MCL is the short form of Medial Collateral Ligament which is very much needed for maintaining stability of knee joint. This ligament along with three other ligaments (namely Anterior Cruciate Ligament ACL, Posterior Cruciate Ligament PCL, and Lateral Collateral Ligament LCL) is responsible for effective joint function. A ligament can be defined as group of fiber like substance which controls the excess of motion of joints, thus preventing wear and tear.
MCL ligament is broad and thick band of fibers present throughout the knee joint ranging from end of thigh bone (femur) till top of shin bone (tibia) and is present inside the joint. They are responsible for preventing the widening of joint movement thus preventing opening up of knee joint. Its function is to restrict the movement of the person to over-extend his legs inward and maintaining the stability of the knee joint.
Whenever the knee joint is attacked due to injury or fall, it is the MCL which suffers maximum damage and tear. When external force is applied it moves the knee ligament inside to open widely and in this process, the MCL gets stretched too far thus subjected to injury and tear. Depending on the intensity of injury it can affect other ligaments like ACL and PCL.
There would be considerable pain on the knee and in most of the cases, the knee joint looks swollen. The inflammation is due to the tearing of MCL and the knee joint may have bruises outside. There can be stiffness of joint, sharp pain inside the knee. For severe MCL injury, the knee may get unstable as if it is ready to “give out” opening the inside part. The intensity of pain and other symptoms vary with the extent of injury. Children may feel unstable while walking or hear some “pop” sound inside the ligament indicating tearing of ligament.
Your doctor will examine the portion of affected knee and may order for X-ray or other imaging tests like MRI to detect the intensity of damage. He may also do Valgus test, in which the affected person will lie down on the table and the doctor gently moves his leg outward twisting his knee over 30 degrees. In case if the knee is very flexible, it is indicative of MCL injury inside.
There are 3 different types of MCL tear varying in degrees of damage due to injury.
- In grade I tear, there can be slight tear or stretching of ligament. The ligament may be still intact with the bone leaving only a portion of it to sag outside. In mild forms of tear, the person can recover shortly and 1-2 weeks of rest is needed. No other treatment is needed, except pain killer medicines.
- In grade II tear, the injury can be somewhat severe. There can be intense pain and swelling and it may take around 3-4 weeks for recovery. Treatment is given depending on the extent of damage.
- In grade III tear, the MCL ligament falls out and breaks. The person may not be able to bend his knee or bear weight on it. He may not walk properly and will have a feeling of “give out” knee. It may take more than 6 weeks to recover and the person should wear knee bear or splint and should undergo therapy for long.
The therapy and treatment method depends on the grade of MCL tear. Pain killers like Ibuprofen and aspirin are given for controlling pain and the knee is strengthened using knee braces or splints. Very often braces are enough for treating MCL tear. Surgery may not be required for MCL tear. Complete rest is recommended. Before visiting the doctor, apply ice on the affected knee to reduce inflammation and pain. Wearing a brace will restrict the knee movement on sides thus facilitating healing.
One has to keep the knee in elevated position to reduce inflammation and for reducing blood flow. Sometimes, the child will have to walk on crutches till the ligament is totally cured. It is not good to exert too much pressure on the affected knee since it may cause intense tear inside. Rehabilitation is recommended on some cases if the injury is severe. It helps in restricting the movement of knee and in reducing the pain due to swelling. Often, the children who come with MCL injury will have to visit rehab center for 3 times a week following exercise regimen at home during rest of the days. For severe type of injury and tear, the child will have to be on rehab program for extended time along with therapy and medicines.