MCL Tear Information
Medial Collateral Ligament (MCL) Injuries
What is an MCL Injury?
An MCL injury is a sprain or tear to the medial collateral ligament. The MCL is a band of tissue on the inside of your knee. It connects the thigh bone of your lower leg. The MCL keeps the knee from bending inward.
You can hurt your MCL during activities that involve bending, twisting, or a quick change of direction. For example, the MCL can be injured in football or soccer when the outside of the knee is hit. This type of injury can also occur during skiing and in other sports with lots of stop and go movments, jumping or weaving.
If a tear in the MCL does not heal sufficiently, you may experience instability in the joint, and you will be more susceptible to re-injury. The MCL usually responds very well to non-surgical treatment, although surgery may be required in rare cases. Depending on the severity of the injury, a period of rest, bracing and physical therapy usually is sufficient to heal the tear.
MCL tear symptoms
You may have swelling, pain and tenderness several hours after you've injured your knee. The pain may increase, and it might become harder to move your knee. You may also notice some bruising, as well as the possibility of the knee feeling unstable. The knee may lock when trying to move it.
The pain can range from mild to severe depending on how severe the injury is. The injury can be classified in three different ways:
1) Complete Rupture: A complete tear.
2) Partial Tear: Tearing of some of the ligaments, blood flow is still present
3) Mild Sprain: Inflammation of the ligament with no tearing
What is the treatment?
Most MCL injuries can be treated at home with rest, ice and anti-inflammatory medicine. Your doctor may suggest that you use crutches or wear a brace that stabilizes while allowing for some movement of the knee.
Reducing activities for a few weeks to help with recovery and help reduce inflammation is highly recommended. Depending on the severity of the tear, increasing blood flow to the affected area will help with the healing process. Physical therapists work on increasing blood flow with exercises, but there are also devices that do this naturally without having to move the muscles, reducing the risk of re-injuring the muscles or tendons.
Time Frame for Recovery
There are three different grades of tears; they are listed below as follows:
Mild or Grade 1 - may take from a few days to a week and a half to heal sufficiently enough for you to return to normal activities, including sports.
Moderate or Grade 2 - can take from two to four weeks to heal.
Severe or Grade 3 - usually takes from four to eight weeks to heal, unless it is associated with damage to the ACL, in which case the recovery time may be longer.
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.
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 or not it is in the knee or elsewhere.
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.
Especially for the knee, it is important to keep the muscles surrounding the affected area strong, 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. Optimal blood flow devices that can target below the surface of the skin and directed to the affected muscle keeps the blood pumping, but lessening the need to exercise the muscle as much.
To keep the knee from moving, your doctor may recommend a lightweight cast or brace that allows your knee to move backward and forward but limits side-to-side motion. This usually is recommended for 72 hours. Depending on how well your pain and swelling decrease, you may be able to start a rehabilitative program in a few days.
Once the pain and swelling subside you will begin rehabilitation, which will include exercises to restore the strength and normal range of motion to your knee. If your knee feels sore while you are doing these exercises, you should proceed slowly to prevent further irritation and possible re-injury and swelling.
A torn medial collateral ligament is rarely treated with surgery. When surgery is done, it is usually done through a small incision on the inside of your knee. It is not done arthroscopically, since the ligament is not inside the knee joint. If the medial collateral ligament has been torn where it attaches to the thighbone or shinbone, the surgeon will re-attach the ligament to the bone using large stitches, or a metal screw or bone staple. If the tear was in the middle of the ligament, the surgeon will sew the torn ends together.
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.
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:
- Life 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
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