Medial Collateral Ligament Tear

Medial Collateral Ligament (MCL) Tear: Causes, Symptoms, and Treatment

People playing sports always complain about the MCL tear. It may have caught your interest. Many young people active in contact sports like soccer or football can experience the issue. Professional athletes also face a complicated problem that can end their career. MCL tear also known as medial collateral ligament tear can happen when your knee gets struck. Hence, it results in an unnatural bend towards your other knee. The twisting or bending of the lower leg too far can also result in the injury.

The incidents can put immense tension on your MCL ligament. Therefore, ligament shaped like a rope band can stretch to its maximum or break in half. Therefore, it results in severe pain and distress. You need to seek your doctor or physical therapist to get the right treatment. So, the right medical care can help you overcome the agony and other complication associated with the medial collateral ligament tear.

What Is Medial Collateral Ligament?

Medial Collateral Ligament

Several tissues run along your legs. One of the thick band of tissue (about four to six inches) that runs down your inner knee is known as the medial collateral ligament. Also referred to as MCL, the wide tissue runs from the femur (your thighbone) to the tibia (shinbone). So, the MCL is located on the side of your knee (close to your other knee). It is one of the four most significant ligaments you can find in your knee joint. MCL is an important part of the leg that keeps your knee stable. It facilitates the easy rotation of the knee and prevents your leg to extend inwards too far.

What Is MCL Tear Or Injury?

The medial collateral ligament holds your bones along the joint together. It provides strength and stability to the joint. The MCL tear refers to the injury caused due to sprain. The injuries to the medial collateral ligament either tear it or stretch to the maximum. Therefore, the MCL tear can cause high-level of pain and discomfort. In most cases, you can suffer from it due to a direct blow to the knee. So, the injury is quite common in contact sports. During the sporting event, the players can get hit or suffer a blow to the knee. The injury can stretch or tear the medial collateral ligament. Therefore, you may have pain and swelling.

MCL Tear Or Injury

In the majority of the cases, the payers with the partial or complete MCL tear take rest to overcome the injury. With adequate bed rest, the injury can heal on its own. The doctor suggests resting for at least one to six weeks for complete recovery. But, irrespective of the extent of the MCL tear, you need physical therapy. The rehabilitation therapy focusses on regaining the strength of the joint. So, it improves your mobility drastically.

Main Causes Of MCL Tear

As discussed above, medial collateral ligament tear occurs in contact sports. It happens when your knee gets hit directly on the outer side. Your ligaments have restricted stretching ability to function properly. But, an MCL tear can stretch the ligaments present on the inside region of the knee too far. So, the result is pain and swelling. In many cases, it is observed that MCL tear accompanies with the anterior cruciate ligament tear (ACL).

Repeated stress is another cause associated with the medial collateral ligament tear. When your MCL suffers too much stress, it is more prone to injuries and sprains. So, it results in the ligament losing its ability to stretch and elasticity. It looks similar to a worn-out elastic band/rubber band. You cannot ignore the MCL tear as it can restrict your mobility. All your physical activities involving the legs like running, walking, dancing, etc. suffers due to the medial collateral ligament tear.

Types Of MCL Tear

Depending upon the severity of the problem, the MCL tear gets grades into three types. Determining the type can help develop the right treatment plan to solve the issue. So, the different grades associated with the MCL tear are:

Grade 1

It is the simplest form of MCL injury. The Grade 1 signifies stretched medial collateral ligament. But, no tearing of ligament occurs with the injury. So, you need only rest to overcome the problem. You experience less pain and swelling associated with the Grade 1 injury.

Grade 2

The grade 2 MCL tear refers that your medial collateral ligament has partial tearing. The grade 2 problem results in the instability of the knee joint. It results in the ligament sagging. So, you may experience more pain and swelling compared to the grade 1 MCL injury. It requires several weeks of rest and physical therapy to regain mobility.

Grade 3

It is the most severe type among the MCL injury. The injury can result in the complete tearing of the medial collateral ligament. If you have grade 3 injury, you may find it difficult to bend your knee. Another common issue is the instability while walking. So, you feel as if your knees may give out any time. For such injuries, you need to use a temporary knee brace. You also need physical rehab for more than six weeks.

