The MCL (or Medial Collateral Ligament) is a band of tissue located on the inner portion of your knee, but not inside the joint itself. It connects your shinbone to your thighbone. The MCL keeps the knee from bending inward. It also contributes to the stabilization of the knee joint and helps the knee rotate.
If you have an MCL injury, this means you have sprained or torn the tissue. This can be a mild sprain, a partial tear or a full tissue tear (also known as a rupture). Since MCL injuries are common in contact sports, they often occur along with ACL injuries.
There are three levels of severity for classifying MCL injuries. These are:
Grade 1 - This is considered an MCL sprain. The MCL has been mildly stretched but not torn. This is the least severe MCL injury grade.
Grade 2 - This means the MCL has been partially torn, but not completely torn. You may notice the knee is slightly unstable when walking on it.
Grade 3 - This is a complete rupture of the MCL, meaning the tissue is in two separate pieces. This is the most severe MCL injury grade. It is likely that your knee won't be able to support your weight.
MCL injuries are often caused by a direct hit to the outside of the knee. This is common in sports such as:
While this is usually the result of a sports hit or tackle, it can also result from a fall or car accident.
Sports that involve bending, twisting and quick changes in direction can also cause MCL injuries. This includes:
The above are known as acute injuries, meaning they are the result of a one-time incident (trauma) that caused the MCL to become damaged. The MCL can also become damaged due to repetitive movements over time. This is known as degeneration. While acute injuries are common amongst younger, more athletic patients, degeneration is usually seen among patients who are 40+.
Signs & Symptoms
Signs and symptoms will vary depending on the severity of your MCL injury. If you have a Grade 1 MCL injury, you may just notice some slight pain and swelling. If you have a Grade 3 MCL tear, you may not be able to put any weight on your injured knee.
Signs and symptoms include:
Popping sound at the time of injury
Pain and swelling
Bruising on inside of knee
Knee feels unstable, can't support your weight
Knee feels like its catching or locking
Inside of knee is tender to the touch
Time Frame for Recovery
The time it takes to recover will depend on the severity of your MCL injury. Your age, activity level and overall health will also play a part in how long it takes for you to heal.
Mild or Grade 1 - These MCL injuries generally take about a week or two to heal. Apply ice and compression to your MCL. Try to avoid any activities that could cause re-injury.
Moderate or Grade 2 - Moderate MCL tears take around 2-6 weeks to heal with conservative treatment.
Severe or Grade 3 - Full tissue tears of the MCL will take about 6-8 weeks to fully heal with the aid of surgery. If your ACL or other tissues in your knee were injured at the same time as the MCL, your healing time will likely be 8-12 weeks.
The medial collateral ligament has a good blood supply and usually responds well to non-surgical treatment. Depending on how bad the injury is, it may be enough to rest the knee, wear a brace, take over-the-counter pain relievers such as ibuprofen and have physical therapy.
Cold & Compression
Ice or cold packs on your knee for 20 minutes at a time to help with the reduction of inflammation, and is always the first step in recovering from any kind of injury, whether it is in the knee or elsewhere. Cold and compression are best when used together -- cold to relieve the pain and compression to control the swelling. While you can use ice or a bag of peas from home, there are cold compression wraps on the market that are specially designed for the knee. These wraps are more comfortable and provide uniform coverage of the MCL.
If you're going to use ice or frozen peas, just be sure to wear a layer of clothing during treatment, or wrap the ice/peas in a towel to prevent burns on your skin.
Rest & Elevate
Rest is essential if you want to avoid re-injury. You should avoid whatever activity caused your MCL injury, as well as any other activities that could cause further strain. Some people choose to use crutches in order to keep the weight off their injured knee. If you decide not to use crutches, at least try to limit the amount of time you spend on your feet during the day.
Prop your knee up with a pillow to reduce pressure when you lay down or sit. This will also help with the reduction of the swelling by keeping your knee above your heart.
You can usually start physiotherapy once you've done about 4-6 weeks of conservative treatment, depending on the severity of your MCL injury. It is important to keep the muscles surrounding the MCL strong and flexible, so attending physical therapy is a good idea. Make sure that the physical therapist isn't hindering your healing by pushing you too hard and re-tearing anything. If it's causing pain, don't do it. This could be a sign that it's still too early in the healing process and your MCL isn't ready yet.
Promote Blood Flow
Once your swelling and inflammation are gone, you need to focus on optimal blood flow. This is what will work to really speed up your recovery. There are devices on the market that can bring extra blood flow to your MCL. These devices promote nutrient-rich, oxygenated blood flow to the injured area, deep below your skin and fat. This takes the place of physical activity, which should not be done early in the healing process, as it leads to re-injury. These devices allow you to rest and receive additional blood flow at the same time. In many cases, they can even help people with MCL tears avoid surgery.
Immobilizing the knee can help you avoid further tearing of the MCL tissue, also known as re-injury. A brace or cast may be used to temporarily keep the knee from moving. This wouldn't be worn throughout the healing process, just for several days, depending on the severity of your injury.
