MCL Injury: Causes, Symptoms, Diagnosis, Treatment, and Prevention
On the inside of the knee, a large ligament called the medial collateral ligament (MCL) joins the thigh and shin bones. It aids in stabilizing and guards against excessive sideways movement of the knee joint. An MCL injury happens when there is a direct hit, a twisting force, or an abrupt change in direction that causes the ligament to be strained or ripped. Sports like football, basketball, and skiing that require a lot of running, turning, and collision are prone to MCL injuries.
Causes
The most common cause of an MCL injury is a direct impact to the outside of the knee, which pushes the knee inward and overstretches the MCL. This can happen when another player collides with the knee during a tackle, slide, or block. Another cause of an MCL injury is a twisting or bending force on the knee, which can occur when the foot is planted on the ground and the body rotates or changes direction. This can happen when pivoting, cutting, or landing from a jump. A third cause of an MCL injury is a gradual wear and tear of the ligament over time, due to repeated stress and pressure on the knee. This may occur when bending over, kneeling, or lifting large objects.
Symptoms
The symptoms of an MCL injury depend on the severity of the damage to the ligament. The symptoms may include:
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Pain and tenderness on the inner side of the knee
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Swelling and bruising around the knee
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Difficulty moving or straightening the knee
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Feeling of instability or looseness in the knee
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Popping or snapping sound at the time of injury
The symptoms may not appear immediately after the injury, but may develop over the next few hours or days. In some cases, an MCL injury may also involve damage to other structures in the knee, such as the anterior cruciate ligament (ACL), the lateral collateral ligament (LCL), or the meniscus. This may cause additional symptoms, such as pain in other parts of the knee, increased swelling, and reduced range of motion.
Diagnosis
A doctor will inspect the knee for evidence of damage and inquire about the injury's history and mechanism in order to diagnose an MCL injury. In addition to testing the stability and strength of the knee joint, the doctor will look for pain, swelling, and tenderness on the inside of the knee. To determine how slack or loose the MCL is, the doctor may also run certain specialized procedures, such the valgus stress test. To confirm the diagnosis and rule out other potential injuries or disorders, the doctor may also request imaging tests like an MRI, ultrasound, or X-ray. These tests can reveal the location and size of the MCL tear as well as a comprehensive image of the knee's bones and soft tissues.
Treatment
The treatment of an MCL injury depends on the grade or severity of the tear, and the presence of any other associated injuries. The treatment options may include:
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Rest: The first step in treating an MCL injury is to rest the knee and avoid any activities that may aggravate the pain or cause further damage. This may include using crutches, a cane, or a walker to reduce the weight and pressure on the knee.
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Ice: Applying ice to the knee can help to reduce the swelling and inflammation, and numb the pain. Ice should be applied for 15 to 20 minutes every few hours, with a towel or cloth between the ice and the skin to prevent frostbite.
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Compression: Wrapping the knee with an elastic bandage or a brace can help to provide support and stability to the knee, and prevent excessive movement. Compression can also help to reduce the swelling and bleeding in the knee.
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Elevation: Elevating the knee above the level of the heart can help to improve the blood circulation and drainage in the knee, and reduce the swelling and pain. Elevation can be achieved by using pillows, cushions, or a stool to prop up the leg.
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Medication: Taking over-the-counter pain relievers, such as ibuprofen or acetaminophen, can help to ease the pain and inflammation in the knee. However, these medications should be used with caution and under the guidance of a doctor, as they may have side effects or interact with other medications.
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Physical therapy: Once the pain and swelling have subsided, physical therapy can help to restore the range of motion, strength, and function of the knee. Physical therapy may include exercises, stretches, massage, ultrasound, electrical stimulation, and other modalities to improve the healing and recovery of the MCL and the knee joint.
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Surgery: In rare cases, surgery may be required to repair a severe or complete tear of the MCL, or to address any other associated injuries, such as an ACL tear. Surgery may involve stitching the torn ends of the ligament together, grafting a piece of tissue from another part of the body or a donor to replace the damaged ligament, or fixing the ligament to the bone with screws or anchors. Surgery is usually followed by a period of immobilization, and a longer and more intensive course of physical therapy.
Prevention
To prevent an MCL injury, it is important to take some precautions and follow some tips, such as:
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Warming up properly before engaging in any physical activity, especially sports that involve contact, running, and turning.
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Wearing appropriate footwear and equipment, such as knee pads, braces, or guards, to protect the knee from impact and injury.
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Practicing good technique and form when playing sports, and avoiding sudden or awkward movements that may strain the knee.
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Strengthening the muscles and ligaments around the knee, especially the quadriceps, hamstrings, and calf muscles, to provide support and stability to the knee joint.
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Stretching the muscles and ligaments around the knee regularly, to improve the flexibility and mobility of the knee joint.
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Avoiding overuse or overexertion of the knee, and taking breaks and rest periods between activities.
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Seeking medical attention promptly if the knee is injured or painful, and following the doctor’s advice and treatment plan.
