From the Guidelines
Symptoms of a medial collateral ligament (MCL) injury typically include pain and tenderness along the inner side of the knee, swelling, stiffness, and a feeling of instability or the knee "giving way" during movement. Most people experience immediate pain at the time of injury, which is often caused by a direct blow to the outer knee or a twisting motion. Walking may be difficult, and you might notice bruising around the inner knee area. The severity of symptoms depends on the grade of the injury:
- Grade 1 (mild) causes minimal pain and swelling with no joint instability
- Grade 2 (moderate) presents with more significant pain and partial ligament tearing
- Grade 3 (severe) involves complete ligament tearing with substantial pain, swelling, and joint instability. Initial treatment includes rest, ice application for 20 minutes every 2-3 hours, compression with an elastic bandage, and elevation of the leg above heart level. Over-the-counter pain medications like ibuprofen (400-600mg three times daily) or acetaminophen (500-1000mg every 6 hours) can help manage pain, as noted in general medical practice, although not specifically mentioned in the provided studies 1. MCL injuries often heal without surgery, but physical therapy is crucial for proper recovery and to prevent future injuries by restoring strength and stability to the knee joint, with recent guidelines suggesting non-surgical treatment of the MCL injury results in good patient outcomes 1. Non-surgical treatment is recommended for MCL injuries, with physical therapy playing a crucial role in recovery and prevention of future injuries, as supported by the most recent study 1.
From the Research
Symptoms of MCL Injury
The symptoms of a medial collateral ligament (MCL) injury can vary depending on the severity of the injury. Some common symptoms include:
- Medial knee pain
- Valgus instability of the knee
- Rotatory instability of the knee
- Difficulty walking or bearing weight on the affected leg
- Swelling and bruising around the knee
Diagnosis and Treatment
Diagnosis of an MCL injury is often made through a combination of physical examination and imaging studies, such as MRI 2. Treatment for MCL injuries can vary depending on the severity of the injury, but may include:
- Conservative treatment with early rehabilitation for minor injuries
- Surgery for more significant tears
- Use of platelet-rich plasma (PRP) injections to promote healing, as seen in cases of chronic MCL injuries 3, 4, 5
- Early rehabilitation to expedite recovery, as shown in a case report of a professional athlete with a Grade 3 MCL injury 4
Chronic MCL Injuries
Chronic MCL injuries can be particularly challenging to treat, as they may not respond to conservative treatments. However, studies have shown that PRP injections can be an effective treatment option for these types of injuries, promoting successful repair and return to sport activities 3. Additionally, the use of serial PRP injections with early rehabilitation has been shown to expedite recovery in a professional athlete with a Grade 3 MCL injury 4.