Acute MCL sprains are graded by severity, but very few require orthopedic surgery. Most respond well to RICE.
On both sides of the knees, both medially and laterally, collateral ligaments help stabilize the knee. The medial collateral ligament, or MCL, is located on the inside of the knee and the lateral collateral ligament, or LCL, is located on the outside of the knee. Force applied to the either side of the knee can result in injury to the collateral ligaments.
Medial Collateral Ligament Sprain – Signs & Symptoms
Injury to the MCL results in immediate knee pain and typically follows a blow to the outside of the knee that forces the knee inwards. A severe twisting injury that applies the same force may also result in MCL injury. The symptoms that follow will depend on the severity of the sprain/tear.
First-degree sprains will exhibit pain and tenderness, and perhaps slight swelling, but the knee will generally retain full motion and stability. With second-degree sprains, range of motion may be limited and the pain to the inside of the joint more severe. Weakness and swelling of the joint will usually be present.
If the MCL has ruptured, as in a third-degree sprain, a defect in the ligament may be felt on the inside of the knee. Pain may dissipate quickly with a complete rupture, but the knee may swell up with blood if deep fibers are torn. Overall, pain and stiffness at the inside of the knee that follows a blow to the outside of the knee or twisting injury indicates an MCL sprain. Evaluation by an orthopedic doctor can determine the extent of any knee injury.
Orthopedic Clinic Treatment and Orthopedic Surgery for MCL Sprains
Without proper treatment, MCL injuries may result in continued instability of the knee joint. Evaluation by an orthopedic doctor will determine if the injury is severe enough to warrant knee surgery. For the first 48-72 hours, treatment will likely include rest, ice, compression, and elevation (RICE). This is recommended to reduce pain and inflammation before proceeding with other interventions.
Conservative treatment of MCL sprains typically involves the use of crutches until knee pain abates and the patient walks without a limp. A knee brace may be prescribed to limit motion of the knee until stability is regained. Once the initial pain has passed, strengthening the muscles that surround the knee will be critical to recovery and preventing future injury. Unless combined with an ACL tear or a meniscal injury, MCL sprains rarely require orthopedic surgery.
Acute knee injuries are common and are more likely to occur when leg muscles are weak. Once injured, it is important to rehabilitate fully before placing stresses back on the knee. A quadriceps/hamstrings strengthening program is typically recommended.
Sources:
Crozer-Keystone Health System. Ligament Injuries to the Knee.
Gulick, Dawn. Ortho Notes: Clinical Examination Pocket Guide. Philadelphia.
Micheli M.D., Lyle J. and Jenkins, Mark. The Sports Medicine Bible for Young Athletes. U.S.