Mobility Exercises for MCL Injuries

These exercises should be carried out as soon as possible as pain allows. Always seek professional advice before beginning any rehabilitation program.

Exercises

Flexion / Extension Exercises

This exercise is extremely important not only to improve the mobility of the injured knee but it will also help maintain the strength of the quadriceps and hamstrings in the early stages of rehabilitation. These movements can also help to decrease the swelling surrounding the knee.

• Aim to bend and straighten the knee as far as you comfortably can.
• This can be done in sitting, standing (as shown) or lying on your front.
• Aim for 3 sets of 10-20 repetitions 3 times a day as pain allows.

Progress this exercise to holding the leg in place at the end of possible range, both in flexion and extension. This will aid in strengthening the muscles. Further details of strengthening exercises can be found in medial ligament strengthening.

 Heel Slides

This exercise aids in promoting mobility in both the hamstrings and the quadriceps. It also helps to mobilize the hip flexor muscles (iliopsoas and rectus femoris) and the hip joint itself. This movement can be made easier by decreasing the resistance between the foot and floor. Hence, in the early stages of recovery this may be done by wearing a thick sock and sliding the foot along a polished floor as oppose to a carpet. It can also be made easier by using a long object such as a towel or rope to pull the heel in as shown opposite.

• Lie on back, flex one knee with the foot firmly on the ground, as shown.
• Slide heel up as far as possible. In the early phases of recovery it may only be possible to attain as little as 30 degrees flexion. This range of movement, with repetitions, should increase over time.
• Repeat 10 to 20 times daily, aiming to increase the range of movement as pain allows
• If there is insufficient muscle strength to bend the knee, the exercise may be made easier by using a towel around the ankle to facilitate flexion

 Light, low resistance exercises such as swimming and light exercise bike training can also aid to increase range of mobility. However these are normally only advised when satisfactory range of movement has been achieved

Forward lunge

• Place the foot up on a bench or chair with the uninjured leg on the floor behind.
• Move forwards from the hips to bring your weight over your front leg and bend the knee as far as comfortable.
• Hold this position for a few seconds and then try a little further and hold again.
• Ease off and then repeat this 5-10 times.

Stretches

The aim of stretching is to increase the range of movement of a joint by increasing the flexibility of the soft tissue structures that surround it i.e. muscles, ligaments and joint capsule. Stretching exercises are extremely beneficial in rehabilitation but should normally be accompanied by a strengthening program so that instability does not develop around the joint. A number of stretching exercises can be used following injury to the medial meniscus. As always these should only be carried out as pain allows.

Quadricep Stretches

• Grasp one foot with the same hand and pull it up behind your buttocks
• Keep your knees together and pull the foot up until you can feel a stretch
• Tilt your hips backwards to increase the stretch 

Hamstring Stretches

• Hamstring stretches are essential to the rehabilitative process as this muscle group is highly prone to injury if not warmed up correctly.
• Stand with the leg to be stretch just in front of the other.
• Band the back knee (keeping the front leg straight) and lean forwards resting your weight on the bent knee.
• If you can't feel a stretch, lean further forwards and tilt the hips forwards.

Calf Stretches

This stretch increases flexibility not only in the calf muscles but also in the hamstrings.

• Place the injured leg one pace behind the other.
• Try and keep the knee of the behind leg as straight as possible while bending the front leg
• Keep the heel of the back leg on the floor
• A stretch should be felt at the back of the behind leg
• Hold for 10 seconds and release slowly
• Repeat 3 times daily

Other Mobility Treatments

A number if other methods to increase flexibility can be also used. These can be performed by trained therapists to aid flexibility of the joint.

Passive Physiological Movements:

This involves a set of movements that follow the body's normal movement pattern. They can be used to regain range of movement and decrease pain. A therapist moves the affected limb through the pain free range and sometimes into the painful range. In doing so he/she can feel the quality of movement and assess where restrictions occur. In addition, gentle graded oscillations at the end of range can be performed to increase the range of mobility.

Passive Accessory Movements:

This treatment modality involves moving the joint into positions that cannot be attained by muscular contractions. In doing so, the therapist passively stretches certain soft tissue structures that may cause restricted movements. These are normally performed in an oscillatory manner which, as with passive physiological movements, can be graded according to the therapists wishes.