What is a Medial Collateral Ligament (MCL) tear?
MCL tear causes and treatments
The Medial Collateral Ligament (MCL) is one of the four major ligaments that contribute to the stabilisation of the knee joint. The MCL is located on the inside of the knee joint, connecting the shin bone to the thigh bone. Its role is to stop the knee joint from buckling inwards.
Approximately 40 per cent of all knee injuries involve an MCL tear. MCL tears are prevalent at all ages and are common in sports which involve jumping and landing, as well as change-of-direction sports such as basketball, football, rugby and tennis.
What is an MCL tear?
An MCL injury can either be classified as contact or non-contact, depending on the circumstances under which the ligament is injured. Contact MCL injuries commonly occur as a result of an external force applied to the outer knee, thus buckling the knee inwards and placing excessive force on the MCL. Non-contact MCL injuries occur when the knee twists inwards with rapid force or due to a change of direction.
When one of these two main types of injury occurs and the MCL is placed under excessive strain, the result is commonly an MCL sprain, tear or rupture. The severity of an MCL injury is graded on a scale of one to three.
A Grade 1 MCL tear is classified as a tear of less than 10 per cent of the ligament’s fibres. The knee will still feel stable, but mild pain and swelling is usually present.
A Grade 2 MCL tear is classified as moderate. The knee will feel slightly unstable, and pain and swelling will be prevalent on the inside of the knee.
A Grade 3 MCL tear is classified as a complete tear or rupture of the MCL. The knee will feel very unstable and symptoms of severe pain and swelling on the inside of the knee joint may be present. A Grade 3 tear of the MCL is commonly an additional injury to an Anterior Cruciate Ligament (ACL) tear or a meniscus tear.
What does an MCL tear feel like?
The symptoms of an MCL tear are dependent on the graded severity of the injury. They usually include pain and swelling on the inside of the knee, knee instability, a pop or clicking noise when the injury occurs, knee locking or catching, and pain when standing on the affected limb.
How to test for an MCL tear
An MCL tear is usually diagnosed by a Physiotherapist or Orthopaedic Specialist. The MCL assessment involves pushing the knee joint inwards while stabilising the lower leg. A positive test is indicated if pain is present and if the MCL does not appear to pull the knee back to its original position. If this assessment is deemed positive, a Magnetic Resonance Imaging (MRI) referral is prescribed to examine the severity of the tear. If the assessment is deemed negative, further investigation may be required.
How to treat an MCL tear
Treating an MCL tear is also dependent on its severity. The initial treatment of an MCL tear involves Resting, Icing, Compressing and Elevating (RICE), as well as bracing or taping to stabilise the knee and taking anti-inflammatory medication. Consult a Physiotherapist to improve the knee’s range of motion and reduce pain and inflammation.
How to strengthen the MCL after a tear
Once pain and swelling has reduced, it is best to consult an Exercise Physiologist (EP). An EP will assess the injury and prescribe an individualised exercise rehabilitation program to re-stabilise the knee joint and improve strength in the muscles surrounding the knee. An EP will also provide an eventual return to sport and work rehabilitation plan.
How long does an MCL tear take to heal?
The MCL will usually heal well due to its relatively superior blood flow capacity. Healing time is dependent on the severity of the tear and if the tear is secondary to an ACL or meniscus injury. A Grade 1 tear will take between one and three weeks to heal, Grade 2 between four and six weeks, and Grade 3 between six and eight weeks. A Grade 3 MCL tear in conjunction with an ACL tear will generally take more than six weeks to heal. In some instances, surgery may be required to repair the MCL.
How can VALD help MCL tear recovery?
VALD’s suite of human measurement technologies includes a range of systems which can assist in diagnosing and rehabilitating MCL tears.
The ForceDecks Dual Force Plate System allows practitioners to gather real-time feedback on relevant metrics, such as single leg and double leg jump height, squat mechanics, and balance and stability assessments.
The NordBord Hamstring Testing System can be used to measure hamstring strength and imbalance in various positions, providing an understanding as to how the muscles surrounding the MCL injury are progressing.
The ForceFrame Strength Testing System is a fully adjustable system which is used to test isometric strength in upper and lower body positions, including the knee and hip muscles, and joints which are vital to an MCL tear recovery.
VALD also recently launched a handheld dynamometer and inclinometer named DynaMo capable of performing more than 300 strength and range of motion tests. These tests can be utilised to assess hamstring and quadriceps strength, both of which are important metrics to monitor throughout the rehabilitation process.
To learn more about DynaMo and how dynamometers can be used in the treatment of conditions like an MCL tear, visit: valdhealth.com/dynamo.
This article was written by Eddie Hess, an Accredited Exercise Physiologist with a Master’s in Clinical Exercise Physiology and a Bachelor in Exercise and Sports Science. Eddie specialises in musculoskeletal rehabilitation of post-surgical clients and has broad clinical experience.