MCL Sprain

Although you will want to get back to your normal routine quite soon, it is important not to rush through your medial collateral ligament sprain recovery program. An early return to activity may worsen the injury.

A sprain is a joint injury that causes a stretch or a tear in a ligament, which is the strong band of tissue that connects one bone to the other. The MCL, or medial collateral ligament, is located on the inner side of the knee, and it attaches the thigh bone (femur) to the shin bone (tibia).

Sprains are graded depending upon the severity of the sprain:

• Grade I sprain: pain with minimal damage to the ligaments
• Grade II sprain: more ligament damage and mild looseness of the joint
• Grade III sprain: complete tearing of the ligament and the joint is very loose or unstable.

Causes
This injury usually occurs when a blow to the outer side of the knee causes stretching or tearing of the medial collateral ligament. It can also be caused by a twisting injury to the knee.

Symptoms
A common symptom is pain on the innermost side of the knee. Your knee may be swollen and tender. And you may sense the knee giving way, or hear or feel a pop or snap at the time of injury.

Diagnosis
Your doctor will examine your knee, and will gently move it around to see if the joint is stable and if the ligament is stretched or torn. He or she may order X- rays or a magnetic resonance image (MRI) of your knee.

Treatment
Among available are the following:

• applying ice to your knee for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain and swelling diminish
• elevating your knee by placing a pillow underneath it
• taking an anti-inflammatory medication or other drugs prescribed by your doctor
• wearing a knee immobilizer or knee brace to keep you from moving and further injuring your knee and to minimize the pain
• using crutches
• doing rehabilitation exercises.

While you are recovering, you will need to change your sport or activity to one that does not make your condition worse. For example, you may need to swim instead of run.

Recovery Outlook
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon, you may worsen your injury and lead to permanent damage. Everyone recovers from injury at a different rate. When you return to your sport or activity will be determined by how soon your knee recovers, not by how many days or weeks it has been since the injury occurred. In general, the longer you experience symptoms before you begin treatment, the longer it will take to get better.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

• your injured knee can be fully straightened and bent without pain
• your knee and leg have regained normal strength compared to the uninjured knee and leg
• your knee is not swollen
• you are able to jog straight ahead without limping
• you are able to sprint straight ahead without limping
• you are able to do 45-degree cuts
• you are able to do 90-degree cuts
• you are able to do 20-yard figure-eight runs
• you are able to do 10-yard figure-eight runs
• you are able to jump on both legs without pain and jump on the injured leg without pain.

If you feel that your knee is giving way, or if you develop pain or swelling in your knee, you should see your doctor.

Prevention
Unfortunately, most injuries to the medial collateral ligament are due to accidents that are not preventable. However, you may be able to avoid these injuries by having strong thigh and hamstring muscles, as well as by maintaining a good leg-stretching routine. When skiing, be sure your bindings are set correctly by a trained professional so that your skis will release when you fall.