First degree medial collateral ligament (MCL) injury

Causes and Risks:
The medial collateral ligament (MCL) is a ligament extending from the upper-inside surface of the tibia to the bottom-inside surface of the femur. The ligament prevents the knee joint from medial instability, that is, instability in the inside of the joint.

The MCL is usually injured by pressure placed on the knee-joint from the outside or lateral pressure, resulting in stress on the inside of the knee joint (valgus stress).

Prevention:
Use proper techniques when playing sports or exercising. Many cases are not preventable.

Symptoms:



Signs and Tests:
A physical examination with a medial collateral ligament test (valgus stress at 25 degrees of flexion) results in unchanged knee joint tightness. This test involves bending the knee to 25 degrees and putting pressure on the outside surface of the knee.

Other tests may include:



Treatment:
Initial treatment of a first degree MCL injury includes ice to the area, elevation of the joint (above the level of the heart), non-steroidal antiinflammatory drugs (NSAIDS), and limited physical activity until the pain and swelling subside. Physical therapy should be involved to help regain knee and leg strength.

Prognosis:
When tissue is damaged, the body begins a healing process almost immediately by moving various cells and elements to the area necessary to rebuild, or replace the injured tissue. Certain types of tissue in the body such as ligaments and cartilage have little blood supply (vascularization) and subsequently, they take longer to heal than comparable injuries to other tissues that are more highly vascularized (such as skin). This means that the MCL injury could take from weeks to months to completely heal.

Complications:

  • weakness of the joint, making it more susceptible to reinjury
  • chronic pain



Call Your Healthcare Provider:
Call your health care provider if symptoms of first degree MCL injury occur.

Call your health care provider if you are being treated for 1st degree MCL injury and you notice increased instability in your knee, if pain or swelling return after they initially subsided, or if your injury does not appear to be resolving with time.

Also call if you reinjure your knee.