Medial Collateral Ligament Injury

MEDIAL COLLATERAL LIGAMENT INJURY

 

 

 

What is the medial collateral ligament?

A ligament is made of tough fibrous material and functions to control excessive motion by limiting joint mobility. The Medial collateral ligament along with the other three stabilizing ligaments of the knee namely the anterior and posterior cruciate ligaments (ACL and PCL, respectively), and the lateral collateral ligaments (LCL) play a vital role in the stability of the knee joint

Origin and insertion:-The medial collateral ligament spans the distance from the end of the femur (thigh bone) to the top of the tibia (shin bone) and is on the inside of the knee joint.

Function:- The medial collateral ligament resists widening of the inside of the joint, or prevents “opening-up” of the knee.

Mechanism of injury

Injury to the MCL often occurs after an impact to the outside of the knee when the knee is slightly bent. The MCL on the inside of the knee becomes stretched and if the force is great enough its fibres will tear
Because the medial collateral ligament resists widening of the inside of the knee joint, the MCL is usually injured when the outside of the knee joint is struck. This action causes the outside of the knee to buckle, and the inside to widen. When the medial collateral ligament is stretched too far, it is susceptible to tearing and injury. This is the injury seen by the action of “clipping” in a football game.

An injury to the medial collateral ligament may occur as an isolated injury, or it may be part of a complex injury to the knee. Other ligaments, most commonly the anterior cruciate ligament (ACL), or the meniscus (cartilage), may be torn along with a medial collateral ligament injury.

Causes

  • Trauma
  • Acute varus or valgus stress on the knee joint
  • Sports related (younger population)
  • Falls (elderly)
  • Overuse syndromes (for example, swimmers who use the breaststroke may repetitively stretch the MCL, leading to injury)

Symptoms

The most common symptom following a medial collateral ligament injury is:-

  • Pain and stiffness are localized to the medial knee.
  • Erythema may appear after several days.
  • Swelling over the torn ligament may appear, and bruising and generalized joint swelling are common 1 to 2 days after the injury.
  • Instability or mechanical symptoms (eg, a locking or popping sensation) are uncommon. In more severe injuries, patients may complain that the knee is unstable, or feel as though their knee may ‘give out’ or buckle.

Symptoms of a medial collateral ligament injury tend to correlate with the extent of the injury. MCL injuries are graded on a scale of I to III.

Grade I MCL Tear This is an incomplete tear of the MCL. The tendon is still in continuity, and the symptoms are usually minimal. Patients usually complain of pain with pressure on the MCL, and may be able to return to their sport very quickly. Usually no swelling.  When the knee is bent to 30 degrees and force applied to the outside of the knee(stressing the medial ligament) pain is felt but there is no joint laxity  .It is advisable to take adequate rest at this time.

Grade II MCL TearGrade II injuries are also considered incomplete tears of the MCL. These patients may complain of instability when attempting to cut or pivot. The pain and swelling is more significant, and usually a period of 3-4 weeks of rest is necessary.

Grade III MCL Tear

A grade III injury is a complete tear of the MCL. Patients have significant pain and swelling, and often have difficulty bending the knee. Instability, or giving out, is a common finding with grade III MCL tears. The athlete may complain of having a very wobbly or unstable knee.

 

What can the athlete do?

  • Apply R.I.C.E. (Rest, Ice, Compression, Elevation) to the injured knee.
  • Rest from training.
  • Wear a hinged knee brace to support the joint, particularly for grade 2 and 3 injuries.
  • Wear a heat retainer after the acute phase.
Visit Physioline for further treatment and rehabilitation
Physioline Management :-
  • Electrotherapy for pain and swelling reduction
  • Bracing: – A knee support or knee brace provides protection and support. They prevent injury to healthy joints and support unstable joints.
  • Strengthening of muscles
  • Sports specific training