Non-steroidal anti-inflammatory drugs (NSAIDs) and analgesics can be used to temporarily relieve the pain. Just be sure not to take painkillers if you plan on being active. This is because painkillers block the pain signal, making you unaware of any damage you may be doing to your knee during physical activity. If you want to avoid re-injury, only take painkillers during times of rest.
While NSAIDs (like Advil and Aleve) work to relieve both pain and inflammation, analgesics (like Tylenol) only relieve pain.
Taping MCL Injuries
Kinesiology tape (also known as sports tape) can help to relieve symptoms by providing your MCL with support and protection. Kinesiology taping is popular among athletes, coaches and medical professionals as a way to prevent re-injury. If you want to try kinesiology taping for your MCL, follow the instructions below:
1. Take a full length piece of tape (about 10 inches long) and cut it in half, rounding the corners, so you have two pieces that are each about 5 inches long.
2. Bend your knee so it's at a 90° angle and take one of the 5 inch strips, tearing the backing in the middle and peeling it away so you are holding onto the two anchor ends.
3. Apply the strip vertically over the point of pain on the inside of your knee (so it's parallel with your thigh) , using 80% stretch in the middle and no stretch at the ends.
4. Take the other 5 inch strip and tear the backing in the middle, peeling it away so you are holding onto the two anchor ends.
5. Apply the strip horizontally over the point of pain (so it's parallel with your calf) to form a "cross" shape, using 80% stretch in the middle and no stretch at the ends.
6. Take a full length piece of tape and tear the backing off one end, anchoring it between the place where the other two pieces were anchored, using no stretch.
7. Using 25% stretch, follow the line of your knee through the center of the "cross", curving along the shape of your knee and up your thigh.
8. Lay down the end with no stretch and rub the tape in to ensure sticking.
While most MCL injuries can be healed through conservative treatment methods, surgery will be required in some cases. If you have a Grade 3 MCL tear (complete rupture), you may need surgery in order to regain proper range of motion. Surgery may also be needed if the ACL or other structures in the knee were damaged along with the MCL.
An MCL Repair procedure is done through a small incision on the inside portion of your knee. While the procedure itself is not done arthroscopically, the surgeon may use an arthroscope (tiny camera on the end of a tube) to get a better look at the damage to your MCL. If your MCL has been detached from your thighbone or shinbone, it will need to be reattached with strong sutures or a metal screw. Tears to the middle portion of the MCL are stitched back together.
Exercises to Strengthen the MCL
Adequate recovery depends partly on the quick diagnosis and aggressive treatment. The MCL itself can't be strengthened, but after the first stage of treatment, which is RCCE (Rest, Cold, Compression, Elevation) exercises to strengthen the other muscles in the knee can help prevent re-injury.
Lunges are the perfect exercise for stretching and strengthening the muscles and ligaments in the knee, including the MCL. By strengthening your knee as a whole, you put less strain and responsibility on your MCL, which is important for avoiding injury. To correctly perform a lunge:
Stand with your feet slightly wider than shoulder-width apart. Keep your back straight, your tummy tucked in and you eyes looking straight ahead.
Take a big step forward with your right foot, bending the knee until your thigh is parallel with the floor. The knee should not extend past the tips of your toes.
Bend the back knee until it is almost (but not quite) touching the floor. Hold this position for 10 seconds, then return to the starting position and repeat with the other leg.
Do Leg Curls
Leg curls are another great exercise for the MCL and strangthening the hamstrings. These exercises are even more effective if you place a resistance band or ankle weight around your ankles as you perform them. Here's the correct way to do them:
Lie face down on an exercise mat, with your legs stretched out behind you. Place an ankle weight or resistance band around your ankle, then slowly lift up your right foot until your heel touches your buttocks.
Slowly lower your right foot back to the floor. Remember to keep your hips pressed into the mat at all times - if you raise them, you risk straining your knee instead of strengthening it.
Repeat the exercise for three sets of 10 to 20 repetitions, then do the same with the opposite leg.
Try Pillow Squats
Pillow squats are exactly what they sound like. Squats with a pillow between your knees, which will helps support the MCL, along with a number of other muscles and ligaments in the inner knee. Strengthening the muscles surrounding the MCL is important, as they provide a support system that makes the knee joint stronger as a whole. Squats target the highest number of muscles and ligaments in a single exercise, so never omit them from your workout. To do a pillow squat:
Stand straight and place a thick pillow between your knees. The thicker the pillow the better - using a thin pillow will significantly increase the difficulty level of the exercise. You could even use a medicine ball if you prefer.
Stand with your feet hip distance apart, keeping your back straight, your tummy tucked in and your eyes looking straight ahead. Bend your knees, pushing your butt backwards as if you were about to sit in an invisible chair.
You don't need to do a full squat, where your thighs are parallel to the floor, you only need to do a half-squat to reap the MCL-strengthening benefits, any anything more is unnecessary.
Slowly return to the starting position, and then repeat the exercise for three sets of 10 reps. Allow one minute of rest time between each set - rest time is necessary for optimum muscle strengthening and growth.
