The Medial Collateral Ligament (MCL) is located on the inner side of your knee. It connects the thighbone to the shinbone and prevents the knee from collapsing inward. MCL injuries are common in contact sports where a blow to the outside of the knee pushes the joint sideways.
MCL injuries generally cause pain localized to the inner side of the knee.
MCL Sprain: This involves stretching or microscopic tearing. You will likely feel tenderness directly over the ligament and experience mild swelling. The knee typically remains stable when walking.
MCL Rupture: A complete tear often causes significant bruising and localized swelling on the inner knee. You may feel a sensation of the knee opening up or wobbling when you attempt to change directions or put weight on the leg.
Most MCL injuries are diagnosed through a physical exam, though imaging helps confirm the grade of the tear.
Physical Exam
Imaging: While X-rays help rule out bone fractures, an MRI is the gold standard for visualizing soft tissue. This allows us to see if the MCL is stretched (sprain) or disconnected (rupture).
The MCL has an excellent blood supply, which means it has a high potential to heal on its own without surgical intervention.
Non-surgical treatment is the standard for the vast majority of patients.
Compression and Bracing: A hinged knee brace is often used to protect the ligament from sideways movement while allowing the knee to bend and straighten.
Progressive Loading: We encourage early weight-bearing as pain allows to promote healthy scar tissue formation.
Platelet rich plasma (PRP) can be a consideration
Even complete ruptures often heal with bracing and physical therapy, but surgery is considered in specific scenarios.
Non-Surgical Management: A period of immobilization in a hinged brace followed by a dedicated strengthening program is usually successful.
Surgical Repair: Surgery is typically reserved for cases where the ligament fails to heal, causes chronic instability, or is torn in combination with other major structures like the ACL.