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MCL/LCL Injury

Ankle/foot

MCL/LCL Injury

The knee joint is a complex structure that relies heavily on ligaments for stability. The medial collateral ligament (MCL) and lateral collateral ligament (LCL) are two crucial ligaments located on opposite sides of the knee joint and play a vital role in preventing excessive side-to-side movement. Injuries to these ligaments, commonly known as MCL/LCL injuries, occur frequently in sports and other activities.

The MCL is located on the inner side of the knee joint and connects the femur (thigh bone) to the tibia (shin bone). It primarily works to prevent the knee from bending outward (varus stress).

The LCL is located on the outer side of the knee joint and connects the femur to the fibula (smallest leg bone). Its main function is to prevent the knee from bending inward (valgus tension).

Symptoms of MCL/LCL injuries

Signs and symptoms of MCL and LCL injuries can vary depending on the severity of the tear. However, some common features include: 

  • Pain: Pain is the most common symptom. The intensity of the pain can range from mild discomfort to severe, sharp pain.
  • Swelling: Swelling around the injured area often develops within hours after the injury.
  • Stiffness: The knee may feel stiff, especially in the morning or after sitting for a long time, making it difficult to fully bend or straighten it.
  • Instability: A feeling of instability or "giving" when putting weight on the injured leg is a common symptom, particularly in more severe tears.
  • Bruising: In some cases, bruising may appear around the injured area, especially with direct blows.

What causes MCL/LCL injuries?

MCL and LCL injuries can occur due to several factors, often involving a force that pushes the knee sideways beyond its normal range of motion. Here are some common causes:

  • Direct blow: A direct blow to the outside of the knee can injure the MCL, while a blow to the inside can injure the LCL. This can occur during contact sports such as soccer, football or rugby, or from falls on the side of the knee.
  • Sudden twisting: Rapid changes in direction or twisting movements can overload the ligaments and cause tears. This is common in sports such as basketball, skiing, and gymnastics.
  • Overuse: Repetitive activities that involve side-to-side movements, such as cutting and twisting in sports, can gradually weaken ligaments and increase the risk of injury over time.
  • Muscle weakness: Weak hamstrings and quadriceps can decrease overall knee stability and increase stress on ligaments during activities.
Close up of knee pain

Predisposing factors for MCL/LCL injuries

While anyone can suffer an MCL/LCL injury, certain factors can increase your susceptibility:

  • Previous knee injuries: Having a history of knee injuries, including ligament sprains or meniscus tears, can weaken the joint and increase the risk of future injuries.
  • Muscle Imbalances: Weak hamstrings or tight quadriceps can disrupt knee mechanics and put additional stress on ligaments.
  • Improper Footwear: Shoes that lack adequate arch support or have worn out soles can disrupt your gait and increase your risk of ankle sprains, which can sometimes lead to MCL/LCL injuries.
  • Certain sports: Athletes who participate in sports that involve frequent changes of direction, jumping, and twisting movements are at increased risk, such as soccer, basketball, soccer, and skiing.
  • Improper warm-up and cool-down: Failure to properly prepare muscles and ligaments for activity can make them more susceptible to injury.
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Treatment Options for MCL/LCL Injuries

The treatment approach for MCL/LCL injuries depends on the severity of the tear, individual needs, and activity level. Here’s an overview of common treatment options:

Non-surgical Treatment:

Avoiding activities that exacerbate the pain and allowing the ligament to heal is crucial in the initial stages. ​

Applying ice packs to the affected area for 15-20 minutes at a time, several times a day, can help reduce pain and inflammation. ​

Wearing a compression bandage or sleeve can help reduce swelling and provide support to the joint. ​

Elevating the affected leg above the heart level whenever possible can also help reduce swelling. ​

Over-the-counter pain relievers like ibuprofen or acetaminophen can manage pain and discomfort. ​

Wearing a compression bandage or sleeve can help reduce swelling and provide support to the joint. ​

Range-of-motion exercises: To improve flexibility and restore full movement in the knee joint. ​

Strengthening exercises: To focus on strengthening the quadriceps, hamstrings, and core muscles to enhance stability and support the knee joint. ​

Proprioception training: Exercises designed to improve balance and awareness of joint position, crucial for preventing re-injury. ​

 In some cases, wearing a hinged knee brace for a short period can provide extra support and stability during the healing process. ​

Close up of knee pain

Surgical treatment

Surgery is typically only considered for complete tears that cause significant instability and prevent individuals from resuming their desired activities, particularly high-demand sports. Surgical options might include: 

  • Arthroscopic surgery: A minimally invasive procedure using small incisions and a camera to visualize the inside of the joint. The surgeon repairs the torn ligament using sutures or anchors.
  • Open surgery: In rare cases, a larger incision might be needed for more complex repairs or when other structures in the knee are also injured.
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Recovery Time for MCL/LCL Injuries

The recovery time for MCL/LCL injuries can vary significantly depending on the severity of the tear, individual factors, and adherence to the treatment plan: 

Grade 1 (Mild)

Can heal within 2-4 weeks with proper rest, ice, and compression.

Grade 2 (moderate)

May take 4-8 weeks to recover with physical therapy playing a central role.

Grade 3 (severe)

Can require several months or even up to a year to recover, often involving physical therapy and potentially surgery for complete tears, especially for athletes returning to high-level sports.
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