Symptoms Of MCL Tear

You can confuse the symptoms of MCL tear with other knee problems. The signs are more or less similar. So, to determine the actual issue, you need to consult the doctor. But, the common symptoms observed with the medial collateral ligament tear are:

  • Swelling of the knee joint
  • Popping sound during the impact
  • Tenderness along the inner part of the knee
  • Severe pain
  • Instability during walking (feeling that the knee will give out)
  • Inability to put weight on the knee
  • Catching or locking of the knee joint

The instability of the knee occurs commonly with the grade 2 and grade 3 MCL tear.

Diagnosis Of MCL Tear

Only a doctor can diagnose the problem precisely. With several knee problems having similar symptoms, you need the right diagnosis. It will help you get the correct treatment to overcome the discomfort caused by MCL tear. So, your doctor can adopt the following methods to diagnose the injury:

Physical Examination

In the majority of the cases, your doctor can diagnose the issue by just physical examination of your knee. You need to keep your leg relaxed. It will make it easier for your doctor to determine the stability of the ligaments. The diagnosis involves putting pressure on the outside of your knee after bending it. Hence, it helps the doctor detect is the inner knee has instability. The loose inner knee points towards MCL tear. So, the test can make you feel uncomfortable. You may experience tenderness as well as pain while the doctor examines.

X-Ray Images

The extent of the MCL tear gets determined with the x-ray images. If your doctor finds the evidence of medial collateral ligament tear during the physical examination, he may suggest x-rays. It helps to diagnose the knee injury with more precision. So, the x-rays can offer a clear picture of the state of your bones in the knee region. The test can also rule out other knee problems.

It is a simple test taken after positioning your knee for the machine to record the images. With an MCL tear, you can experience pan with the position. Therefore, the x-ray images can provide the doctor with the right information regarding your injury. It also sheds light on the condition of your bones in the knee region.

MRI Scan

The sophisticated imaging test uses radio waves along with the magnetic field to produce images in the body clearly. The MRI scan suggested by your doctor can shed provide a clear image of your knees. It is mostly used to detect the grade 2 and grade 3 MCL tear. Unlike x-rays, which records images of hard tissue like bones, MRI can look at soft tissue. So, it can give a clearer picture of the muscles and ligaments. Some doctors use the imaging technique to confirm the diagnosis.

MCL Tear Treatment Options

Depending on the diagnosis, your doctor can determine the severity of the MCL tear. So, the treatment option depending on the grade of the medial collateral ligament tear can help you heal properly.

Grade 1 MCL Tear Treatment

The grade 1 injury requires no medical treatment. It can heal on its own after you rest your leg completely. But you need immediate treatment to ease the swelling and pain. It also helps stabilize the knee. So, you can follow the steps provided below to reduce the discomfort:

  • Apply an ice pack or ice to the affected area. It can reduce the swelling considerably.
  • You need to keep your knee elevated. Placing it above the heart level can help with the swelling.
  • To relieve the pain associated with the issue, you can take over-the-counter pain relievers. The best option is to take NSAIDs (Nonsteroidal Anti-Inflammatory Drugs) to ease the pain.
  • Take good rest and avoid using the leg too much. It promotes quick healing.
  • You can use a brace or elastic bandage to compress the knee and reduce the problem.
  • Using crutches or cane to keep the weight and pressure away the injured knee can heal the leg effectively.

Physical Therapy

Physical Therapy

It is mostly suggested for grade 2 and grade 3 MCL tear. These types of medial collateral ligament tear take weeks or months to heal properly. So, your doctor advises you to see a physical therapist. You can regain your strength in the knee with physical therapy. The rehabilitation can also prevent further injuries of complications. The physical therapist offers a range of physical exercises to improve the range of motion in the knee region. It can also strengthen the muscles in the knee. Therefore, physical therapy limits the injuries and helps the faster healing of the MCL tear. It focuses on the following:

Take Steps To Reduce Pain

The physical therapist can take steps to reduce the pain and swelling associated with the issue. Using the different treatment options, you can reduce the pain. The following methods are adopted to give you relief from the excruciating agony:

  • Use ice packs for fifteen to twenty minutes every two hours to reduce the swelling.
  • Adopt techniques like electrical stimulation, heat therapy or ultrasound to promote quick healing.
  • Use hands-on therapy like a massage to relieve the pressure and pain away from the knee area.
  • Taping or wearing a protective knee brace during any physical activity offers relief.
  • Teach you exercises to strengthen the knee and enhance the flexibility.

