Medial Collateral Ligament (MCL) /
Lateral Collateral Ligament (LCL) Sprain

The medial collateral ligament (MCL) is the knee ligament located on the inner side of the knee joint. It links the femur (thigh bone) and the tibia (shin bone). An MCL sprain is usually caused one of two ways. In contact sports such as football and soccer, the MCL can be damaged when an opponent applies force to the outside aspect of the knee. The MCL also can be damaged if an individual’s foot becomes caught in the ground and he or she tries to turn to the side, away from the planted leg.

The lateral collateral ligament (LCL) is the knee ligament located on the outside of the knee linking the femur (thigh bone) and fibula. An LCL sprain is less common than an MCL sprain, but in collision sports such as football and soccer, the LCL can be damaged when an opponent applies force to the inside aspect of the knee.

Damage to these ligaments is referred to as a sprain, and is classified as a Grade I, II, or III sprain, depending on the severity of the injury:

  • Grade I: Damage to only a few ligament fibers.
  • Grade II: Damage to a more extensive number of ligament fibers, but the ligament remains intact.
  • Grade III: Complete rupture of the ligament.

Symptoms of sprained knee ligaments include knee pain and swelling, point tenderness over the injured ligament, and a feeling of instability at the knee joint.

Diagnosis

The initial evaluation includes a complete history of the injury — how it happened, the type of movement that caused the injury, whether the individual heard a pop, where and how badly the knee hurts, and whether the knee feels unstable — as well as details of previous knee injuries.

Once a thorough history is obtained, the physician performs a physical exam of the knee to assess the stability of the ligaments. Using specific tests, the physician can diagnose ligament injuries by applying forces to the knee and feeling for abnormal motion. Obtaining additional studies, such as x-rays and an MRI, can be very helpful to give an accurate picture of the extent of the injury.

Treatment

If you have a Grade I or Grade II knee sprain, treat with rest, ice, compression, elevation, nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, and wearing a knee brace for a short period of time. A Grade III MCL sprain is usually treated conservatively with rest, ice, compression, elevation, NSAIDs, and physical therapy. In certain cases, surgery may be used to repair a torn MCL. A Grade III LCL sprain is treated just as an MCL. With a severe LCL sprain, the torn ligament often is repaired surgically.

Prevention

To help prevent sports-related knee sprains, consider the following tips:

  • Warm up and stretch before you participate in athletic activities.
  • Perform exercises to strengthen the leg muscles around the knee, especially the quadriceps.
  • Avoid sudden increases in the intensity of training programs. Never push yourself too hard, too fast. Increase the intensity gradually.
  • Wear comfortable, supportive shoes that fit your feet and fit your sport. If you have problems in foot alignment that may increase your risk of a twisted knee, ask a health care professional about shoe inserts that can correct the problem.

Rehabilitation Exercises

  • Quad sets: Sit with legs extended and fully contract the muscles of the front thighs. Hold contractions for 10 seconds. Repeat 10 times for three sets.
  • Straight leg raises (hip flexion): Lie with one leg extended and the other bent at the knee. Lift the entire leg from the hip so that the heel is about five inches above the floor. Hold this position for five to 10 seconds and then slowly lower the leg. Repeat 10 times for three sets.
  • Backward leg raise (hip extension): Lie on stomach with legs straight. Lift one leg as high as possible and hold for five to 10 seconds, then slowly lower the leg. Repeat 10 times for three sets.
  • Hip abduction: Lie on side of uninjured leg, so that the injured leg is on top of the uninjured leg. Lift the injured leg at the hip away from the body. Lift the leg as high as possible and hold for five to 10 seconds, then slowly lower the leg. Repeat 10 times for three sets.
  • Hip adduction: Lie on side of injured leg, with uninjured leg bent at the knee and foot flat on the floor. Lift the injured leg at the hip toward the other leg. Hold for five to 10 seconds and then slowly lower the leg. Repeat 10 times for three three sets.
  • Half-knee bends: Stand with feet shoulder width apart. Slowly lower the body weight by bending the knees. Do not perform a full squat, but rather stop at about half of the full squat position and then fully extend the knees. If there is pain before achieving the half-squat position, stop downward travel at that point. Repeat 10 times for three sets.
Content on this page is for informational purposes only. If injured, please consult a physician.

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