The medial co-lateral ligament or MCL is one of 4 main stabilising ligaments of the knee. It is a thick, strong ligament which runs from the femur to the tibia on the inside of the knee and acts to restrict opening up of the inside of the joint. The MCL is almost always injured as a result of a fall or being struck on the outside of the knee.
What Is It
When the MCL is stretched too far, it results in tearing of anything from just a few fibres to complete rupture of the ligament. MCL injury can be an isolated injury or part of a complex injury to the knee involving cartilage and or other stabilising ligaments such as the ACL.
- Pain over the middle part of the knee, usually in combination with swelling in the painful area.
- Pain with stretching the middle of the knee and often with fully straightening the knee.
- In severe cases, bruising may appear at the site of the injury after a day or so and may track down into the calf.
- A significant tear to the MCL often results in a feeling of instability of the knee and a feeling that the knee may give way.
The initial phase of management of an MCL injury is avoiding aggravating activities. This usually involves rest from weight bearing activity and particularly avoiding positions that stretch the inside of the knee or having it fully straightened. Ice and anti inflammatory medication are generally used to control pain and inflammation. In cases where there is significant damage to the ligament, taping or the use of a brace may be required to take the strain off the injured area. In the event of complete rupture of the ligament, surgery is often needed to repair the ligament.
The next phase of management involves massage and tissue release to the knee by your physiotherapist to break up scar tissue and adhesions and restore normal joint mechanics. At this point, your physio will also start you on a program of strength and control exercises for the knee of increasing intensity as the injury improves.
The final phase involves return to sport and activity. It is important that an adequate level of balance and control has been achieved and that pain at the injury site is monitored.