What is the Medial Collateral Ligament?
What is the Medial Collateral Ligament?
There are four major ligaments in the knee which provide strength and stability. They are called the medial collateral ligament, the lateral collateral ligament, the anterior cruciate ligament, and the posterior cruciate ligament. The medial collateral ligament (MCL) is connected to the femur (thigh bone) and the tibia (shin bone) on the inside surface of each knee. The MCL keeps our knee stable when we get hit from the outside or have our foot pushed to the outside.
How do Medial Collateral Ligament Injuries Happen?
One of the ways a MCL injury occurs is by an external force to the side of the knee that pushes the legs together while the foot remains planted to the ground. This is frequently seen when a player is tackled in football or other contact sports. Medial Collateral Ligament injuries are one of the most common alpine ski injuries as well. Often beginner skiers are affected most as the “snowplow” technique places significant stress on the MCL. Many other sports also lead to frequent MCL injuries when the athlete lands awkwardly and the foot is pushed outwards relative to the knee. Even a slip and fall can lead to an MCL injury.
Symptoms and Initial Management of MCL Injuries
MCL injuries cause sudden and severe pain to the inside of the knee. With most MCL injuries, the swelling is limited to the inside surface of the knee. However, a severe MCL injury can lead to swelling of the entire knee if the joint capsule is disrupted. A knee with an MCL injury will often feel stiff and unstable. Ice, elevation, and compression may help to relieve swelling and discomfort. Resting the knee and using crutches is advised until it can be fully examined. A physician will look for other injuries and ensure proper treatment of the injured knee. Sometimes, a meniscal tear, fractured bone, or another ligament injury can mimic an MCL injury. Occasionally, there may be multiple injuries to the same knee. Your physician may order an X-ray and/or MRI to evaluate for other injuries.
MCL injuries can present with varying degrees of severity. Physicians often describe these injuries based on a “grade” scale from 1 to 3. Grade 1 injuries are mild sprains, while Grade 3 injuries are full tears. Grade 2 injuries fall somewhere in-between. A mild sprain can be painful with no significant instability. However, a full tear of the ligament may result in a great deal of instability with even minor activity.
The large majority of MCL injuries can be treated without surgery. A combination of medications, rehabilitation, and bracing is sufficient for most injuries. On the other hand, some MCL injuries benefit from surgical repair due to the amount of instability and location of the tear. Timing can be critical and the knee should be evaluated by a physician soon after the injury. Even MCL injuries in combination with other joint injuries, such as meniscal tears or ACL tear,s can often be treated non-surgically. However, the additional injuries may require operative intervention even if the MCL does not.