The Medial Collateral Ligament (commonly shortened to MCL) is one of four ligaments that are essential to the stability of the knee. The MCL covers the area from the top of the tibia (shin bone) running all the way to the end of the femur (thigh bone). It is located on the inside of the knee. An MCL tear occurs when the outside of the knee is struck. It may be an isolated injury or it may be part of a more complex injury to the knee. The most common symptom of an MCL injury is pain right over the ligament. There may also be swelling and bruising in the area. In more severe cases, patients may feel as though their knee may buckle or “give out”, or that their knee feels unstable. MCL injuries are graded on a scale of 1-3. Grade I and II tears are considered incomplete tears, while Grade III is a complete tear.
An MCL injury is caused by stress or pressure on the outside part of the knee. It is usually injured at the same time as an ACL injury, although it can be an isolated injury. It is a very common injury in football, when a player is blocked. A tackle or block hitting the side of the knee can cause the bones to be pushed apart on the inside of the knee, overstretching the ligament, resulting in an MCL tear. In football, this can happen when a ball carrier is tackled from behind or from the side. It can also happen to someone who doesn’t have the ball. A defensive player running to make a tackle may be blocked by an offensive player, who dives into the side of their knees, resulting in an MCL tear. Offensive linemen are also at risk because of the pattern of the grip on their cleats, and companies are trying to research and create better cleats to help avoid potential MCL tears in the future.
For all MCL tears, initial treatment focuses on reducing the inflammation and pain in the knee while ensuring the knee remains stabilized by keeping it immobilized. Elevating the knee, icing it, and resting it all help make this possible. You can also take over-the-counter pain medication. A lightweight brace or cast may be applied to restrict side-to-side movement but still allow the knee to move forward and backward. Depending on the severity of the injury, the knee needs to be immobilized for at least 72 hours. The MCL generally answers very well to non-surgical treatment. In rare cases, surgery may be required. If the ACL is damaged as well as the MCL, surgery is almost definitely required. The University of California San Francisco’s Medical Center has more information abut treatment methods for MCL tears.
After initial treatment is administered and no new swelling or pain is experienced, it may be possible to start some easy stretching exercises to help the knee gain mobility. If these initial exercises do not cause any swelling or pain, further exercises can be gradually introduced to help strengthen leg muscles that give support to the knee joint, which also helps prevent further injury. Exercises such as heel slides, quad stretches, and hamstring stretches all help build strength and increase mobility. Each tear brings a different recovery period. Grade 1 MCL Tears generally require one to two weeks of recovery time; Grade II MCL Tears require three to four weeks of recovery time; and Grade III MCL Tears generally take over three months, as they are more severe.