MCL tear

MCL Tear Description
MCL Tear is a common injury in sports and exercise.   The MCL is the medial collateral ligament of the knee.   Knee sprains, or strains on the inside of the knee typically result from valgus contant injuries to the knee.  This occurs when something hits the outside of the knee, forcing the knee inwards.  

MCL Tear Anatomy
The medial collateral ligament is the main ligament on the inside of the knee.  The MCL is the primary restraint to valgus instability of the knee.  The MCL is a secondary stabilizer to anterior translation and also resists external rotation.

MCL Tear Symptoms
MCL Tear causes pain and swelling on the inside of the knee.  This typically occurs after an injury.  In MCL injuries the swelling is on the inside of the knee, instead of all over the knee or deep inside the knee (effusion) which is an indication of ACL injury.

MCL Tear Treatment 
MCL Tear diagnosed based on a detailed history, physical exam and xrays performed by an orthopaedic surgeon, or sports medicine specialist.

MCL injuries are grade based on the severity of injury.  Grade I injuries demonstrate 0 to 5 mm of medial opening when examined by the orthopaedic surgeon.  Grade II injuries demonstrate 6 to 10 mm of medial opening.  Grade III injuries demonstrate 11 to 15 mm of medial opening.

Treatment of ACL injuries generally does not require surgies.  After the initial period of pain and swelling most people are able to walk on the knee.  Icing, compressions and taking NSAIDs after the initial injury are helpful.   The most important part of treatment is wearing a hinged Knee brace with early motion and functional rehabilitation. Typically the range of motion in the brace opened from 15° to 60° for first 4weeks. The brace is opened from 0°-120°for 4 weeks afterwards for a total of 8 weeks of bracing. 

MCL injuries frequent are part of a more severe injury to the knee in which other ligaments such as the ACL are injured as well.  It is very important to have knee ligament injuries evaluated by an orthopaedic surgeon to ensure there are not other associated injuries that may require further treatment for the best outcome.  

Athletes returning to sports after MCL Tear should begin with a graduated exercise program. First they should be pain free with daily activities with full range of motion and at least 85% strength in the injured leg compared to the uninjured leg. Exercise begins with light jogging in a straight line, followed by sprinting in a straight line. When these have been done without pain the athlete can proceed to doing agility type drills such as 45º cuts, 90º cuts and jumping. Agility drills should begin at half-speed and proceed to full-speed provided the athlete remains pain free.

MCL Tear Prevention
There are many important opportunities to decrease the risk of ACL injury.  As in all sports it is most important to maintain flexibility by stretching before and after practice or games.  Maintaining a proper diet and overall physical fitness is important. 

ACL injury prevention exercise programs have been shown to have a substantial beneficial effect.  ACL injury prevention programs have demonstrated  a risk reduction of 52% in the female athletes and 85% in the male athletes.  ACL injury prevention programs should include at least ten minutes of exercises three times per week, with a focus on neuromuscular training.  ACL injury prevention programs include lower extremity plyometrics, dynamic balance and strength, stretching, body awareness and decision-making, and targeted core and trunk control exercises.  
-Knee braces have been shown to decrease the risk of MCL injury, but does not affect ACL or LCL injuries

MCL Tear Risk Factors
MCL Tear is associated the following sports: Baseball; Basketball; Boxing; Cycling; Dance; Diving; Equestrian Sports; Figure Skating; Football; Golf; Gymnastics; Hockey; RowingRugby; Running; Skiing; Snowboarding; Soccer; Swimming; Tennis; VolleyballWeight Lifting; Wrestling.

MCL Tear Rehab and Exercise Program
MCL Tear

MCL Tear Outcomes
Most MCL tears recover fully without long-term limitations.

Similar injuries that can be confused with MCL Tear include:

  • ACL tear
  • Tibial Plateau fracture
  • Knee Dislocation
  • Meniscal tear
  • Pediatric distal femoral fracture
MCL tear, MCL rupture, MCL sprain, medial collateral ligament tear, tibial collateral ligament

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