Knee pain

MEDIAL COLLATERAL LIGAMENT INJURIES (MCL)

The medial collateral ligament (MCL) is located on the inside of the knee. It spans from just above the knee joint (attaching onto the femur, thigh bone) to just below the knee joint (finishing at the tibia, shin bone). It’s job is to prevent the knee travelling too far inwards, and to prevent it from valgus forces (blow to the outside of the knee which pushes it inwards). The ligament also stabilises the knee in conjunction with the other knee ligaments, and also allows the knee to rotate.

 

WHAT CAUSES MCL INJURIES?

Typically, this injury is classed as an acute condition as it’s sustained during running sports, such as: a collision with another player (blow to outside of knee) or a quick change of direction which causes the knee to collapse inwards (this is knee valgus). 

However, MCL strains & tears can also occur with an accumulated weakness overtime, potentially due to having recurrent stresses travelling through the knee. For example, kick boxers take blows to the outside of the knee which would create a valgus inward force therefore weakening the MCL overtime. This is considered a chronic, or repetitive MCL strain.

 

COMMON SYMPTOMS OF MCL INJURIES

Symptoms can vary, depending on the severity of the MCL strain or tear. Commonly, one would experience:

- A popping sound at the time of the injury IF the MCL is torn.
- Pain & swelling, primarily around the inside and front of the knee
- Knee stiffness & muscular tightness surrounding the knee, again specifically around the inside and front of the knee/thigh. 
- Difficulties bending or straightening the knee.
- Pain with walking up/down stairs
- Medial (inside) knee pain when changing directions whilst walking.  

 

MCL INJURY ADVICE BY YOUR FRIENDLY SYDNEY PHYSIOTHERAPISTS

Just like with most knee conditions, runnings, jumping, walking up/down stairs and turning directions can make the pain worse. Additionally, sitting for too long can cause the build up of swelling & inflammation, so sitting in one position for too long is not advised. Continuing to ‘play through’ the pain is also not advisable, as this could further compromise the knee and put it at a great risk for further damage.

 

WHAT TO EXPECT FOLLOWING AN MCL INJURY

MCL strains are classed into 3 categories:

Grade 1: here, the MCL ligament is strained and overstretched, but not fully torn. Expect a 4~5week healing period.

Grade 2: the ligament is stretched to the point where it does not recoil and is loose, therefore makes the knee unstable. This typically does not require surgery if it is not a complex grade 2 strain/tear of the MCL, but physiotherapy is advised to strengthen the knee. A range of motion knee brace may be required to limit movement & to promote healing (could be worn for up to 2~3 weeks). Expect a 6~8week healing period.

Grade 3: full rupture/tear of the ligament which usually requires surgery

 

TREATMENT AT ONE OF OUR SYDNEY PHYSIOTHERAPY CLINICS

Injuries to the site of the MCL can be conservatively managed, if not fully torn. Seeking the advice and help of a Physiotherapist to ensure your knee recovers to its pre~injury health is recommended.

Here at Infinite Health, our highly trained physiotherapists will be able to give you the recovery, reassurance and the tools to get your knee as healthy as it’s ever been! In your first session, our IH therapists will conduct a subjective interview to understand what led to the injury. From here, an objective assessment will help the therapist to determine what the source of your knee pain is, and the severity of the injury. This will be achieved through passively assessing your knee’s range of motion, in conjunction with functional movement tests to pinpoint the source of your pain.

Once your physiotherapist has determined what structure has been damaged in the knee and the severity of the injury, they will use a range of pain relief modalities such as soft tissue, dry needling, passive muscular & joint stretching to decrease your brain’s perception to the pain.

 
Once this is accomplished, the therapist will take you through a structured rehabilitative program suited to your knee’s function and current condition. From here in subsequent physio sessions, the therapist will progressively add exercises and increase the difficulty/intensity of your rehab as healing takes place. Most importantly, once all pain has ceased, your therapist will prescribe an ‘end phase’ return to sport/activity rehab plan which will be your tools to use to prevent the recurrence of this particular injury again!

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