MCL Tear

Written by Dr.Mary

What is MCL Tear?

An MCL tear or Medial collateral ligament tear is a physical injury sustained on the knee, dealing critical damage to one of the vital components of the joint in the knee that offers support and stability to the entire limb and body.


The MCL is one of the four main ligaments of the knee, along with the anterior cruciate ligament, the posterior cruciate ligament, and the lateral collateral ligament – each one an important factor to keeping the knee steady and secure as they are all made of a tough material designed to withstand stress and great power. However, despite their natural durability, these ligaments are not immune to injury and possible permanent damage.

Any form of injury to the MCL can be extremely painful and is mostly brought about by sports accidents. The tear is caused by applying a high amount of stress or pressure onto the joint, which may be achieved through landing onto a bent knee with great force. This incident stretches the MCL beyond it capacity and in consequence, tears the ligament apart. The tear impairs the affected leg’s ability to control flexion, maintain stability, as well as rotate, as each one is a role the medial collateral ligament performs – along with the main function of preventing the leg from flexing inwardly for far too much.

Recovery and treatment for MCL tears depends upon the extent of the injury. The MCL tears are classified according to grades that indicate the degree of damage that has been dealt. The grade of injury is determined according to the symptoms experienced.

Symptoms

The symptoms that accompany the MCL tear are crucial to determining the magnitude of the injury along with the appropriate care needed and the potential for recovery. In general, the following are the typical symptoms of an MCL tear:

  • Severe pain, situated directly on the location of the medial collateral ligament
  • Development of a swollen knee, centered over and around the torn medial collateral ligament
  • Appearance of visible bruising on injured area; will usually develop within 2 days after the injury is sustained
  • Patient may state that the knee feels unstable or gives the impression of being on the edge of giving out

To further characterize each grade of an MCL tear, each symptom possesses specific features that distinguish the injury to a particular grade alone, possibly classifying the damage as 1st, 2nd, or 3rd grade. The following is the system utilized for determining the grade given to an MCL tear:

Grade I MCL Tear

  • Minor pain and tenderness
  • Ligament does not feel unstable
  • Pain only experienced upon applying pressure onto the MCL

Grade II MCL Tear

  • Observable looseness of the knee when moved with assistance
  • Instability experienced especially when patient attempts to turn or pivot
  • Greater pain and tenderness
  • Affected knee is swollen

Grade III MCL Tear

  • Extreme pain and swelling
  • Limited ability to bend the knee
  • Knee is found to give out or buckle as stability is severely impaired

Treatment and Surgery

The treatment necessary for an MCL tear will depend on the grade of the injury. Certain methods are maintained constant regardless of the grade however; these include the control of pain as well as the rehabilitation to regain movement and strength. Braces are also often utilized to supplement treatment by stabilizing and immobilizing the knee while it is still in the process of recovery.

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The specific treatment for Grade I tears is not extensive as the injury is minor and does not leave permanent debilitation of mobility. Treatment consists of maintaining rest and avoiding activity for a period of weeks to give the ligament some time to heal. Pain and swelling is helped through applying ice over the site of the tear, as ice or the application of any amount of cold promotes the constriction of blood vessels supplying the injured area – thereby limiting bleeding and pain. Anti-inflammatory medications are also prescribed to address swelling. The doctor will then prescribe some knee exercises to bring back normal tolerance to movement in the affected knee.

For grade II MCL tears, a hinged knee brace is commonly used for treatment, allowing movement but simultaneously providing support at the same time. Treatments for Grade II injuries are grossly similar to that for Grade I MCL tears.

Grade III MCL tears will require more extensive treatment due to the greater severity of the injury. Patients are given braces for the knee and are temporarily required to make use of crutches for movement while the pain in the injury still persists. After the period of immobilization, the patient will return for regular exercises to engage his or her range-of-motion, improving the joint’s return to tolerating movement.

Another method of rehabilitation apart from range-of-motion exercises involves stationary bicycling. The patient can then progress along treatment by attempting walking and jogging, depending on the severity of the pain that accompanies the activities.

Surgery is only a final resort for severe MCL Tears. The procedure is termed as arthroscopic surgery, involving the repair of the torn ligament or even replacement of the MCL if mere suturing or repair does not appear to suffice.

Recovery

Recovery, like treatment for MCL tears, will depend on the extent of the injury as the time it takes for an injury to heal is directly proportional to the immensity of the damage incurred. For MCL tears that are classified to belong to the lowest grade, Grade I, full recovery may take only about 2 to 10 weeks. Recovery periods for Grades II and III of MCL tears are not as easy to calculate because damage sustained is considerably greater in these cases. In most cases, Grade II MCL tears may require at least a month for full recovery to take place, after which normal sports activities may then be resumed. Grade III MCL tears will need a greater amount of time to heal, taking as much as about 6 weeks up to 3 months before the patient may be able to go back to his or her usual routine of sports and other physical activity.

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