Assessment of a medial ligament sprain should include questions and background of the injury as well as a series of physical tests.
The therapist will observe the joint for swelling, bruising and deformity and then proceed to palpate around the joint for areas of tenderness, warmth, swelling etc. In cases of medial collateral ligament (MCL) injury palpating over the ligament will range from mild tenderness in grade one sprains, to acute pain in more serious injuries.
Range of motion
The therapist will check the range of motion at the knee. They will usually ask you to bend and straighten the knee yourself (active) and will then ask you to relax as they do it for you (passive). In MCL injuries range of motion is often affected in more severe injuries and is usually only limited by pain or swelling.
Resisted muscle tests
The therapist will usually ask you to try to bend and straighten your knee against resistance. Doing this causes the muscles to contract. Pain on contraction suggests a muscular injury.
Valgus stress test
This test is used in cases of suspected MCL injuries. The therapist takes hold of the limb, ensuring the knee is slightly bent (approx 30 degrees). They stabilise the thigh whilst applying an outward pressure on the lower leg. This stretches the medial ligament. Pain on the inside of the knee indicates a positive test. The degree of damage can be determined by how much movement/stability is present.