Download Medial Collateral Ligament

Medial Collateral Ligament
The medial collateral ligament (MCL) is a superficial ligament found on the inside aspect
of the knee. A ligament is a fibrous band of tissue, which connects bone to bone. The
MCL provides stability on the medial aspect of the knee by connection the medial
condyle of the femur, the large bone of the tight, to the tibia, the large bone in the lower
aspect of the knee.
Right Knee Anterior View
The MCL is most commonly injured in sports such
as football, soccer, and skiing. The mechanism of
injury to this ligament most widely occurs from a
contact force or a blow to the outside of the knee.
Frequently in sports such as soccer, players will
cross-kick the ball at the same time and stress the
MCL. Signs and symptoms of this knee injury
include localized swelling and tenderness over the
MCL. Most often knee motion is limited and the
patient has pain with full weightbearing activities.
Pain is also elicited with digital pressure to the
medical joint line of the knee. In severe cases, the
individual with this injury may complain of the feeling
of instability on the inside aspect of the knee.
Injury to the medial collateral ligament can be classified as a grade I, II, or III. A grade I
injury indicates a slight sprain to this ligament in which the stability of the knee is not
severely comprised. A grade II injury is a more significant injury and indicates a 10 –
90% strain or stretch to this ligament. A grade II injury often results in an unstable knee.
A grade III injury , the most severe kind of injury, is a complete rupture of the MCL and
most often requires surgical correction.
After receiving such an injury, it is important to have x-rays to rule out any type of
fracture, damage to the femur or tibia, or a medial cartilage tear. During the initial
phases or rehabilitation for this injury, the goals of treatment are to reduce swelling and
pain, increase motion and weightbearing, and improve the active contraction of the
quadriceps muscle.
Norman
Newcastle
Purcell
2475 Boardwalk
Norman, OK 73069
PH (405) 447-1991
2340 N.W. 32nd
Newcastle, OK 73065
PH (405) 392-3322
2132 N. Green Ave
Purcell, OK 73080
PH (405) 527-1500
www.TherapyInMotion.net
1
The recommended initial treatment phases include the following:
Ice – The use of an ice massage for 5-7 minutes or an ice pack for approximately 15
minutes I recommended several times throughout the day to reduce the initial
inflammation.
Elevation – If the knee is swollen, it is advised to keep the knee elevated above the
heart during activities of daily living and especially at night during sleeping.
Compression wrap – The use of a 4-6 inch compression wrap is advisable to reduce
the swelling and the help restore stability to the knee joint.
Medication – The use of anti-inflammatories is often recommended to help aid in the
healing process.
Knee brace – A knee brace specifically designed to protect
the MCL is most often advised immediately after this injury.
Many physicians will initially lock the brace in a 30° position to
help alleviate additional stress on the injured ligament. In
other cases, it is advisable to allow full extension and the
brace should be utilized with all activities of daily living.
Crutches/Cane – Although it is frequently painful to bear full
weight on the injured leg, progression to partial and full
weightbearing is encouraged as soon as the pain subsides.
After the initial 48 hours, the following treatment is recommended:
Whirlpool/Heat - The use of heat, especially in the form of a whirlpool is advisable to
help promote healing of this area.
Stretches – Actively stretching the hamstring and calf muscles is exceptionally
important during this phase of the rehabilitation.
Quadricep strengthening – Strengthening of the quadricep muscles in a progressive
sequential fashion is advised. Initially, quad-sets and bent leg raises should be
performed. Exercises should be progressed into straight leg raises, step-downs,
isometric quadricep exercises, and eccentric or negative quadricep exercises.
Cardiovascular exercise – Use of a stationary bicycle, fastrack, Nordic track, stairstepper, or treadmill can be incorporated to enhance in the blood supply to the affected
area.
2
Adductor strengthening – Strengthening the hip adductors is recommended. The use
of home theraband exercises during which the leg is brought from the outside of the
body across mid-line to the inside of the body is recommended. Certainly exercise
machines at a health club or local fitness center can be utilized to strengthen this
muscle.
Agility and coordination drills – The use of many agility and coordination drills will be
helpful to return the injured individual to activities of daily living. Participation in a minitramp exercise protocol is a simple suggestion to initially begin this phase of the
rehabilitation. A gradual return to vertical and long jumping activities, as well as kicking,
is also recommended.
Sports activity is resumed when the knee has full
motion, good muscle control, no tenderness in the
medial aspect of the knee, appropriate balance,
and a stable ligament laxity test. The use of a
medial collateral ligament stabilizing brace is
however often required during the return of
sporting activities for the first several months.
3