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 The medial collateral ligament or MCL is one of the four important ligaments in the knee joint responsible for stability and movement. The other ligaments include the anterior and posterior cruciate ligaments and the lateral collateral ligament. Made of tough, fibrous material, the MCL extends from the bottom end of the thigh or femur bone right down to the shin or tibia bone. The MCL lies on the inner portion of the knee joint and prevents the opening up or widening of the joint. The MCL can become sprained or injured when there is any trauma to the outside of the knee joint. This will cause the knee to buckle and the MCL to stretch beyond its capacity and tear.

Symptoms

Common symptoms of an MCL sprain or injury include pain and swelling over the ligament, bruising and a feeling of instability in the knee and a locking or catching of the knee. Depending on the severity of the accident or impact, MCL injuries are classified on a scale of I to III. For example:

• Grade I MCL Injury: This is the lowest grade of injury where the ligament is only minimally torn or injured. A few days of pain or pressure felt on the knee may keep a sportsperson or athlete out of the fray for one or two weeks at the most. Other symptoms include a feeling of tenderness over the area of the ligament but no joint laxity or severe pain.
• Grade II MCL Injury: Incomplete tears of the MCL leading to swelling and pain around the knee joints, cause these types of injuries. Three to four weeks of rest is prescribed as treatment for a Grade II MCL injury. Tenderness of the knee, moderate laxity in the joint and pain during movement are all symptoms of a Grade II injury.
• Grade III MCL Injury: This is a complete tear of the MCL and results in severe pain, bruising and swelling. The knee ‘gives way’ or becomes unstable after such an injury and wearing a knee brace is required during the healing process. This can take up to six weeks or more.
  

Treatment

Treatment of an MCL injury depends on the severity of the symptoms. The first step towards recovery is to rest the knee joint and reduce pain and swelling. Following that, physiotherapy may be required to restore mobility and stability. In very rare cases, surgery may be necessary to repair the torn ligament.

After an injury to the knee and MCL, you should follow R.I.C.E. – Rest, ice, compress, and elevate the knee to speed up the healing process. It is better to consult with a doctor or a sports injury specialist at the earliest to prevent further damage to the knee.

• For Grade I MCL injuries, the recommended treatment includes rest, icing of the area of injury, medications to bring down the swelling and knee exercises to strengthen and repair the joint.
• For Grade II MCL injuries, in addition to rest and medications, your doctor may recommend the use of a hinged knee brace which provides support while the joint heals.
• For Grade III MCL injuries, the knee needs to be immobilized during the early days of treatment. Post healing, a number of strengthening and range-of-motion exercises such as walking and stationery cycling are included. A knee brace may be necessary during the recovery process.
  

Exercises to help rehabilitate the knee include knee flexions and extensions, heel slides, and forward lunges. These help improve stability and the range of movement of the knee. However, if any pain persists, it is important to stop the exercises immediately. Always seek professional help before beginning any new exercise or rehabilitation program.

References:

1. http://www.nlm.nih.gov/medlineplus/ency/article/001076.htm

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