MCL Tear

An MCL tear is a common knee injury and develops when the medial collateral ligament of the knee gets overstretched and damaged. MCL injury symptoms include inner knee pain, swelling and instability. 

An MCL injury is most commonly caused by a sudden twisting force through the knee, which damages some or all the fibres of the ligament and occasionally some of the other surrounding structures as well such as the knee cartilage. There are three grades of MCL tear depending on what proportion of the ligament is injured.

Here we will look at what causes MCL tears, the different grades of ligament injuries and their symptoms, treatment options, and what you can do to prevent long term problems after an MCL injury.

Causes of an MCL Injury

Diagram of the knee ligaments showing a complete MCL tear (medial collateral ligament)

Knee ligament injuries are common, especially a tear to the Medial Collateral Ligament. The MCL is one of four ligaments that helps stabilise the knee and is found on the inner side of the knee joining the femur (thigh bone) and the tibia (shin bone).

Its job is to hold the tibia and femur bones together and limit the sideways widening of the gap between them.

An MCL injury usually occurs when there is a force through the outer side of a bent knee, e.g. a tackle hitting the outer side of the knee. This pushes the bones apart on the inside of the knee which overstretches the ligament causing an MCL tear.

Grades of MCL Injury

MCL tears can be classified into three grades, each varying in severity. Here you will find information on how they are classified and the symptoms, treatment options and recovery time for each:

Grade 1 MCL Tear

1) What is it: A few of the fibres (less than 10%) are damaged

2) Symptoms: It is usually tender on the inner side of the knee especially when any pressure is put through the region and bruising/swelling may develop over the first couple of days

3) Treatment: PRICE - protect, rest, ice, compression and elevation. Click the link to find out how to use it safely and effectively

4) Recovery: A grade 1 MCL injury usually heals itself within a couple of weeks

Grade 2 MCL Tear

MCL tears usually occur when there is a force through the knee eg a sporting tackle

1) What is it: Many fibres are damaged but the ligament is still intact

2) Symptoms: There may be medial knee pain with a moderate amount of swelling and bruising (which appear in the first 48 hours), and the knee may feel slightly unstable

3) Treatment: PRICE first. May also benefit from tubigrip or a hinged knee brace in the short term if the knee is giving way to help provide stability and prevent further injury. Ultrasound treatment and deep tissue friction massage can also help reduce pain and speed up healing from an MCL injury. This is usually carried out by a physical therapist or sports therapist

4) Recovery: Symptoms normally settle down within 4-6 weeks

Grade 3 MCL Tear

1) What is it: This is when the ligament ruptures i.e.tears completely

2) Symptoms: There will be significant swelling and it is often difficult to bend the knee although it is sometimes less painful than a grade 2 sprain. The knee will likely feel unstable and may give way

Knee braces can be a really useful tool when recovering from MCL tears as they help provide support and stability

3) Treatment: A knee brace can be really helpful if the knee is feeling unstable.  People usually find an advanced or elite knee brace most helpful as they help prevent any sideways movement at the knee. Your doctor may advise you to get one that prevents bending or straightening of the knee, depending on the severity of the injury. Braces are a great way to reduce pain and instability, improve function and prevent further MCL injury.

Exercises should be done to help to increase movement, strength and circulation, all of which will lead to a quicker, fuller recovery. If you are wearing a brace, it should be removed several times a day to carryout exercises to ensure the knee does not get stiff. Crutches may be needed in the short term to keep weight off the knee when walking around. The crutches can stop being used once you can walk without a limp.

4) Recovery: Symptoms often take 6-8 weeks to settle and it can take 3-4 months to fully recover from a grade 3 MCL tear. Recovery will be quicker if you keep up with your exercises. A combination of strengthening and movement exercises should be done daily - see the knee exercises section for suitable exercises.

Remember, always consult your doctor or a rehab therapist after any injury to ensure the most effective course of action for you.

How to Avoid Long Term Problems

An MCL injury can have a long lasting impact on the stability of the knee therefore affecting balance and function (e.g. running on uneven ground and quickly changing direction) so it is important to rehab properly.

You may want to see a therapist for a rehab programme or try these exercises that you can do at home. But don’t worry, with proper rehabilitation, most people make a full recovery from all grades of MCL tear.

As some of the fibres of the MCL connect to the medial meniscus, in more serious injury this is often damage too - see the Meniscus Tear section for more information.

Not Sounding Like Your Knee Pain?

If you didn't twist your knee or don't have pain on the inner side of your knee, it is unlikely you have an MCL tear. If your knee pain was caused by a specific incident such as a fall, visit the Common Knee Injuries section. If your knee pain has come on gradually over time, go to the Common Knee Conditions section.

If you would like help working out what is wrong with your knee, visit the knee pain diagnosis section.

Go to Common Knee Injuries or Knee Pain Guide

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