Your knee moves freely backwards and forwards; however, the thought of it moving from side to side probably makes you cringe. This is because the knee joint has sturdy ligaments either side of it that prevent sideways movement and we instinctively know that a lot of force would be required to shift it in this direction.
The ligaments on either side of the knee are called the Collateral Ligaments and they each work to provide stability and restrict the knee’s movement into a sideways direction. The Medial Collateral Ligament (MCL) is found on the inside of the knee and acts to prevent the knee bending sideways away from the body.
The typical mechanism for an MCL tear is a force that drives the lower leg sideways away from the upper leg. This can occur from an awkward landing from a height, or when twisting with a foot fixed on the ground or from an external force hitting the outside of the knee, such as with a rugby tackle.
MCL tears distinctively create pain and swelling quite specifically on the inside of the knee. The severity of the pain and swelling will be related to the number of ligament fibres damaged. Larger tears may also make the knee feel unstable or loose.
A grading system is used to classify the severity of the injury and help to guide treatment. Grade 1 indicates that a few ligament fibres have been torn and grade 3 is used for a complete tear of the ligament with associated joint laxity. Very severe MCL tears often also involve injury to the medial meniscus and ACL and can require surgical repair. However, most MCL tears can be managed well with physiotherapy. Grade 1 and 2 MCL tears take between 2-8 weeks to fully heal and a complete rehabilitation program is strongly recommended to prevent future injury.
In the early stages of MCL tears, treatment is focused on pain and swelling management, while allowing the body to start the healing process through inflammation. This is best managed thought the P.O.L.I.C.E. principles (Protect, Optimal Loading, Ice, Compression and Elevation).
Following any injury, it is natural for muscles to waste a little and the damaged tissues to lose what we call proprioception, the ability to sense their position in space. This loss of muscle strength and proprioception can contribute to further injury if not restored with a proper rehabilitation program.
Physiotherapy also aims to restore movement to the joint and support the ligament while healing to ensure that it is strong and healthy, and the scar tissue forms in an organized fashion, which makes the new ligament as strong as it can be and protects against future tears.
Don’t let that MCL tear keep you away from your sport for longer than you need to be. Book your appointment today to allow our highly trained physiotherapists to look after you and get you back out on the sports field.