An MCL sprain refers to a tear of the knee’s inside ligament, typically resulting from sudden twisting, direct impact, or gradual wear and tear.
Medically reviewed by Dr Chaminda Goonetilleke, 5th Dec. 2021
MCL sprain symptoms
Symptoms of an MCL sprain vary with severity, including:
- Inner knee pain or tenderness.
- Possible swelling.
- Uncomfortable or weak knee sensation.
- For severe sprains, significant pain with rapid swelling.
- Positive result for the valgus stress test.
MCL sprains are graded 1, 2, or 3 based on severity.
Anatomy
The Medial Collateral Ligament (MCL) links the thigh bone (femur) and shin bone (tibia) inside the knee, stabilizing it against lateral movements, especially from external forces.
The MCL comprises:
- A deep section, connected to the knee’s cartilage and capsule.
- A superficial band, originating from the femur’s lower part and attaching to the upper, inner surface of the tibia.
What causes an MCL sprain?
MCL sprains often result from acute knee injuries but can also develop progressively over time.
Sudden onset/acute injuries
Contact Sports: MCL injuries often occur in sports like football, rugby, and martial arts or daily activities that involve a fall or knee twist.
Direct Trauma: A direct blow to the outer knee, especially when bent, can stretch or tear the MCL, potentially damaging the deep part of the ligament and leading to a medial cartilage meniscus injury.
Twisting: Quick turns with a planted foot can twist the knee, causing an MCL sprain and possibly an ACL tear. This action opens the inside of the joint, tearing the medial ligament.
Gradual onset MCL sprains
Repeated sideways forces on the knee, such as frequently kicking a football or martial arts movements, can lead to a progressive MCL sprain. However, consistent inner knee pain might also indicate pes anserine tendinopathy or bursitis.
Treatment for medial ligament sprains
- Cold Therapy & Compression: Immediately apply the PRICE principles (Rest, Ice, Compression, Elevation). Use a cold therapy wrap for 10-15 minutes every hour, reducing frequency as symptoms improve. Never apply ice directly to the skin to prevent ice burns.
- Rest: Refrain from any painful activities to facilitate healing.
- Bracing: In the early stages, use a compression bandage or knee support. Later, for grade 2 and 3 injuries, a hinged knee brace can provide added support and protection.
- Electrotherapy: Therapists may use ultrasound treatments to control swelling and pain.
- Taping: Sports taping can offer support, especially when returning to full training.
- Massage: Avoid early-stage massage. Later, light cross-friction massage can assist in recovery, especially for lingering pain.
- Surgery: While most MCL sprains don’t require surgery, additional joint damage like an ACL tear might necessitate it. The benefit of surgical treatment for even severe injuries remains controversial.
- Recovery Time: Mild MCL injuries may take 3-6 weeks for full recovery. Severe grade 2 or 3 injuries could require 8-12 weeks.
