As an athlete or active adult, knee injuries can be common. However, that doesn’t make them any less painful or overwhelming to deal with, especially when the knee injury prevents you from playing the sport you love. At The Ohio State University Wexner Medical Center, our orthopedic knee surgeons and Sports Medicine team will assess the severity of the damage caused by your injury, including a tear in the medial collateral ligament (MCL), and provide an individualized treatment plan to get you back to enjoying life quickly.
What is an MCL tear?
The medial collateral ligament (MCL) is a band of tissue located on the inner part of the knee. When it becomes stretched due to an injury, it can tear partially or completely.
The MCL is a major ligament that holds the bones and joint of the knee in place, along with the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL) and the lateral collateral ligament (LCL).
How common are MCL tears?
An MCL tear is a common knee injury and is involved in roughly 40% of all knee ligament injuries.
What causes an MCL tear?
An MCL tear happens when movement stretches the ligament too far or there’s a powerful, direct impact to the outer side of the knee. Some scenarios that can cause an MCL tear include:
- Sports – Physical activities, such as football, basketball or skiing, require sudden twists and direction changes, and can result in collisions that can damage the MCL.
- Falls – Landing awkwardly or slipping while walking can cause the MCL to stretch and tear.
- Direct hits – A blow or other trauma to the outside of the knee may be responsible for an MCL injury.
Can you still walk with an MCL injury?
Whether you can walk with an MCL injury will depend on the severity of the tear. Typically, we evaluate the severity of an MCL tear using the following grading system:
Grade 1 MCL tear
A grade 1 MCL tear is a mild tear with less than 10% of fibers being torn. The injury will cause some tenderness, but you should still be able to walk.
Grade 2 MCL tear
A grade 2 MCL tear is a moderate or partial tear. You’ll most likely have some pain and tenderness on the inside of the knee. Your knee could feel loose and unstable, making it difficult to walk.
Grade 3 MCL tear
A grade 3 MCL tear is a complete tear of the superficial and deep parts of the ligament, causing extreme instability, pain and tenderness. Most people with a grade 3 MCL tear won’t be able to walk because of the pain and instability.
What does an MCL tear feel like?
Symptoms of an MCL tear can vary from person to person, depending on a variety of factors including the severity of the injury and your overall health. Some of the most common symptoms include:
- Pain or tenderness on the inner side of the knee
- Swelling
- Stiffness
- Instability or a feeling that your knee may give out
How are MCL tears diagnosed?
The knee specialists at the Ohio State Wexner Medical Center are experts at diagnosing whether a knee injury is an MCL tear or another condition. We can also accurately determine whether the injury is solely an MCL tear, or if it includes the tearing of other nearby ligaments.
To diagnose an MCL tear, we may recommend one or more of the following diagnostic tools:
- Physical examination – Usually, our knee specialists can diagnose an MCL tear with a thorough examination of the knee. During the exam, your doctor will apply pressure to assess pain level and how loose the knee feels. We’ll also collect a medical history, including how the injury occurred.
- Imaging tests – We can use several different types of imaging to help us make a definitive MCL tear diagnosis. Imaging can include X-rays, magnetic resonance imaging (MRI) or ultrasounds.
MCL injury treatment
Even though an MCL tear can be a painful and activity-limiting injury, most people are able to recover using conservative, nonsurgical treatments. For some, surgery may be a recommended treatment, depending on the severity and location of the tear, associated knee conditions and goals for returning to sports.
Nonsurgical MCL treatment
Since the MCL receives a good blood supply and is located outside the knee joint, it’s often able to heal with nonsurgical treatment. Typically, you can follow the RICE method (rest, ice, compression, elevation), to treat an MCL tear. Depending on how unstable or loose the knee feels on examination, a brace may be necessary during healing.
Other nonsurgical treatment methods include:
- Anti-inflammatory medications
- Activity limitations and modifications
- Physical therapy
- Wearing a brace or other device
Surgical MCL treatment
While most MCL injuries heal well without surgery, your doctor may recommend surgery if you have torn other knee ligaments as well or if the tear is on the shinbone side of the MCL.
If your MCL tear is severe enough to require surgery, you’ll want a surgeon who specializes in knee surgery and sports medicine, like the experts available at the Ohio State Wexner Medical Center.
Surgery for an MCL tear typically involves:
- Using general anesthetics to put you to sleep during the surgery
- Making small incisions on the inner side of the knee to access the ligament
- Reattaching the torn ligament or reconstructing the MCL using a tissue graft from another part of your body, such as the hamstring tendon, or a donor tendon.
- Closing the incision site
How long does it take to recover from an MCL tear?
Recovery time for an MCL injury will vary based on severity. A grade 1 MCL sprain should heal in a week or two with proper rest. A grade 2 MCL tear could take between four and six weeks, and a grade 3 MCL tear could take as long as two months. If surgery is required, recovery could be even longer.
It’s important to listen to your health care providers about rest and when it’s appropriate to return to normal activity. Pushing yourself to resuming activities too early can result in further damage or injury.
How do you prevent an MCL injury?
While MCL injuries aren’t always preventable, there are steps you can take to strengthen your knee to make an MCL tear less likely. Ways to prevent an MCL injury include:
- Doing exercises to strengthen your knee
- Using proper techniques for your sport
- Stretching regularly, especially before activity
- Wearing a brace if you have a history of knee or leg injuries
- Returning to physical activity and sport only when cleared by a physician
You can also work with the knee specialists in the Lower-Extremity Injury Prevention Program in Ohio State Sports Medicine. Our licensed sports physical therapists, athletic trainers and certified strength and conditioning specialists collaborate to target and address each athlete’s deficiencies. They’ve developed this unique program that can reduce your risk of a lower-extremity injury by up to 70%.