Improve Leg Motion

Specific physical activities can restore the normal movement in your knee and leg. So, your physical therapist opts for the treatments and activities to restore the strength and flexibility of your knee joints. You may start with passive motions that gradually progress to active motions. Hence, you start gently at first and proceed to stretch the knee and leg.

Enhance Strength

The physical therapist chooses the right exercises to promote healing and restore the strength in your legs. After the MCL tear heals, you need to regain the agility of the knee. So, physical therapy uses the following to enhance your strength:

  • Stretchy bands
  • Cuff Weights
  • Use Cardio Equipment (stationary bike or treadmills)
  • Weight-lifting

Improve Balance

The physical therapy also focuses on improving your balance after an injury. So, you learn exercises to maintain the balance properly.

Speedy Healing

The healing is faster when you take good care of the MCL tear. Depending on the extent of tissue damage, the healing time may vary. So, your physical therapist may suggest certain techniques to help you return to the normal life faster:

  • By asking you to compress the affected region with elastic bandage wrap.
  • Limiting physical activities involving leg movements and contact sports.
  • Using knee brace or crutches while walking to avoid strain.
  • Take good rest of the leg by limiting the activities inducing pain like walking.
  • Suggest work retaining activities as well as sports-specific drills.

These pointers can help you get back your normal lifestyle swiftly without any delay. The main aim of the physical therapist is to adopt the treatment that can prove effective to you. Hence, the safest and effective treatment plan can help you achieve the goals with ease.

Prevent Future Injury

In order to prevent future injuries, the physical therapist develops an exercise plan. You can perform the program at home. It strengthens and stretches your knee muscles. So, the muscles and tissue around the upper leg, knee, and abdomen can gain strength and agility. It also provides flexibility to the knee, leg, and core muscles.



In rare cases, your doctor can suggest surgery to overcome the complications due to MCL tear. Your doctor opts it when the ligament is torn badly and the chances of repairing itself become less. The surgery is also a viable option for MCL tear that happens with other ligament injuries. The doctor performs arthroscopy before performing the surgery. Arthroscopy is the procedure that provides comprehensive information about the injuries sustained in the knee. It can look for all the problems in your knee. So, the procedure involves using a camera to check for MCL tear. It is inserted into the body through a small cut or incision.

The examination can reveal the extent of the ligament tearing. the ligament torn from the thighbone or shinbone get reattached using the following options:

  • Bone staples
  • Large stitches
  • Suture Anchor
  • Metal Screw

Your surgeon stitches together the tear found in the middle of your ligament. So, depending upon the problem, your doctor takes the necessary steps.

Prevention OF MCL Tear

Prevention of MCL tear is possible by taking good care by playing contact sports. As it is impossible to prevent injuries during sporting activities, you can adopt some steps. It will help you prevent the damage to an extent. You can get the guidance from the physical therapist regarding the same. So, you can follow some steps like:

  • You need to learn the technique to avoid letting the knees collapse. It can happen while you jump, run or turn quickly. So, try to manage the collapsing of knees towards each other.
  • Include agility exercises and physical activity that promotes balance. The drills can help you improve flexibility and balance.
  • Before starting any heavy physical activity or exercise, do warm up workout.
  • Include exercise in your daily routine that can provide you strength and flexibility. It can also condition the body irrespective of the sporting season.
  • Wear shoes without any wear and tear to improve the balance. A well-fitting shoe can improve your posture and help the balance.


With good rest and care, you can overcome the discomfort due to MCL tear. The medial collateral ligament tear/tears irrespective of its grade has a good prognosis. Even if you need surgery, you can bounce back quickly. Depending on the grade, the time taken to heal can vary. But, you can get back your mobility within weeks. Taking medical help at the right time can prevent further damage and severe pain. So, take good care to avoid the issue from affecting your life adversely.

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