Sprains of the Medial Collateral Ligament
By Sarah Myers, ATC
The medial collateral ligament (MCL) is a ligament found on the inner side of the knee. The MCL is commonly injured by either a direct blow to the outside of the knee, with the force going inward, or a severe outward twisting motion. There are varying degrees of an MCL sprain ranging from 1 (mild) to 3 (severe).
A grade 1 sprain will be stable during testing (when the knee is slightly bent and the lower leg is moved outward in relation to the thigh), little or no swelling, and some pain over the MCL. A grade 2 sprain will show some looseness during testing, slight swelling, inability to extend the knee, unable to place the foot flat on the ground, and general weakness. Finally, a grade 3 sprain is a complete tear of the ligament resulting in complete loss of stability, moderate swelling, severe pain followed by a dull ache, and loss of motion. No matter what grade sprain is sustained the initial treatment is the same: rest, ice, compression, elevation (RICE).
For more severe injuries, a knee brace and crutches will help maintain stability and comfort. An MRI is recommended to determine the severity of damage to the MCL, as well as to determine any possible damage sustained to surrounding structures such as the anterior cruiciate ligament (ACL) or meniscus. Rehabilitation exercises should include quadriceps strengthening and activities to regain a normal range of motion. Return to play will vary depending on the degree of injury sustained, but typically will range from 2-8 weeks of rehabilitation with gradual incorporation of sport specific activities. Surgical repair may be warranted in the case of a grade 3 sprain, usually if other structures are damaged in addition to the MCL. Steps may be taken to prevent injury such as strengthening surrounding musculature of the knee and wearing supportive braces.
References
Prentice WE. Arnheim’s Principles of Athletic Training. 12th ed. Boston, MA: McGraw Hill; 2006:587-589.
 Sarah Myers, ATC, a native of Portsmouth, New Hampshire, is a first year graduate student and recipient of the Hughston Athletic Training Fellowship in Columbus, Georgia. She graduated from The University of Connecticut in May of 2008 with a Bachelor of Science Degree in Athletic Training. While attending UConn, Sarah completed rotations with men’s and women’s track & field, football, and women's volleyball. In addition, she also completed rotations at Loomis-Chaffee School and Trinity College, specifically with men's hockey and men's lacrosse. Sarah served as the Vice President of Student Athletic Training Club at UConn and was involved in the publication of several research articles relating to hydration and athletic participation. She is an active member of the National Athletic Trainer’s Association (NATA). Sarah currently serves as the Head Athletic Trainer at Smiths Station High School, Smiths Station, Alabama.
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Health - Sprains of the Medial Collateral Ligament