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MCL Knee Ligament Injury Explained

The Medial Collateral Ligament is the knee ligament located on the inner side of the knee joint. It links the thigh bone and the shin bone and acts to prevent excessive inward movement of the knee joint. A knee ligament injury is referred to as a sprain, and this knee injury can occur if the knee is twisted or subject to force from an opponent during sport.

The Medial Collateral Ligament is the large ligament on the inside of the knee that links the thigh bone and the shin bone. Damage to a ligament is referred to as a sprain, and depending on the severity of the injury it is classified as first, second or third degree:

  • A first degree sprain is damage to only a few ligament fibres.
  • A second degree sprain is damage to a more extensive number of ligament fibres, but the ligament remains intact.
  • A third degree sprain is a complete rupture of the ligament. Because of the force involved in this injury other structures in the knee, such as the Meniscus (Cartilage) or the Anterior Cruciate Ligament can also be damaged.

The injury is usually caused in one of two classic ways. In collision sports such as football (soccer), rugby, and American football, the Medial ligament can be damaged when an opponent applies a force (usually from their knee) to the outside aspect of the leg, just above the knee. Alternatively the Medial ligament can be damaged if the studs get caught in turf and the player tries to turn to the side, away from the planted leg .

Anatomy of medial collateral ligament sprain injury

MCL Knee Ligament Injury Signs & Symptoms

With a first degree sprain of the Medial ligament there will be pain when the site of the damage is touched. Stressing the ligament (when the knee is slightly bent and the shin is moved inwards in relation to the thigh) is painful - this action is reproduced when standing up from sitting in a chair.

In the case of a second degree sprain, the pain is more severe when touched and when the ligament is stressed. There will usually be a swelling of the knee joint and maybe some bruising, but this may take 24 hours to appear.

In the case of a third degree sprain, where the ligament is ruptured, the knee joint is unstable and activity cannot be continued. There will be a bleed and an inflow of fluid into the joint but, because the capsule that surrounds the joint is also damaged, this fluid may leak out and swelling may not be evident

MCL Knee Ligament Injury Treatment

In the initial stage of all three levels of injury medication prescribed by a doctor for pain relief should be taken if necessary. The PRICE protocol should be followed - Protection, Rest, Ice, Compression and Elevation (never apply ice directly to the skin). The knee should be rested in an elevated position and Cohesive Bandage (which sticks to itself) should be used as a compression bandage to help prevent excessive swelling.

Ice Packs applied for twenty minutes, every two hours, can aid pain relief and help to prevent more tissue damage by constricting the tissues. The Aircast Knee Cryo/Cuff is the most effective method of providing ice therapy and can be used for the home treatment of knee injuries and knee pain. It can provide continuous ice cold water and compression for 6 hours - and significantly reducing knee pain and knee swelling.

In the case of a first degree sprain, sporting activities should not be undertaken for about 3 weeks, until symptoms have resolved and some strength regained.

For second degree sprains, the rehabilitation period will be between 6 and 8 weeks. Rehabilitation under the supervision of a chartered physiotherapist is desirable to prevent a recurrence of the injury, which can be common if the joint still lacks strength and stability or a return to sport is attempted too early.

In the case of a third degree sprain, where the ligament is completely ruptured, the treatment of choice is surgery to repair the structure. The type of reconstruction used will depend on the exact site of the damage and the preference of the surgeon. Many people find that using a Knee Brace can be very helpful if they have suffered a Medial Collateral Ligament injury. The brace supports the knee and takes the strain off the ligament during the early stage of injury, particularly for preventing painful, twisting movements when sleeping. The knee brace also provides confidence when returning to activity and protection during the later stages of rehabilitation. Running in a swimming pool, using a Buoyancy Aid, is an ideal method of maintaining fitness while the ligament is healing.

Many people find that using a Knee Brace can be very helpful if they have suffered a Medial Collateral Ligament injury. The brace supports the knee and takes the strain off the ligament during the early stage of injury, particularly when sleeping. The knee brace also provides protection during the later stages of rehabilitation.

MCL Knee Ligament Injury Prevention

You can't do a lot if a prop forward (in rugby) or a centre half (in football) decides to throw their weight against your knee. Passing the ball earlier is probably the best advice that can be given. In the case of someone who has had a previous Medial Ligament injury there may be a slight weakness, but there are measures that can be taken to help prevent a recurrence. A Knee Brace can provide increased knee stability and reassurance following previous knee injuries, especially during activities such as skiing.

Following a rehabilitation programme under the supervision of a chartered physiotherapist will help. This should include a lot of proprioception exercises (these improve the stimuli within the body relating to position and movement), since proprioceptive ability will be affected by the damage to the ligament. A Wobble Board is an excellent tool for continuing proprioception exercises at home.

Addressing strength in the joints above and below the knee, such as the ankle and hip can also help provide added stability to the entire limb and reduce the load on the knee.

Guide to Proprioception




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