself. An ice pack may be applied for 10 to 20 minutes for every 1 to 2 hours to reduce swelling. You may be prescribed anti-inflammatory medicines to reduce the pain and swelling. Your doctor may recommend crutches and braces to support, protect and limit movement in your knee. Rehabilitation procedures and exercises for MCL sprains generally focus on regaining knee range-of-motion, muscle control and strength, and reduce swelling. Surgery is performed very rarely, mostly in cases of significant third-degree ligament injury or a tear.

Third-degree ligament injury or tear

Treatment options include non-surgical and surgical treatment. Non-surgical treatment consists of rest, ice, compression and elevation (RICE protocol); all assist in controlling pain and swelling. A knee brace may be worn to help immobilize your knee. Use of crutches may be recommended to protect your knee and to keep you from putting weight on your knee while walking. Physical therapy exercises may be recommended to improve knee motion and strength.

Most often, surgery is not necessary for the treatment of an MCL tear. If needed it is usually performed using arthroscopy. In many cases, this injury cannot be prevented. However, using proper techniques during sports or exercising can help prevent injury.

FAQ

What about an MCL injuries in children? Is there a similar protocol to follow?

A medial collateral ligament tear is less common in children. Most often, it occurs in teenage athletes who participate in sports, such as football and ice hockey. Younger children below the age of 12 years are less likely to injure their MCL, as the bone where the ligament attaches may break.

The skeletally immature knee in a child slightly differs from the adult knee and may result in mild variations of injury patterns. In children, the epiphyseal plates (growth plates) are weak compared with ligaments in adults. A growth plate, also called the epiphyseal plate or physis, is the area of growing tissue made up of cartilage (rubbery material) found at the ends of the long bones in children. Therefore, any extraneous force on the knee causes physeal injury rather than the ligament injury. Hence MCL injuries are less common in children.