Symptoms of an MCL sprain usually develop suddenly in response to an acute injury and can worsen in the acute phase as swelling and stiffness develop. Common symptoms of an MCL sprain are as follows:

• Pain on the inside of the knee.
• Stiffness and pain when trying to move the knee.
• Swelling that can spread from the inside of the knee to surrounding areas of the joint.
• Pain when trying to walk, squat, run or turn.
• Feelings of instability in the joint when standing or walking.

ANATOMY OF AN MCL SPRAIN

Reviewing the anatomy of the medial collateral ligament helps us to understand how these injuries occur and how physical therapy can be beneficial in treating them. The knee joint is a hinge joint created by the flattened surface of the tibia (shin bone) and the distal end of the femur (thigh bone). Each end is lined with cartilage to allow smooth motion. Between the two ends lie two crescent-shaped menisci which provide shock absorption and cushioning in the joint.

On the outside of the knee the lateral collateral ligament (LCL) runs between the end of the femur and the top of the fibula (thinner bone on the outside of the lower leg) to provide lateral stability to the knee. On the inside of the knee the MCL runs from the end of the femur to the top part of the tibia providing medial stability to the knee. Several other ligaments criss-cross through the knee joint providing additional stability to the joint. Injury to any of these ligaments, if severe enough, can compromise the stability of the joint.

Because of its location in the inside of the knee, sprains to the MCL usually occur as a result of a sudden twisting of the knee or a large force applied to the outside of the knee which forces the knee to bend inward. Some common mechanisms of MCL sprain include:

• Cutting or turning quickly on the field when the foot gets stuck in the grass.
• A hit or blow to the outside of the knee during a soccer or football game.
• A sudden twist of the knee while skiing.
• Trauma from a car accident or other accident.

If you decide to work with a physical therapist to help correct your MCL sprain, your entire treatment plan could consist of around 8-20+ different physical therapy for back pain sessions that will each last 60-90 minutes. Once you complete your customized back pain physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your back pain PT sessions yet in the comfort of your own home.

ARE ALL SPRAINS THE SAME?

Ligaments are bands of tissue that support bones, joints and organs. Many ligaments stretch from one side of a joint to the other to connect the bones together and stabilize the joint. When a joint is moved beyond its normal range of motion it stresses and stretches the inelastic fibers of the ligament and can cause tearing. Sprains are graded based on severity and number of fibers affected:

Grade I (mild): microscopic damage has occurred to the ligament but only mild local tenderness and minimal bruising/swelling is noted without compromising joint stability. Typically takes 2-3 weeks to heal.

Grade II (moderate):partial tear/rupture of the ligament. Obvious swelling and tenderness noted over the injured ligament but joint instability is either minimal or absent. May require up to 6 weeks to heal.

Grade III (severe): complete rupture of the ligament with severe swelling and tenderness. This injury may be difficult to distinguish from a fracture initially. Instability of the joint is noticeable due to the severity of the rupture. Prolonged time to heal is frequent and may require surgery to repair.

PHYSICAL THERAPY AS A TREATMENT FOR AN MCL SPRAIN

Physical therapy is an excellent option to manage MCL sprains. In the case of Grade III sprains or if other ligaments in the knee are also injured, surgery may be the best treatment option. In either case, you will benefit from working with a physical therapist to help facilitate healing, address any factors that may have predisposed you to this injury and facilitate return to full activity. In the early phases of healing your PT will educate you on how to protect healing tissues including how to modify activities and use assistive devices like crutches or a cane. As the ligament heals, your PT will help guide you through a progressive rehab program that can strengthen the ligaments and the surrounding structures while gradually helping you return to your former level of activity. Rather than taking the wait-and-see approach, physical therapy can help you to heal faster and more completely while reducing your risk of future reinjury.

If you are dealing with a MCL sprain and are ready to find a long-lasting solution to your pain call us today to learn more about our services and schedule an evaluation