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Knee Medial Collateral Ligament (MCL) Injury Physiotherapy

Our medial collateral ligament (MCL) is the most commonly damaged ligament in the knee that leads to knee pain.

The MCL can be sprained or torn as a result of

• a blow to the outer side of the knee
• by twisting the knee or
  
• by quickly changing directions while walking or running

MCL injury most often occurs in athletes, although of course nonathletes can also be affected.

Our senior physiotherapists treats an MCL sprain or tear to

• reduce pain
• reduce swelling
• reduce joint stiffness
• reduce any associated weakness in the knee or lower extremity

What is the Medial Collateral Ligament (MCL) Injury?

The MCL is a small, thick band of tissue on the inner side of the knee joint. It connects two bones—the thighbone and the shin bone—and prevents the knee from bending inward toward the other knee.

When the knee is hit on the outer side of the leg (eg, the left side of the left leg), or if the knee is twisted violently, the MCL can overstretch resulting in a partial or complete tear.

MCL injuries commonly occur in football players who get "clipped" or hit on the outer side of the knee.

Other causes may include

• twisting and turning while skiing
• blows received on the soccer field
• trauma experienced in a car accident or
  
• simply turning the knee sharply while the foot is planted on the ground

Healing times vary from a couple of weeks to a couple of months, depending on the severity of the injury.

How Does it Feel?

When you experience an MCL injury, you may feel:

• Pain on the inner side of the knee
• Swelling and bruising at the inner side of the knee
• Swelling that spreads to the rest of the knee joint in 1 or 2 days following injury
• Stiffness in the knee
• Difficulty or pain when trying to bend or straighten the knee
• An unstable feeling, as though the knee may give out or buckle
• Pain or difficulty walking, sitting down, rising from a chair, or climbing stairs

Signs and Symptoms

With an MCL injury, you may experience

• A "popping" sound as the injury occurs
• Pain and swelling in your knee
• Difficulty moving your knee
• Difficulty bearing weight on your leg for walking or getting up from a chair

How Is It Diagnosed?

If you see our senior physical therapist first, we will conduct a thorough evaluation that includes taking your health history. We will also ask you detailed questions about your injury, such as:

• Did you feel pain or hear a "pop" when you injured your leg?
• Did you turn your leg with your foot planted on the ground?
• Did you change direction quickly while running?
• Did you receive a direct hit to the leg while your foot was planted on the ground?
• Did you see swelling around the knee in the first 2 to 3 hours following the injury?
• Does your knee feel like buckling or giving way when you try to use it?

We also will perform special tests to help determine the likelihood that you have an MCL injury. We will gently press on the outside of your knee while it is slightly bent as well as when it is fully straight to test the strength of the ligament.

We will also check the inner side of your knee for tenderness and swelling and measure for swelling with a tape measure. The therapist may use additional tests to determine if other parts of your knee are injured, and will also observe how you are walking.

To provide a definitive diagnosis, we may collaborate with an orthopedic doctor or other health care provider. The orthopedic physician may order further tests, such as magnetic resonance imaging (MRI), to confirm the diagnosis and to rule out other damage to the knee.

The MRI scanning will also help to determine whether surgery is required.

MRI is not required in all cases but may be ordered to determine the severity of the medial collateral ligament injury or if there is any other secondary/additional structures that are damaged.

We or your doctor may recommend 

• a knee brace
• a knee immobilizer or
  
• crutches

to reduce pain if the MCL injury is severe.

how our senior physiotherapists can help

We will work with you to design a specific treatment program that will speed your recovery, including exercises and treatments you can do at home. Physiotherapy will help you return to your normal lifestyle and activities.

The First 24-48 Hours

Our senior physiotherapists may advise you to:

• Rest the area by avoiding walking or any activity that causes pain. Crutches and a knee brace may be recommended to reduce further strain on the MCL when walking.
• Apply cold therapy to the area for 15-20 minutes every 2 hours.
• Compress the area with an elastic bandage wrap.
• Consult with a physician for further services such as medication or diagnostic tests.
  

Reduce Pain

We may use different types of treatments and technologies to control and reduce your pain, including

• cold therapy
• heat therapy
• ultrasound therapy
• radio-frequency Indiba physiotherapy
• manual therapy
  
• deep tissue release
• stretching exercises
• taping
• joint mobilization
  

Improve Motion

We will choose specific activities and treatments to help restore normal movement in the knee and leg. These might begin with passive motions that we will do for you to gently move your leg and knee joint, and progress to active exercises and stretches that you do yourself.

Improve Strength

Certain exercises will aid healing at each stage of recovery; your physical therapist will choose and teach you the correct exercises and equipment to steadily restore your strength and agility.

These may include using

• cuff weights
• stretchy bands
• weight-lifting equipment
• and cardio-exercise equipment such as treadmills or stationary bicycles

Improve Balance

Regaining your sense of balance is important after an injury. We will teach you exercises to improve your balance skills.

Speed Recovery Time

Normal healing of time is a few weeks to a few months, depending on which tissues are injured and how severely they are injured. We're trained and experienced in choosing the right treatments and exercises to help you heal, return to your normal lifestyle, and reach your goals faster than you are likely to do on your own.

Return to Activities

We will discuss your goals with you and use them to set your work, sport, and homelife recovery goals. We will design your treatment program to help you reach those goals in the safest, fastest, and most effective way possible.

We will apply hands-on therapy, such as massage, and teach you exercises, work retraining activities, and sport-specific techniques and drills to help you achieve your goals

If Surgery Is Necessary

Surgery is often not necessary in the case of an knee medial collateral ligament injuries but if a knee surgery is needed, you will follow a recovery program over several weeks guided by our senior physical therapist, who will help you

• minimize pain
• regain motion
• regain strength and
  
• return to normal activities as quickly as possible after surgery