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Medial collateral ligament (MCL) injury of the knee

Medial collateral ligament (MCL) injury is an injury to the ligament on the inner part of the knee. This ligament keeps your shin bone (tibia) in place.

It can be a stretch, partial tear, or complete tear of the ligament.

Alternative Names

Knee injury - medial collateral ligament (MCL); MCL injury

Considerations

The medial collateral ligament (MCL) goes from the inside surface of the upper shin bone to the inner surface of the bottom thigh bone.

The ligament helps keep the inside portion of the knee joint stable.

Causes

The MCL is usually injured by pressure or stress on the outside part of the knee. A block to the outside part of the knee during football is a common way for this ligament to be injured.

It is often injured at the same time as an anterior cruciate ligament (ACL) injury occurs.

Symptoms

Symptoms of a tear in the medial collateral ligament are:

  • Knee swelling
  • Locking or catching of the knee with movement
  • Pain and tenderness along the inside of the joint
  • The knee gives way or feels like it is going to give way when it is active or stressed in a certain way

First Aid

The health care provider will examine your knee. An MCL test will be done to detect looseness of the ligament. This test involves bending the knee to 25 degrees and putting pressure on the outside surface of the knee.

Other tests may include:

Treatment includes:

  • Applying ice to the area
  • Nonsteroidal anti-inflammatory drugs (NSAIDS)
  • Raising the knee above heart level

You should limit physical activity until the pain and swelling go away.

The health care provider may put you on crutches and in a brace to protect the ligament. You may also be told not to put any weight on your knee when you walk.

After a period of keeping the knee still, you will be taught exercises to strengthen and stretch the knee. Physical therapy may help you regain knee and leg strength.

Surgery is often not needed when only the MCL has been torn. Most MCL injuries can heal with immobilization.

If you need surgery, it will require an open incision where the ligament is repaired back to the bone.

When to Contact a Medical Professional

Call your health care provider if:

  • You have symptoms of MCL injury
  • You are being treated for MCL injury and you notice increased instability in your knee, pain or swelling after they initially faded, or your injury does not get better with time
  • You re-injure your knee

Prevention

Use proper techniques when playing sports or exercising. Many cases are not preventable.

References

De Carlo M, Armstrong B. Rehabilitation of the knee following sports injury. Clin Sports Med. 2010; 29:81-106.

Singhal M, Patel J, Johnson D. Medical ligament injuries: 1. Medical collateral ligament injuries in adults. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Drez's Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier; 2009:chap 23;sect C.

Silverstein JA, Moeller JL, Hutchinson MR. Common issues in orthopedics. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 30.

Updated: 6/29/2012

Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.


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