From the Guidelines
Treatment for a medial collateral ligament (MCL) strain should prioritize rest, ice, compression, and elevation (RICE protocol) for 24-72 hours after injury, along with over-the-counter pain medications like ibuprofen or acetaminophen for pain management. The use of prophylactic knee braces in preventing MCL injuries has been studied, but the evidence is limited by inadequate control groups, subjective biases, and inconsistent methods of data collection 1. While some researchers have concluded that prophylactic knee braces significantly reduce MCL injuries, others have noted few beneficial effects with regular use 1.
Key considerations in managing MCL strains include:
- Grade of the strain: Grade 1 (mild) strains may require only 1-2 weeks of recovery, while grade 2 (moderate) strains need 3-4 weeks, and grade 3 (severe) strains can take 8-12 weeks
- Pain management: Over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or acetaminophen (500-1000mg every 6 hours) can help manage pain and reduce inflammation
- Physical therapy: Crucial for proper healing, focusing on gradually restoring range of motion, strength, and stability
- Support: A knee brace may be recommended during recovery to provide support, although its effectiveness in preventing MCL injuries is still debated 1
It is essential to follow medical advice about progression to avoid re-injury, as MCL strains can heal well due to the ligament's good blood supply.
From the Research
MCL Strain Overview
- The medial collateral ligament (MCL) is a major stabilizer of the knee joint, providing support against rotatory and valgus forces 2.
- MCL injuries are the most common ligament injuries in the knee, particularly in athletes, and can result in valgus instability and degenerative knee osteoarthritis 3, 2.
Diagnosis and Treatment
- History and physical examination are often adequate for diagnosis, but the gold standard for diagnosis is MRI 3.
- Lesser injuries to the MCL can often be treated conservatively with early rehabilitation, while more significant tears may necessitate surgery 3, 4.
- Nonoperative management is commonly used for grade I and II tears, while grade III tears may require operative management, especially if associated with injuries to the anterior cruciate ligament or posterior cruciate ligament 4, 5.
Rehabilitation and Management
- Rehabilitation programs for conservative treatment of MCL injuries and postoperative programs after anterior cruciate ligament or multiple ligament reconstruction are essential for optimal recovery 4.
- Functional and prophylactic bracing may be used for injuries of the MCL to provide additional support and stability 4.
- The use of advanced imaging, such as magnetic resonance imaging and stress radiography, can help determine the severity of the medial-sided injury and guide treatment decisions 6.