Medial Collateral ligament injury

April 7, 2017

 

 

Anatomy

The knee joint is made up of the femur (thigh bone), tibia (shin bone) and patella (knee cap). Ligaments connect bone to bone; the medial collateral ligament connects the femur to the tibia and the lateral collateral ligament connects the femur to the fibula. These ligaments are important in maintaining the stability of the knee.

 

Injury to the medical collateral ligament usually occurs due to a valgus (inwards stress) to the knee or twisting which is common in skiing.

 

Symptoms:

  • Pain

  • Swelling

  • Instability feeling

 

Grading of ligament injuries:

  1. Slightly stretched- no laxity or swelling, some tenderness on medial side of knee

  2. Partial tear- Some laxity, some local swelling, tenderness

  3. Complete tear- instability, lots of laxity, may not have as much pain as a partial tear. Grade 3 tears are often accompanied with ACL tears

 

Treatment:

- Unless other structures (such as the ACL is ruptured) medial collateral ligament injuries are often treated conservatively (without surgery)

 

Rehab for MCL injuries

 

Phase 1 (0-1 weeks for mild injury) (0-4 weeks severe injury)

1. Control swelling- (PRICE: protect, rest, ice, elevate, compress), electrotherapy (which can be done by your PT)  

2. Control pain- ice, crutches, rest, and painkillers

3. Regain/maintain range of movement of the knee: aim for 90+ degrees knee flexion; allow -20 degrees of full extension for mild and -30 for severe strains

- Exercise: bending and straightening of knee

4. Maintain quadriceps strength

- Exercise: -Lying on your back with your knee extended try to push your knee downwards to touch the bed- you should feel your quadriceps contracting

- Hold this position for 5 seconds. Repeat 15 times

5. Normalize gait/ walking pattern and as pain allows try to walk without support

6. Maintain/ improve strength of supporting muscles

 

Exercises:

 

Strengthening 

  1. Calf raises holding onto something (come up onto your tip toes and slowly lower yourself back down x15)

  2. Resistance band hamstring curl- lying on your stomach tie a theraband around your ankle, slowly bend your knee upwards towards your buttocks and then slowly lower down (x15) - you should feel the muscle on the back of your thigh contracting

  3. Straight side leg raise- increases strength of hip abductors (muscles around hip)-

  • -Lying on your side with your injured leg on top

  • -Tighten your quadriceps and lift your leg about 20cm of the bed

  • - Try to keep your knee and hip straight and in line with the rest of your body

  • - Hold for 5 seconds and then slowly lower your leg back down. Repeat 15 times

  •  

4.    Bridging- helps strengthen your hip, core and hamstring muscles

 

  • -Lying on your back with your knees bent

  • -Slowly raise your bottom of the bed, squeezing your glutes together as you do this. Then slowly return to the starting position

  • -Repeat 15 times

 

stretches

 

. Gentle stretches as pain allows; try to hold for 30 seconds x 3

 

1. Hamstring (the muscle on the back of your thigh) stretch

-  Standing up, place your leg to be stretched in front of the other foot, this leg should remain straight and whilst keeping your heel on the floor point your toes upwards. Bend the other knee slightly and bend over so both hands are on that bent knee. Keep bending over from your hips until you can feel the stretch

2.  Calf stretch

- Standing with your hands touching a wall, place your foot with your heel touching the floor and your toes pointing upwards against the wall. Lean forwards until you feel the stretch. Your heel must not leave the floor.

3. Quadriceps stretch

Standing up, bend your knee and holding onto your ankle pull your foot towards your buttock until you can feel a gentle stretch

 

Phase 2 (week 1-2 mild) (4-6 severe)

Regain full flexion by continuing bending and straightening exercises, continue stretching exercises

- if you are struggling to regain full flexion try placing a dressing gown around your foot and use this to help bend your knee

Continue to ice your knee regularly, continue to rest from painful activities

You can begin light swimming (front crawl), jogging, road biking

 

Progress strengthening exercises:

Single leg calf rises

Mini squats and lunges

Step-ups

Single leg bridges

Add Theraband to hip abduction exercises

Start basic balance exercises such as standing on one leg, reaching to cones etc.

 

Phase 3 (2- 4 weeks mild) 6-10 weeks severe

Regain full ROM and strength, return to running and be able to do a full squat

Start agility drills- ladder drills, changing direction exercises, hopping, kicking, jumping etc.

Progress exercises- increase repetitions/weights

Increase difficulty of balance exercises e.g. wobble cushion exercises- standing on wobble cushion, one-legged stand on cushion, squats and lunges onto cushion

 

Phase 4: 3-6 weeks mild, 8-10 weeks severe tear

  • Return to sports

  • You may be advised to wear a knee brace but do not become reliant on this

  • Staged rerun to match play/ competition 

  • Sport specific strengthening which your physiotherapist will be able to guide you through

 

Exercises should be completed under the guidance of a physiotherapist

 

 

 

 

 

 

 

 

 

 

 

Please reload

Featured Posts

Summer season finished 

 

The Summer season has finished, school has started and the signs of winter are coming.  We are still having some beautiful wea...

End of summer season

September 12, 2015

1/1
Please reload

Recent Posts

September 10, 2019

April 2, 2019

April 1, 2019

January 28, 2019

January 6, 2019

Please reload

Archive