The mcl can be sprained or torn as a result of a blow to the outer side of the knee, by twisting the knee, or by quickly changing directions while walking or running. Rehabilitation after injury to the medial collateral ligament of the. The ligament injuryosteoarthritis connection journal of. Mcl sprain rehabilitation protocol medial knee ligament. The above program may be accelerated for first degree mcl sprains or may be extended depending on the severity of the injury. These exercises can be used from the early stages onwards. This protocol is intended to provide a general guideline to treating an mcl sprain. Knee motion and valgus stability at 0 and 30 of knee flexion are assessed. Discussion of treatment options along with potential novel. Rehabilitation after injury to the medial collateral ligament of the knee. Secure the knee with a brace and ice the area to keep swelling down, and stay off of the injured leg as much as possible until after a doctor has evaluated it. If youve ever twisted your knee the wrong way, you might have felt a strain in your medial collateral ligament mcl. Rehabilitation after ankle sprain center for sports.
Treatment of isolated medial collateral ligament injuries in athletes with early functional rehabilitation. In the midst of some form of activity, you likely twisted or turned your knee at a bad angle, and heard a loud pop. Mcl rehabilitation from ruin to return to play rayner. Hopefully my story will help many of you successfully heal your mcl sprain. The increased participation in football, ice hockey, and skiing has all contributed to the increased frequency of mcl injuries. Medial collateral ligament mcl rehabilitation protocol.
The medial collateral ligament mcl is located on the inner aspect, or part, of your knee, outside the joint. Traumatic anteromedial instability of the knee arises from the combined lesion of the anterior cruciate ligament acl and medial collateral ligament mcl. Dec 12, 20 a quick synopsis of my situation after a slip in a wet soccer field and a series of soccertennis matches i ended up suffering from an mcl sprain probably grade i that was making it almost impossible even to jog find more here. The initial treatment for most grade 1, 2 or 3 mcl tears focuses on reducing the pain and inflammation in the knee while immobilizing the knee to keep it. Article information, pdf download for the epidemiology of medial collateral ligament. Distal knee medial collateral ligament repair with suture. Injuries to these ligaments can occur during sport, work, or leisure activities due to trauma, such as a. Do this exercise if you are not able to extend your knee fully. The authors focused on finding the best evidence to help decrease pain, improve function, and return patients to activities after a knee ligament sprain or tear. To treat an mcl sprain, you should seek medical attention immediately. Ankle sprains need to be rehabilitated properly to prevent re injury or a chronic problem from developing. These systems describe 3 grades of mcl injury but the amount of instability is classified. As you work through the initial stages of recovery, and your knee begins to heal, start to introduce some very gentle movements, using light stretches and rotations to reduce the build up of scar tissue and allow greater flexibility at the injured part. As the understanding of the anatomy, biomechanics, and causes of medial knee injuries has evolved, as has the treatment.
Twisting or turning motions on a torn mcl can cause the knee to buckle or give way. Rehabilitation after injury to the medial collateral ligament of the knee phase 1. The following schedule serves as guidelines to help in the expediency of returning a patient to his or her pre injury state. It was decided surgery was not required for the healing of this 3rd degree mcl sprain. Dec 01, 2012 specific medial collateral ligament anatomy medial knee stability is provided, for the most part, by its medial static and its dynamic stabilisers. The ideal outcome would be a stable, pain free knee with good range of motion. Pdf the medial collateral ligament mcl is commonly injured in the setting of anterior cruciate ligament acl injuries.
The anatomy of the medial knee has been divided into 3 layers, consisting of the deep fascia of the thigh, the superficial medial collateral ligament mcl and the deep mcl and posteriomedial joint capsule1. Doctor answers on symptoms, diagnosis, treatment, and more. The medial collateral ligament mcl is the most commonly injured ligament of the knee. These can be a result of a traumatic injury or stress over time. The medial collateral ligament mcl is located on the inner part, of your knee. Enter r100 in the search box to learn more about medial collateral ligament sprain. Click here to download pdf activities and exercises after injury to the medial collateral ligament mcl of the knee. Medial collateral ligament mcl sprain nonoperative protocol. The first mcl sprain treatment is to start off by getting. Download acrobat pdf file 3mb icmje author disclosure forms.
To complete my experience on my mcl sprain recovery i am glad to report that now, 2 months later, my knee is perfectly fine and i enjoy the perks of having two soccer matches per week. You may do the remaining exercises when you have less pain and swelling in your knee. It is important to know how bad your injury is as this determines where you start from and how you progress on the mcl rehabilitation program. Keeping these muscles strong can relieve foot and ankle pain and prevent further injury. It is one of the most common knee injuries and results mostly from a valgus force on the knee. Pdf medial collateral ligament injuries of the knee. The medial static stabilisers, which work as an integrated unit, are the superficial mcl, the posterior oblique ligament and the middle third of the deep mcl. Easy stationary bike for range of motion roms, quads, straight leg raises slrs, calf raises. Mcl grade iii sprain rehabilitation program the gundersen. The majority of mcl tears are isolated injuries and many times are treated nonoperatively. On average, it takes six weeks for a mcl injury to heal. The mcl, unlike other ligaments like the anterior cruciate ligament acl, has a great blood supply. Medial collateral ligament mcl knee sprains can be a painful and debilitating injury to deal with. Radiographs were taken to confirm 3rd degree sprain to mcl and rule out osteochondral defects along with other ligamentous or meniscal involvement.
