What is a MCL Injury
The knee has four ligamentous structures that act to stabilise the joint and limit excess movement. One of these ligaments is known as the Medial Collateral Ligament, or the MCL for short. The ligament runs over the inside of the knee, attaching the femur (thigh bone) and tibia (shin bone). The MCL also has some deep attachments into the meniscus of the knee, and for this reason meniscal and MCL injuries are often seen simultaneously. Due to its attachment points on the inside of the knee, the role of the MCL is to prevent the knee collapsing inwards (this is known as medial, or valgus collapse).
Unlike Anterior Cruciate Ligament injuries, damage to the MCL is usually sustained through direct contact to the knee. A blow to the outside of the knee, forcing it inwards causes the MCL to stretch, and potentially rupture completely.
What are the Signs and Symptoms of a MCL Injury
+ Pain, swelling and tenderness over the inside of the knee, where the thigh and shin bones meet is also
+ Reduce knee flexion and extension due to swelling
+ Inability or reduced ability to weight bear
+ Instability/unsteadiness on the leg with walking
What is the Treatment of MCL Injuries
Treatment for Medial Collateral Ligament injuries is dependent on the grade of damage sustained. MCL injuries are graded from I to III, with grade I injuries involving a stretching of the ligamentous fibres. A partial tear of the MCL is considered a grade II injury, while a grade III injury describes a complete rupture of the ligament.
Grade I injury: Treated with simple pain relief techniques, appropriate exercises prescribed by a physiotherapist, and a short recovery period (ranging from several days – two weeks).
Grade II and III injuries: Treated slightly more conservatively, requiring bracing in specific positions to ensure correct healing, and to protect the ligament throughout this process. Grade II tears of the MCL are expected to heal over a 4-6 week period, while grade III ruptures require at least 6-8 weeks before returning to specific activities.
Surgery is rarely indicated for MCL injuries, although may be required if the ligament does not respond to conservative management. Tears or ruptures further towards the shin bone are less likely to heal completely than injuries to the upper portion of the ligament. A graft is taken from either the hamstrings, Tibialis Anterior muscle, or Achilles’ tendon when performing a Medial Collateral Ligament reconstruction.