Introduction:
The medial collateral ligament (MCL) connects the bones in the thigh and lower leg. The medial and lateral collateral ligaments (tissue that connects bone to bone) are present on the sides of the knees. They help to keep the knee in position. A medial collateral ligament sprain is common in sports. These ligaments and surrounding muscles provide stability for knee joints. Any direct contact with the knee or changing direction while running will cause ligament injury. The medial collateral ligaments are injured more often than the lateral collateral ligaments.
What Is a Medial Collateral Ligament Sprain?
The medial collateral ligament is the sprain-stretching or tearing of the ligaments. Ligaments consist of strong connective tissue that connects two bones. During injury, the ligament is stretched and becomes loose, whereas the tear splits the ligament into two. Medial collateral ligament tear will cause instability of the knee joints.
What Are the Types of Sprains?
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Grade 1 Sprain: The ligament is mildly damaged and slightly stretched. The knee joints are stable in this condition.
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Grade 2 Sprain: The ligament is stretched to a maximum and reduced in flexibility resulting in a partial tear of the ligament.
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Grade 3 Sprain: There is a complete tear of the ligament. The knee joint is unstable, and the ligament is half torn or completely pulled out from the bone.
What Are the Causes?
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Contact sports such as football, boxing, ice hockey, basketball, and skiing.
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Changing the direction while running.
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A direct blow to the outside of the knee pushes the knee inwards and results in medial collateral ligament tears.
What Are the Symptoms?
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Causes pain on the inside of the knee. Medial collateral ligament tears will cause more pain than strain.
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Individuals will hear popping sounds during medial collateral ligament tears.
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Swelling in the injured site. A few days after injury, swelling may spread to other areas of the knee joint.
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Stiffness in the knee joint causes strengthening and bending difficulty. Climbing the stairs and sitting on a chair for a longer time becomes challenging.
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The individual feels the looseness of the kneecap.
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In case of severe injury, the supporting structures are injured and cause severe pain.
How to Diagnose?
Physical Examination:
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A thorough medical history will be gathered by the medical professional.
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Next, the physician will do a physical examination by palpating the injured site for any swelling and tenderness and asking to do some movements. This helps to compare with the unaffected knee.
Other investigations:
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X-rays- help to locate the broken bones in and around the knee.
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A magnetic resonance imaging (MRI) scan- is a confirmatory test. Since it pictures the soft tissues, the medial collateral ligament tear is visible through this scan.
What Is the Treatment Plan?
Injuries to the medial collateral ligaments are treated using a hinged brace, and surgery is done for rare cases.
Non-Surgical Treatment:
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Rest: Resting after a medial collateral injury helps to recover faster. Individuals should avoid contact sports and movements that put pressure on the knee joint to prevent further damage.
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Ice: Cold compression onto the injured site reduces swelling and improves the healing process. This should be given for fifteen to twenty minutes at a time between one-hour intervals.
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Bracing: Bracing protects the injured ligament from stress. Along with bracing, the individual should change daily activities to avoid risky movements. Also, the knee must be protected from the same sideway force which causes the injury. In case of severe injuries, using crutches helps to reduce the load on the knee.
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Physiotherapy: Strengthening exercises should be done under the physician's advice to strengthen the knee muscles and restore their function. Doing gentle exercises is recommended.
Surgical Treatment: Most ligament injuries do not require surgery. In some cases, the ligament is torn in such a way that it cannot heal, and in some instances, if it is associated with other ligament injuries, then surgery is done to repair the defect.
What Are the Exercises for Recovery From Medial Collateral Ligament Tears?
Hamstring Curl:
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Should stand up straight by engaging the stomach muscles.
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Next, with the support of one leg in a standing position, one should bend the knee of the other leg such that the heel is towards the buttocks.
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This should be done for thirty seconds and should repeat with another leg.
Wall Slide:
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Stand firmly against the wall with both feet flat on the floor.
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Should slowly slide down against the wall to a squatting position.
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It should be done for thirty seconds and repeated ten to fifteen times.
Chair Squat:
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Should stand on one leg and slowly sit down on the chair in a squat position.
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Return to a standing position- standing on one leg.
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While standing, bend at the waist, and the body should be in a straight line.
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The person should build up to sit fully on the chair.
What Are the Preventive Measures?
The preventive measures include:
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Warming up and keeping the knee muscles stronger helps to prevent injuries.
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Wearing well-fitting shoes.
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Wearing appropriate protective guards such as kneecaps.
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Should not run on uneven surfaces and should not exercise with an existing injury, as both increase the risk of falling or twisting the knee.
When to Return to Sports?
In the case of minor injury, it may take up to two weeks to recover, whereas, in severe injury, it takes up to two months or more for recovery. The doctor suggests functional movements when the individual can walk without a limp or can move the knee without pain. By this time, the athlete can return to sports activity in a gradual manner. The physician will suggest a knee brace depending on the sprain severity to avoid further progression of injury.
Conclusion:
Most medial collateral ligament tears occur during contact sports or doing an activity that involves sudden twisting or changing directions. Avoiding these situations is not possible in sports, but following preventive measures will be helpful to a certain extent. After a medial collateral ligament tear, taking enough time to recover will prevent further injury. For athletes exercising and staying strong throughout the year can prevent injuries.