Most injuries result from a valgus force on the knee. Medial collateral ligament injury of the knee mcl tear. Rehabilitation after ankle sprain brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. Medial collateral ligament injury of the knee physiopedia. Physical therapists guide to medial collateral ligament.
Physical therapy for medial collateral ligament injury. Regaining a full range of motion of the knee joint is the first priority in this phase of the rehabilitation process. Your medial collateral ligament mcl is the knee ligament on the medial inner side of your knee connecting the medial femoral condyle and the medial tibial condyle. Medial collateral ligament mcl rehabilitation protocol weeks postinjury 12 weeks initiate physical therapy. Medial knee ligament sprains are graded 1, 2 or 3 depending on the severity of the injury. Brace for the first 6 weeks after injury grade 2 and 3 3 weeks after injury grade 1. Here are some things to consider when rehabilitating your ankle. Relieve the pain and stabilize your knee with one of the many knee braces made specifically for mcl injury and available right here with mmar medical. Medial knee ligament mcl sprain symptoms, treatment.
Place a towel or cloth between the skin and the ice to prevent skin injury. The epidemiology of medial collateral ligament sprains in young. Accelerated program start with sand bags on tibial tubercle. This foot and ankle conditioning program should be continued for 4 to 6 weeks, unless otherwise specified by your doctor or physical therapist. Dec 19, 2016 how to treat knee pain medial collateral ligament sprain mcl meniscus with kinesiology tape duration. Within the next 6 weeks, proliferation occurs as new capillaries begin to form. It should be stressed that this is only a protocol and should not be a substitute for clinical decision making regarding a patients progression.
A medial collateral ligament mcl knee sprain is a prevalent injury in athletic populations that may result in. A medial collateral ligament mcl injury is a stretch, partial tear, or complete tear of the ligament on the inside of the knee. Our telemedicine options include virtual video visits, telephone checkins, and patient portal communication. Signs and symptoms of a medial collateral ligament mcl injury include swelling, pain, stiffness, and a feeling that the knee may give way. While lying on your back, place a rolledup towel under the heel of your injured leg so the heel is about 6 inches off the ground. Massage therapy acl mcl sprain answers on healthtap. A guide for patients with collateral ligament sprain of. Apr 05, 2020 to treat an mcl sprain, you should seek medical attention immediately. Knee sprains and strains university of california, berkeley. Mcl knee sprain grade iii adopted 298, revised 204, revised 109 1 general principles. Patient will wear immobilizer for 2 weeks following injury, except in p. Injury to the mcl is often called an mcl sprain or tear. Medial collateral ligament mcl sprain rehabilitation exercises therapy. Advancing too quickly in your sport or activity can.
Knee rehabilitation exercises to ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Grade 2 and 3 injuries locked in extension x 1014 days prior to initiating physical therapy and then limited 090 degrees for an additional 2 weeks. Lift the lower part of your affected leg and straighten your knee by tightening your thigh muscle. The exercises may be suggested for a condition or for rehabilitation. After an mcl sprain, depending on severity, the knee loses some of its sidetoside stability and the knee feels like it buckles or is unstable. Mcl injury rehab orthopaedic medical group of tampa bay. Chattanooga, tn 423 6242696 the injury ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Phase 1 begins immediately following injury and usually lasts 1 week. Following an mcl injury, it is important to strengthen the surrounding muscles to help take the strain off the ligament.
Illustration of the subtle imaging characteristics on ultrasound and mri. Nonoperative mcl tear rehabilitation protocol the intent of this protocol is to provide the clinician with a guideline for a nonoperative rehabilitation course of a patient with an isolated medial cruciate ligament injury. Feb, 20 4010 west 65th street edina, mn 55435 phone. Medial collateral ligament mcl sprain nonoperative. May 29, 2016 medial collateral ligament mcl sprain rehabilitation exercises therapy. A sprain of the medial collateral ligament mcl can be a painful and serious injury. This ligament connects your thigh bone to your shin bone along the inner side of your. Medial collateral ligament injuries of the knee in male professional. This brought memories of a traumatic experience of a really serious patellar chondropathy i faced 4 years ago. Mcl injury most often occurs in athletes, although nonathletes can also be affected. Normal radiological anatomy of the medial collateral ligament mcl. If there is any increase in pain or swelling or loss of rom, these can serve as signs that the progression of the. The medial collateral ligament is one of the most commonly injured ligaments of the knee. Keep the bottom of your knee on the foam roll or r.
