MCL Injury and Medial Collateral Ligament Sprain
Prevent MCL injury and recover quickly from a MCL tear or sprain with these prevention and treatment tips.
by Brad Walker | Updated October 11, 2023
The knee joint is susceptible to a range of injuries, including sprains, strains and dislocations. So, what is a MCL Injury?
An MCL injury (also referred to as an MCL sprain or tear), is a common injury that affects the Medial Collateral Ligament (MCL) located on the inside of the knee joint.
An injury occurs when the Medial Collateral Ligament is stretched or torn. Tears of the medial collateral ligament (MCL) are the most common knee ligament injury.
How is the MCL Injured?
As with any sprain, a MCL injury is the result of excessive stretching or tearing of the medial collateral ligament. The severity of the injury can range from a slight stretching to a complete rupture or tear.
By far the most common cause of a medial collateral ligament injury is a blow or sudden impact to the outside (lateral) of the knee joint. This causes the outside of the knee to collapse inward toward the mid-line of the body and the inside of the knee (where the medial collateral ligament is located) to widen and open up. This opening up stretches the ligament, which results in the injury.
Athlete’s involved in contact sports are most susceptible to MCL injury. Sports that involve the highest risk are football, gridiron, soccer, and skiing.
Anatomy of the Knee
The medial collateral ligament (sometimes called the tibial collateral ligament) is a flat ligament on the inside (medial) of the knee that connects the tibia (lower leg bone) to the femur (thigh bone). The medial collateral ligament is very important in providing stability to the knee joint.
The picture is a front-on view of the bones and ligaments that make up the right knee. On the right hand side of each picture is a ligament called the “Medial Collateral Ligament.” It is this ligament, most commonly referred to as the MCL, which is damaged in a MCL injury.
What are the Signs & Symptoms of a MCL Injury?
The severity of the symptoms tends to correlate with the severity of the injury. In other words, the worse the injury, the worse the symptoms. The most common symptom of a MCL injury is pain around the inside of the knee joint. Also common is bruising, swelling and tenderness. Sometimes a popping sound can be heard at the moment of injury.
Immediate Treatment for MCL Injury
A minor MCL injury is just like any other soft tissue injury and should be treated accordingly. This involves the application of R.I.C.E.R. (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment. The following two points are of most importance.
- Rest & Immobilization: Once a MCL injury is diagnosed it is important that the affected area be rested immediately. Any further movement or stress will only aggravate the condition and prolong recovery. It is also important to keep the injured area as still as possible.
- Ice: By far the most important part. The application of ice will have the greatest effect on reducing bleeding, swelling and pain. Apply ice as soon as possible after the injury has occurred or been diagnosed.
The most common recommendation is to apply ice for 20 minutes every 2 hours for the first 48 to 72 hours. These figures are a good starting point, but remember they are only a guide. My personal recommendation is that people should apply ice for as long as it is comfortable. Obviously, there will be a slight discomfort from the cold, but as soon as pain or excessive discomfort is experienced, it is time to remove the ice. It is much better to apply ice for 3 to 5 minutes a couple of time an hour, than not at all.
During the first 24 to 72 hours be sure to avoid any form of heat at the injury site. This includes heat lamps, heat creams, spas, Jacuzzi’s and saunas. Avoid all movement and massage of the injured area. Also, avoid excessive alcohol. All these things will increase the bleeding, swelling and pain of your injury.
- The next phase of treatment (after the first 48 to 72 hours) involves a few physiotherapy techniques. The most common methods used to do this include ultrasound, heat and massage.
- Next, start to incorporate very gentle range of motion exercises for the muscle groups around the knee. The buttocks, hamstrings, quadriceps and groin are a good place to start.
- Once most of the pain has reduced, it is time to move onto the rehabilitation phase of your treatment. The main aim of this phase is to regain the strength, power, endurance and flexibility of the muscles and tendons around the knee.
MCL Injury Prevention
Although it is important to be able to treat MCL injury, prevention should be your first priority. So what are some of the things you can do to help prevent medial collateral ligament sprain?
- Warm-up properly: A good warm-up is essential in getting the body ready for any activity. A well-structured warm-up will prepare your heart, lungs, muscles, joints and your mind for strenuous activity.
- Avoid activities that cause pain: This is self-explanatory, but try to be aware of activities that cause pain or discomfort, and either avoid them or modify them.
- Rest and Recovery: Rest is very important in helping the soft tissues of the body recover from strenuous activity. Be sure to allow adequate recovery time between workouts or training sessions.
- Balancing Exercises: Any activity that challenges your ability to balance, and keep your balance, will help what is called, proprioception: – your body’s ability to know where its limbs are at any given time.
- Footwear: Be aware of the importance of good footwear. A good pair of shoes will help to keep your knees stable, provide adequate cushioning, and support your knees and lower leg during the running or walking motion.
- Strapping: Strapping or taping can provide an added level of support and stability to weak or injured knees.
- Stretch and Strengthen: To prevent MCL injury, it is important that the muscles around the knee be in top condition. Be sure to work on the strength and flexibility of all the muscle groups in the leg.
Research and References
- Andrews, K. Lu, A. Mckean, L. Ebraheima, N. (2017). Review: Medial collateral ligament injuries. Journal of Orthopaedics, 14(4): 550–554.
- Bahr, R. Maehlum, S. (2004) Clinical Guide to Sports Injuries, 1st Edition (ISBN: 978-0736041171)
- Chen, L. Kim, P. Ahmad, C. Levine, W. (2008). Medial collateral ligament injuries of the knee: current treatment concepts. Current Reviews in Musculoskeletal Medicine, 1(2): 108–113.
- Encinas-Ullán, C. Rodríguez-Merchán, C. (2018). Isolated medial collateral ligament tears – An update on management. EFORT Open Reviews, 3(7): 398–407.
- Martini, F. Tallitsch, R. Nath, J. (2009) Human Anatomy, 9th Edition (ISBN: 978-013432076X)
- Phisitkul, P. James, S. Wolf, B. Amendola, A. (2006). MCL Injuries of the Knee: Current Concepts Review. The Iowa Orthopaedic Journal, 26: 77–90.
- Physiopedia contributors. (February 13, 2020). Medial Collateral Ligament Injury of the Knee. Retrieved March 27, 2020, from https://www.physio-pedia.com/index.php?title=Medial_Collateral_Ligament_Injury_of_the_Knee&oldid=230688.
- Walker, B. (2018). The Anatomy of Sports Injuries, 2nd Edition (ISBN: 978-1623172831)
- Wikipedia contributors. (2020, March 1). Medial collateral ligament, In Wikipedia, The Free Encyclopedia.
About the Author: Brad Walker is often referred to as the "Stretch Coach" and has even been called the Stretching Guru. Magazines such as Runners World, Bicycling, Triathlete, Swimming & Fitness, and Triathlon Sports have all featured his work. Amazon (author page) has listed his books on five Best-Seller lists. Google cites over 100,000 references to him and his work on the internet. And satisfied customers from 122 countries have sent 1,000's of verified customer reviews. If you want to know about stretching, flexibility or sports injury management, Brad Walker is the go-to-guy.
Disclaimer: The health and fitness information presented on this website is intended as an educational resource and is not intended as a substitute for proper medical advice. Please consult your physician or physical therapist before performing any of the exercises described on this website, particularly if you are pregnant, elderly or have any chronic or recurring muscle or joint pain.