Perform Calf Exercises
When performing leg strengthening exercises, it's important to exercise the entire leg throughout your routine, and not just specific parts otherwise you'll be left with a weak spot. Calf exercises help the MCL while also building the calf muscles, which support the knee and help to relieve pressure on the joints and ligaments. To perform these simple calf exercises:
Stand with your feet one shoulder width apart and make sure that you have something to grab onto for balance, like an exercise bar or the back of a chair.
Simultaneously lift both heels off the ground, rising up onto the balls of your feet, as high as you can go. Then slowly lower your heels, flattening your feet onto the ground.
Repeat this exercise for three sets of 15 to 20 repetitions.
Practice Contracting Your Quads
Contracting the muscles in your quadriceps engages the muscles and ligaments in the knee, helping to support the MCL. Building up the quads themselves is also a good idea, as this will provide more support for the knee joints. To do quad contractions:
Lie down on an exercise mat, facing the ceiling, extending your legs fully. If your knees need some extra support, place a rolled up towel or piece of foam underneath them.
Contract the muscles in your quards and hold for ten seconds before relaxing Do 10 to 20 contractions, relaxing for three seconds between each.
Do Hip Abductions
Hip abductions are another great exercise for strengthening the MCL. Having strong, flexible hips will also help absorb some of the impact while running, which takes pressure off the knees. To perform:
Stand with your feet one shoulder-width apart, holding onto the back of a chair for balance. Place an ankle weight or resistance band around your right ankle.
Slowly lift your right foot off the floor and extend it out to the side, as high as your leg will go. Return to the standing position and repeat for three sets of 10 to 20 repititions, before repeating on the other leg.
Use The Leg Press Machine
Most gyms are equipped with a leg press machine, which is excellent for strengthening the muscles surrounding the knees, and providing support to the MCL. To use the leg press machine:
Sit into the machine, lying back against the seat and placing your feet on the vertical plane in front of you.
Adjust the weight according to your strength level, then use your feet to push the weight away from your body by extending your legs. Don't lock your knees when you extend your legs, try to keep them slightly bent.
Slowly return to the starting position, then repeat the exercise for two or three sets of 10 to 20 repetitions. Rest for a full minute between each set.
Exercise With A Loop Band
Exercising with a loop band is a great way to exercise the MCL, as the band creates pressure against the outside of the knee, which in turn forces the MCL to push the knee outward. This recreates the type of stress the MCL is exposed to during normal physical activity. To use a loop band:
Place the loop band around your ankles and stand with your feet hip-width apart, toes pointing forwards. Keep your back straight and your knees slightly bent.
Take five sideways steps towards the right, using your hips and maintaining your stance as much as possible. Now take five sideways steps towards the left. This is one full set.
Do three sets of this exercise, resting for one full minute in between each set.
If Re-Injury Occurs
After injuring the MCL re-injury is common, as the joint becomes unstable. Symptoms of re-injury might include pain, swelling and stiffness in the knee. Pain can range from mild discomfort to intense pain. Usually rest, rehabilitation and using a brace will help a relapsed MCL injury.
Resting and icing is always very important, especially when there is swelling involved. Elevation to take the pressure off the MCL when sitting or lying down will help with inflammation as well as relieve pain.
Braces are designed to give limited movement in the knee and calf area. Movements that put strain on the MCL are movements such as squatting, kneeling or bending over should be avoided. Any movement that bends the knee past 90 degrees can possibly injure the ligament further.
Physical therapy is a great way to create optimal blood flow to the area promoting healing, as well as strengthening the muscles. Strong muscles around the knee will help prevent re-injury.
A bursa is a closed, fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. The major bursae are located next to the tendons near the large joints such as the shoulders, elbow, hips and knees. When a bursa becomes inflamed, the condition is known as bursitis. Most commonly, bursitis of the knee occurs when the bursa fills with blood from an injury and overuse. Athletes are the main suffers of bursitis, but can also be caused by rheumatoid arthritis. Diagnosis is based on the location of the bursa showing signs of inflammation including knee pain, tenderness, stiffness, and sometimes redness and warmth. Rest, cold compression and anti-inflammatory medications are the main treatment methods, and cortisone is rarely administered. To prevent bursitis, as it is caused by injury or athletic activity, it can be prevented by avoiding re-injury to the bursa and tissues surrounding it.
King Brand Health Care Forum Content for knee injuries
The King Brand forum is a great place to research specific knee ailments and to figure out whether the BFST and ColdCure products can help. Their treatment advisors are constantly posting on forums to help educate people on how to heal their injuries. If you can't find the answer you're looking for, then feel free to take part in their forum by registering.
Just below, is a perfect example of the quality customer service that King Brand provides on a daily basis. This is the perfect online community that will help educate, heal and get you back on your feet in no time.
If you are wondering whether the BFST Wrap will at all interfere with a cochlear implant, we don't have any specific testing related to cochlear implants as they are still fairly rare. But, we would not expect the Energy Web® to interfere with the implant in any way. The BFST® units do not have any magnetic field associated with their operation; the emitted energy is photonic in nature.
If you have any further questions, please don't hesitate to ask.