Strengthening the muscles that support your lower leg, foot, and ankle will help keep your ankle joint stable. A quick synopsis of my situation after a slip in a wet soccer field and a series of soccertennis matches i ended up suffering from an mcl sprain probably grade i that was making it almost impossible even to jog find more here. Trauma, falls, or sports injuries can produce forces that tear, over stretch or compress the joint or the soft tissue. Youre likely reading this because you are on the receiving end of a pretty crummy feeling. Whilst in the 1970s and 1980s surgical treatment for mcl injuries was common place, today most mcl injuries are treated conservatively with early rehabilitation phisitkul, et al. Mcl sprain rehabilitation protocol medial knee ligament sprain. The mcl runs along the inner knee and connects the lower femur.
A anterior cruciate ligament acl, posterior cruciate ligament pcl, medial collateral ligament mcl, and lateral collateral ligament lcl. Stretching, ice, compression would be best to see a physical therapist. Mcl injury rehabilitation and considerations for the athlete. Here are some examples of exercises for you to try. It is one of four major knee ligaments that help to stabilise the. You may heal on your own with basic care, rest, and rehab. It is important to know how bad your injury is as this determines where you start from and how you progress on the mcl rehabilitation program grade 1 injuries are regarded as a mild sprain. Medial collateral ligament mcl rehabilitation protocol weeks post injury 12 weeks initiate physical therapy. Rehabilitation after injury to the medial collateral. Strengthening exercises for medial collateral ligament mcl. Mcl injury rehabilitation and management considerations. Recovery from an mcl sprain might take weeks or months of physical therapy.
An ankle sprain occurs when a ligament connecting the ankle bones is stretched or torn. Revised mar 2009 1 physiotherapy acl protocol rehabilitation following anterior cruciate ligament reconstruction aclr is an essential part of a full recovery. If you have a grade 1 mcl sprain, you may have mild tenderness on the inside of the knee over the ligament. The first six weeks after injury grade 2 and 3 three weeks after injury grade 1 the knee should be protected with a shorthinged brace for 3 to 6 weeks, depending upon the severity of the injury. After your recovery, these exercises can be continued as a maintenance program for lifelong protection and health of your feet and lower legs. Injuries to the collateral ligaments tend to occur when a person is bearing weight and the knee is forced inwards or outwards, such as slipping on ice or. It helps add stability and strength to the knee joint.
Medial collateral ligament injuries occur following a traumatic valgus force, often while the knee is slightly flexed. Tears of other ligaments and of the menisci can be associated to this combined injury. An mcl sprain is an injury sustained by the medial collateral ligament mcl, which is used to stabilize the knee joint. There are two collateral ligaments, one either side of the knee, which act to stop side to side movement of the knee. Biomechanics and pathophysiology of chronic mcl syndrome. The majority of patients who sustain an mcl injury will achieve their preinjury activity level with nonoperative treatment alone. Standard closure in layers is then performed, and the patient is placed in a hinged knee brace.
The mcl medial collateral ligament is a band of tissue that runs along the inner edge of your knee. Summit medical group is making it easier than ever for patients to seek care while limiting exposure to covid19. Lie on your back with your knees bent over a foam roll or a large rolledup towel. At about two or three weeks following injury, the pain is usually subsiding and the swelling is lessened. Knee pain is often caused by ligament sprains, muscle strains, or irritateddamaged cartilage. After an injury or surgery, an exercise conditioning program will help you return to daily activities and enjoy a more active, healthy lifestyle. You can now try to stretch the knee to regain motion. One way is through the medial collateral ligament mcl. The rehabilitation protocol for a mild medial ligament sprain can be split into 4 phases. This blog aims to provide a succinct overview of the rehabilitation of mcl injuries, with the approach i use to return an individual to full function. A torn knee ligament can destabilize the knee and prevent you from doing things that involve twisting or turning your knee. In the past, surgery or cast immobilization was consid ered the standard treatment for complete mcl sprains.
Pdf knee medial collateral ligament injuries researchgate. Pdf primary repair of the medial collateral ligament with. Rehabilitation of isolated mcl sprains this program may be accelerated for grade i mcl sprains or may be extended depending on the severity of the injury. Description of clinical presentations and difficulties in diagnosis. Treatment typically includes rest, ice, elevation, compression, knee braces, and pain relievers. With a proper mcl injury rehabilitation protocol, even a complete mcl tear should completely heal. The use of a knee brace in the treatment of mcl injury is, however, not supported by highquality evidence, but it may provide mechanical. Do this exercise if you are unable to extend your knee fully. Increased blood flow means more nutrients, proteins. This protocol was designed to provide the rehabilitation professional with a guideline of postoperative care. The medial collateral ligament mcl is the most commonly damaged ligament in the knee.
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