Medial collateral ligament injuries (MCL) are the commonest ligament injuries around the knee. They are sustained in almost all types of sports and affect people of any age. They tend to affect male athletes more than female and are most common in contact sports such as football, rugby and in martial arts including wrestling and judo.
Examination of a patient with an MCL injury generally reveals tenderness along the line of the ligament and pain on stressing the knee into a valgus position. The integrity of the MCL is also evaluated when stressing the knee into valgus. If abnormal laxity is detected it is compared with the opposite knee as there is some individual variation in the natural degree of ligament laxity.
The severity of symptoms experienced is closely related to the intensity of the mechanism of injury, with the degree of tearing to the tendon dictating the levels of pain, swelling and instability of the knee that is present.
Treatment is also dictated by the severity of the injury. Most MCL injuries are treated conservatively but rarely, persistent laxity of the MCL requires surgical repair or reconstruction of the ligament.
However, regardless of the course of action, we can help you to recover through hydrotherapy, physiotherapy and our unique method of sports rehabilitation for knee injuries.
Collateral ligament surgery
In most cases, lesions to the collateral ligaments present in combination with other lesions to the knee (cruciate ligaments and meniscal lesions) which also require surgical intervention. These injuries can typically be treated without surgery, but where symptoms persist surgery may be the best option. The procedure here involves suturing the lesion with wire, and using staples to hold everything in place while it heals. Post-operatively, the knee is held at 20° flexion for around 3 weeks.
Post-operative rehabilitation will begin in the gym, slowly building load before hydrotherapy starts once the brace is removed. After around 4 months, work on the field will come to an end, sporting activity can resume and any staples used to hold the ligaments in place will be removed.
For isolated lesion of the medial collateral ligament (MCL) patient reports a valgus trauma (knees inward) without rotation; varus trauma that leads instead to a lesion of the lateral collateral (LCL) is not a common occurrence, so here we will describe only the conservative treatment after MCL injury.
The medial collateral ligament (MCL) in question is very innervated and vascularized, therefore, during the early stages of treatment will be important to avoid the rotation and valgus open loop movements (without the support of the foot on the ground) that trigger a sudden pain and stinging.
The treatment involves strengthening the muscles that stabilize the knee medially as the vast media, adductors, medial flexor and medial twin and the muscles of the bridle. Subsequently will be performed exercises that functionally limit the valgus as hip external rotators, and the gluteus muscles of the core exercises for balance, stability and proprioception.
During rehabilitation the pain usually persists for a long time so it is very important to inform the patient and make a long and gradual recovery of the sports movement in the phase of the rehabilitation field.
It is important to perform the Movement analysis test (MAT) in the Green room especially with regard to relapse after jumping and changing direction at 90 ° and 180 ° to educate the correct motor strategies and avoid re-injury.