Medial Collateral Ligament (MCL) Injury

The medial collateral ligament, or MCL, is commonly injured while participating in sports such as football, hockey, and skiing. When the leg is hit from the outside while the knee is bent, the knee tends to twist and buckle causing the MCL to over-stretch or tear. The medial meniscus of the knee may also be torn during an MCL injury because the MCL is connected to the medial meniscus. Clipping during a football or hockey game is an excellent example of how this type of injury may occur.

Knee Ligament Anatomy

The knee has 2 collateral (parallel) ligaments and 2 cruciate (crossing) ligaments. The medial collateral ligament (MCL) and the lateral collateral ligament (LCL) provide support to the knee by limiting the sideways motion of the joint. The anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL) bond the upper and lower parts of the leg together and stabilize the knee by limiting the rotation and the forward and backward movement of the joint.

The medial collateral ligament runs along the inside of the knee and joins the end of the femur (thigh bone) and the top of the tibia (shin bone). It is tightly drawn when the leg is straight thereby preventing the inside widening of the knee joint.

MCL Injury Symptoms

If you have an MCL injury your symptoms will probably include pain and swelling directly over the ligament, with pain increasing when you try standing or moving the knee. Bruising will often appear 1-2 days following when the injury occurs. More serious tears or ruptures of the MCL ligament may also make the knee feel unstable or loose.

Sufferers of an MCL stretch or minor tear will experience mild tenderness with little swelling on the outside of the knee. More severe tears or ruptures result in obvious pain along the outside of the knee.

MCL Injury Causes

An injury to the medial collateral ligament occurs when there is a stretch, partial tear, or complete tear (rupture) to the ligament.

A blow to the outside of the knee during any number of contact sports is usually the cause of this injury. The force to the outside of the knee joint pushes the knee inward resulting in stress being placed on the medial collateral ligament. This overextension causes the stretch or tear.

It is also possible that an injury to the MCL will occur in conjunction with injury to other ligaments in the knee depending on the amount of force the knee experiences. If an MCL tear is accompanied by injury to the medial meniscus and ACL, it is referred to as the "unhappy triad".

Diagnosing MCL Injuries

To diagnose an MCL tear and the extent of damage that has occured, your doctor will perform a variety of assessments:

• Palpation and Observation is often the first step in diagnosing. The joint will be examined for swelling, bruising and deformities. Next the doctor pressing lightly in the ligament area to check for the degree of tenderness, swelling and warmth. Some tenderness usually indicates a mild, or grade 1, sprain and acute pain indicates a more serious injury such as a tear.
• The doctor will also assess the range of motion at the knee. You will be asked to bend and straighten your knee and then the doctor will bend it for you to check for limitations due to pain and swelling.
• The Valgus Stress Test is used if an MCL injury is suspected. During this test, the doctor will stretch the MCL by supporting your leg and, with the knee bent at 30 degrees and the thigh stabilized, will apply outward (abduction) pressure on the lower leg. If you experience pain on the inside of your knee, an MCL injury is diagnosed. The severity of the injury is determined by the knee movement and stability.
• An MRI may also be recommended so the doctor can take a look at the actual ligament for a more accurate diagnosis.

MCL Injury Treatments - What You Can Do!

Like most sprains or tears to a ligament, immediate treatment of the MCL injury includes the application of cold compression, ultrasound therapy, and elevation of the knee. It is also important to allow the injured knee to rest.

Treatment differs from case to case depending on the degree of instability in the knee and the patient's activity level. Treating a medial collateral ligament injury with rest, Cold Compression Therapy, Ultrasound Therapy, and Blood Flow Stimulation Therapy will speed healing and improve the function of the knee once you return to your normal activities. Once the MCL has improved and activities can be resumed, you will first want to build muscle strength in the leg under the guidance of a doctor or physical therapist.

If MCL surgery is required, using these therapies prior to surgery will reduce further damage and improve the health of the MCL and surrounding tissue so the surgery is less invasive.

Using these therapies after surgery will control pain and swelling, reduce tissue damage, speed healing and treat the scar tissue resulting from the surgery. As a result, you will have a healthier knee with a greater range of motion than if your MCL was left to heal on its own.

