The medial collateral ligament, or MCL, is a broad band of stabilizing tissue that runs along the inner side of the knee, from just above, to just below. The MCL is generally injured when a force is applied to the outside of the knee, or in an abrupt twisting motion. Most patients will describe a popping sensation, along with pain, when they tear their MCL.
R.I.C.E
Immediately following the injury, and for the next 48 hours, the patient should apply the R.I.C.E method of treatment. This stands for rest, ice, compression and elevation. The patient should rest the knee and may be directed to use a knee immobilizer and crutches for three to seven days. Ice applied for 20 minutes several times per day will help control swelling and pain following an MCL injury. The injured knee should be wrapped with an elastic bandage and elevated above heart level as often as possible to also help prevent swelling.
Exercise
Generally the physician will prescribe a course of physical therapy to begin within one week of the MCL injury. According to the Physio Advisor, physical therapy is vital to hasten recovery and decrease the likelihood of re-injury. During physical therapy, the patient will be instructed in exercises to increase range of motion and strengthen the surrounding knee muscles. These may include wall sits, straight leg raises and balancing activities. As the patient advances, more work or sport-specific exercises will be introduced and a home exercise program initiated. Once the patient has full range of motion and normal strength, he will be allowed to return to work or athletics.
Surgery
According to Cedars-Sinai, MCL tears are rarely treated surgically. The MCL receives a good amount of blood supply which makes it a good candidate to heal with conservative treatments. If conservative measures have failed or the patient has extenuating circumstances, however, surgery may be suggested. MCL repair cannot be done arthroscopically because the ligament is not located on the interior of the knee. A small incision is made along the inside of the knee and the ligament stitched back together or reattached to the bone as the situation warrants. The patient will be placed in a knee immobilizer and prescribed physical therapy for four to eight weeks.
