Medial Collateral Ligament Tear

Anatomy

The medial collateral ligament (MCL) is a strong ligament in the knee. It is located on the inside (medial side) of the knee and stabilises the knee by resisting forces from the outside of the knee. The MCL is usually injured when a large force is applied to the outside of the knee. This normally occurs in sports tackles like football or rugby. It can also occur after a fall or twisting the knee. More severe grades of injury may be associated with an Anterior Cruciate Ligament rupture (ACL).

Symptoms

An MCL injury normally produces sharp pain on the inside of the knee. It is difficult to walk initially and the knee may swell. Bending the knee is normally difficult due to the pain. When one is assessed clinically there is normally a painful area on the inside of the knee. The knee may also feel unstable initially.

Treatment

The initial management of MCL injuries focuses on pain relief and limiting side to side movement of the knee. In acute injuries the RICE (rest, ice, compression and elevation) approach is recommended.

Hinged knee braces are very useful as they provide the side to side stability whilst still allowing the knee to flex and extend (bend and straighten). As the acute phase settles the next important step in treatment is getting the knee moving freely and building the thigh (quadriceps muscles). This is normally with physiotherapy assistance and in addition using an exercise bike is a very effective.

Normal function usually returns by 3 months. If pain and the feeling of instability persist beyond 3 months consult with your orthopaedic surgeon

Foot & Ankle

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Paediatric Orthopaedics