Medial ligament sprain

Medial Collateral Ligament

The medial collateral ligament (MCL) joins the inner surfaces of the femur (thigh bone) and the tibia (shin bone). Its function is to resist forces applied from the outer surface of the knee and so prevent the medial (inner) portion of the joint from wideing under stress. The medial ligament has two parts to it - a deep, inner section that attaches to the cartilage meniscus and joint margins and a superficial band that attaches from higher up on the femur to an area, lower down, on the inner surface of the tibia.

What is a medial ligament injury?

Injury to the MCL often occurs after an impact to the outside of the knee when the knee is slightly bent. The MCL on the inside of the knee becomes stretched and if the force is great enough its fibres will tear. The deep part of ligament is prone to becoming damaged first and this may lead to medial meniscal damage also. See also Medial Cartilage Meniscus Injury

Medial collateral ligament injuries are graded 1, 2 or 3 depending on the degree of damage sustained:

Grade 1 symptoms:

Mild tenderness on the inside of the knee over the ligament.

Usually no swelling.

When the knee is bent to 30 degrees and force applied to the outside of the knee (stressing the medial ligament) pain is felt but there is no joint laxity (looseness) (video).

Grade 2 symptoms:

Significant tenderness on the inside of the knee on the medial ligament.

Some swelling seen over the ligament.

When the knee is stressed as for grade 1 symptoms, there is pain and laxity in the joint, although there is a definite end point (the knee cannot be bent sideways completely).

Grade 3 symptoms:

This is a complete tear of the ligament.

Pain can vary and is sometimes not as bad as that of a grade 2 sprain.

When stressing the knee there is significant joint laxity.

The athlete may complain of having a very wobbly or unstable knee.

To test for medial ligament damage:

Put the medial ligament under stress by applying gentle pressure to the outside of the knee as shown opposite.

If pain or excessive laxity are apparant it is possible the medial ligament is damaged.

If the injury is recent - go easy - don't push too hard (although older injuries may require more pressure)

What can the athlete do?

Apply R.I.C.E. (Rest, Ice, Compression, Elevation) to the injured knee.

Rest from training.

Wear a hinged knee brace to support the joint, particularly for grade 2 and 3 injuries.

Wear a heat retainer after the acute phase.

Consult a Sports Injury Professional.

A Sports Injury Specialist or Doctor could:

Apply a support bandage or plaster cast.

Aspirate the joint (suck off a the fluid with a needle).

Apply sports massage techniques to accelerate rehabilitation.

Operate.

Prescribe a rehabilitation programme to maintain leg muscle strength and mobility.

Use ultrasound or laser treatment.

Provide a referral for an MRI scan and the possiblity of surgical reconstruction for severe ligament tears.

Damage to the ligamanets of the knee should be taken seriously as they affect the balance and stability of the joint. Without the proper functioning of these ligaments, activities such as running over uneven gound become increasingly difficult with the knee having a tendancy to "give way". However, with proper rehabilitation, full recovery can be expected following most MCL tears.