Cold Compression Therapy

Using Cold Compression immediately following a medial collateral ligament tear reduces pain and swelling and reduces the amount of damage to the tissue that occurs with soft tissue injuries like ligament tears.

The Knee Freezie Wrap™ allows you to treat yourself in an effective and convenient way following an MCL tear and after any further re-injury (which is common due to the instability of the knee).

Cold Compression Therapy works by interrupting and slowing nerve and cell function in the damaged area. This is important because once blood vessels are damaged they can no longer carry oxygenated blood to the damaged tissue and cells begin to break-down. The deep cold provided by the Knee Freezie Wrap™ slows cell function thereby reducing cellular break-down. Furthermore, because the cold wrap serves to numb the nerves, it also reduces pain! The Knee Freezie Wrap™ uses a deep cold gel pack with a medical-grade neoprene compression cover to keep the cold pack off your skin preventing cryoburn and to keep the cold in the area that you need it.

Ultrasound Therapy

Ultrasound waves stimulate tissues increasing tissue elasticity while promoting the flow of blood (filled with vital oxygen and nutrients) to your injured MCL. This cleans the injured area by getting rid of damaged tissue and reducing the inflammation surrounding the MCL and within your knee joint.

During the healing process, scar tissue builds on the ligament making it tough and inflexible, limiting the range of motion in your knee. Fortunately, you can treat your MCL with therapeutic ultrasound to soften scar tissue and improve flexibility and your range of motion.

Not only does ultrasound aid in healing your ligament properly, it helps to prevent long term complications. Pain, scar tissue, lack of mobility and arthritis are some of the more common long term complications from a medial collateral ligament injury. By treating your ligament with ultrasound, less scar tissue is formed reducing the risk of chronic problems in the future.

For those who suffer from long term complications of existing medial collateral ligament injuries, ultrasound can help. Ultrasound therapy can help to break up scar and fibrous tissue in the affected area, even if it has been there for a long period of time.

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.

Phonophoresis can be received using a MendMeShop Ultrasound Therapy System. The treatment is safe, easy, painless, and generally requires between 5 - 10 minutes. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your body and slightly increase the temperature of your soft tissue cells. The waves are delivered through a hand held transducer and conductive gel that are used together in a slow, circular motion on your skin over the injured area.

Once the inflammation and swelling of your MCL tear has been alleviated, nourishing and strengthening the ligament tissue is recommended. Using Blood Flow Stimulation Therapy will speed your recovery and heal your ligament more completely preparing it for leg strengthening exercises. Talk to your doctor or physical therapist to find out which exercises are appropriate for your situation.

Blood Flow Stimulation Therapy™

After the inflammation and swelling is gone you can begin to treat your MCL tear with Blood Flow Stimulation Therapy, or BFST. This therapy increases the amount of blood that flows naturally to your knee to nourish cartilage, tendons, ligaments and muscles to speed healing..

By treating yourself with Blood Flow Stimulation Therapy you can increase your body's blood supply to the knee and the natural healing power. In addition, the fresh blood flow whisks away dead cells and toxins that have built up from the injury leaving the area clean and able to heal faster. Our Knee Inferno Wrap™ provides effective, non-invasive, non-addictive pain relief and healing with no side effects.

During your recovery, you will probably have to modify and/or eliminate any activities that cause pain or discomfort in your knee area until your pain and inflammation settle.

With these 3 easy therapies you will notice incredible improvement in your knee. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!

We recommend that you consult your doctor and/or physiotherapist before using any of our outstanding products, to make sure they're right for you and your condition.

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Prevention

To prevent knee injuries it is recommended that you gradually increase the intensity of any exercise or activity when you begin and to be aware of the movement of the knee during activity.

A knee that is supported by strong leg muscles is less prone to injury. Therefore, regular exercise and maintaining good physical condition, particularly when participating in sports such as football and rugby are also excellent ways to avoid ligament injuries. If your knee is unstable or weak, wearing a brace during exercise and activity can reduce the risk of reinjury of the ligament while your knee is regaining strength.

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