Your MCL or medial collateral ligament is a band that allows the knee to rotate, prevents it from bending inward, and keeps it stable. This wide ligament connects your femur to the tibia, running down the inner side of the knee. MCL injury can lead to swelling, pain and knee instability.

Symptoms of MCL Injury

MCL injury is marked by symptoms just like those of other problems in the knee. Consult a doctor for proper evaluation and treatment if you experience these MCL injury symptoms:  

• Upon injury, a sound like popping may be heard
• Tenderness and pain are felt in the inner side of your knee
• Knee joint swelling
• A sensation that your knee is unstable while supporting weights
• Locking in the knee joint

Causes of MCL Injury

MCL injuries often occur when the knee sustains a direct hit on the outer side. This causes stretching of the ligaments on the inner side of the knee, which can also tear them. Many athletes suffer from tears of both the MCL and anterior cruciate ligament. MCL injury can also occur through repeated stress, which causes it to lose its elasticity, just like a worn-out or old rubber band.

Diagnosis of MCL Injury

1. Patient History and Physical Examination

After a knee injury, a doctor will ask you how you got injured, your symptoms, and if you have experienced other injuries in the past. He may also ask you about your goals and athletic plans to help determine the best treatment options for you.

The physical examination involves checking the inside of your knee for pain and tenderness. Your doctor may also test the stability of your knee by applying pressure on the outer side of your knee while your leg is bent, and again while it is straight.

2. Grades of MCL Injury

The intensity of pain and degree of looseness in your joint will determine the classification of your MCL injury as follows:

• Grade 1: Your pain is mild, indicating that the ligament may have been stretched but not torn.
• Grade 2: You have pain, swelling and some knee instability, indicating that the ligament is partially torn.
• Grade 3: You have swelling, severe pain and marked knee instability, indicating that the ligament has been completely torn.

Treatment for MCL Injury

There are several treatment options for MCL injury, which may vary according to the extent of ligament damage. In most cases, the injury heals with rest.

1. Immediate Treatment

The treatment for a knee injury should begin as soon as possible to reduce pain, swelling and stabilize the joint. Immediate treatment includes:

• Applying ice on the site to ease swelling
• Keeping the knee elevated to a level above your heart to reduce swelling
• Taking non-steroidal anti-inflammatory drugs (NSAIDs) to reduce swelling and pain
• Applying a brace or elastic bandage to compress the knee, thus stabilizing the joint and reducing swelling
• Resting the joint and supporting it by using crutches, thus keeping weight off your knee

2. Rehabilitation

During recovery from your MCL injury, your aim is to improve the strength of the injured knee and to prevent more injury. Your treatment may include the following options:

• Physical therapy, which helps strengthen leg muscles and improves the range of movement of the joint.
• Limit physical activities that may cause added injury, especially contact sports.
• Wear a knee brace to protect it during activity.

3. Surgery

An MCL injury rarely requires surgery. However, surgery may be needed when the injury involves other structures or the MCL is torn, and self-repair is not possible.

Before surgery, the surgeon may use an arthroscope to examine the severity of your knee injury. Arthroscopy is a procedure that includes inserting a pencil-thin instrument with a camera into a small skin incision into the knee point. However, unlike other knee surgeries, surgery on the MCL cannot be done arthroscopically. The reason is that the ligament is outside the joint.

Following arthroscopic examination, the surgeon will incise the skin and tissues behind the knee and reattach the torn ligament using stitches, staples or metal screws.