Medial Collateral Ligament Strain (MCL Strain)

Editor: Dr. Amy Spencer, PT, DPT, OCS, MTC, CSCS, CKTP - A Board Certified Clinical Specialist in Orthopedic Physical Therapy and Certified Manual Therapist. Owner and Physical Therapist, Specialized Physical Therapy in North Reading, MA.

The medial collateral ligament (MCL) spans the distance from the end of the femur (thigh bone) to the top of the shinbone (tibia) and is on the inside of the knee joint. The MCL resists widening of the inside of the joint, or prevents opening-up of the inner knee. Since the MCL resists widening of the inside of the knee joint, the ligament is usually injured when the outside of the knee joint is struck. This force causes the outside of the knee to buckle and the inside to widen. When the MCL is stretched out too far, it is susceptible to tearing and injury.

Causes of a MCL Strain:

The most common cause of a sprained MCL is force applied to the outside of a bent knee, which pushes the knee inwards and beyond its normal range of motion. This injury is often sustained during contact sports.

Symptoms of a MCL Strain:

Symptoms of an MCL injury tend to correlate with the extent of the injury. MCL injuries are generally graded on a scale of 1 to 3:

• Grade 1 MCL Tear: Grade 1 injury is a minor sprain of the MCL. It has been slightly stretched but is still able to help keep the knee joint stable. Symptoms are typically minimal. Patients usually complain of pain with pressure on the MCL and may be able to return to their sport very quickly. Most athletes only miss 1 to 2 weeks of play.
• Grade 2 MCL Tear: Grade 2 injuries are also considered partial tears of the MCL that stretch the ligament to the point where it becomes loose. These patients may complain of instability when attempting to cut or pivot. The pain and swelling is more significant and usually requires 3 to 4 weeks of rest is necessary.
• Grade 3 MCL Tear: Grade 3 injuries refer to a complete tear of the MCL where the ligament has been torn into two pieces. Patients have significant pain and swelling and often have difficulty bending the knee. Instability or giving out is a common finding with grade 3 MCL tears. A knee brace or a knee immobilizer is usually needed for comfort and healing may take six weeks or longer.

Treatment of a MCL Strain:

Treatment of an MCL tear depends on the severity of the injury. Physical therapy treatment may include modalities for pain relief, such as ice and ultrasound. This will help to restore range of motion, and strengthening the knee enough to return normal daily activities, including sports. In addition, a knee brace can often be useful for treatment of MCL injuries. Fortunately, surgery is not usually necessary for the
treatment of an MCL tear.

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