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Medial Collateral Ligament Tear (Knee)

 

Medial Collateral Ligament Tear - Why does this happen?
  

The knee is a complex hinge joint.  The convex surfaces of the femur sit on the concave surfaces of the tibia.  The Menisci, fibro cartilaginous discs, sits between the femur and tibia to act as a shock absorber and improve the shape of the joint.

 

The knee has a ligament, connective tissue, on either side of the joint to help control sideways movements.  The medial collateral ligament is located on the inside of the knee which attaches from the lower end of the femur to top of the tibia.
 
 
 
 
  
 

A Medial Collateral Ligament Tear is a tear in the connective tissue.  It can occur following a side impact  or a twist when the foot remains on the floor and the knee rotates.  For example playing football when the boot is stuck in mud or when the knee twits during a skiing accident.

 

The medial collateral ligament can be damaged in isolation or in conjunction with the medial meniscus and/ or the anterior cruciate ligament.  This will depend on how much force is involved in the injury. There are varying grades of injury from a minor tear to a few fibres of the ligament to a complete rupture.

 
 
 
  
What are the symptoms?
 
  • Pain on the inside of the knee.
  • Swelling of the knee.
  • Pain is worse on twisting or sideways movements.
  • Pain is relieved after a period of rest.    
  • Stiffness in the knee, particularly in the morning and after rest.
  • Difficulty straightening the knee.
 
 
Diagnosing a Medial Collatral Ligament Tear
 

Your GP or Physiotherapist can usually diagnose a Medial Collateral Ligament Tear simply by examining your knee and hearing where the pain is and how it started.  It is important to ensure the meniscus and/or cruciate ligament are not also injured.

 

If the knee is unstable it may be an indication of additional damage to the meniscus or cruciate ligament and further tests may be required.

 
 
What is the treatment?
 

A Medial Collateral Ligament Tear will usually recover with some simple changes to activity and exercise.  By trying to avoid or reduce the activity which causes the pain, to allow the damaged ligament time to recover and heal. 

 

To help reduce the symptoms an 'ice pack' can be placed on the painful area for 15 - 20 minutes, twice a day.  Do not place the 'ice pack' directly on the skin.  Wrap the 'ice pack' in a damp towel before placing on the painful area to ensure you do not burn the skin. Elevate the leg where possible for the first 48 hours.

 

During the initial painful stages it is important to manage the pain.

 
Painkillers and anti-inflammatory medications  -  These may be prescribed by your GP if the pain is costant.  This is a temporary measure to break the pain cycle, but can continue as required.
 
Exercise  -  Exercise is important to help regain full ankle movement in the acute stage. Once the pain has settled it is important to strengthen the surrounding muscles and work on your balance to help prevent reoccurrence.  Click here for a list of exercises suitable for a Medial Collateral Ligament Tear.
 

Biomechanical Analysis  -   If there are significant mechanical problems insoles or specific trainers may improve your leg position and help avoid further injuries.  A biomechanical assessment by a Podiatrist or Physiotherapist will determine whether insoles or specific trainers would be of benefit.

 
Physiotherapy  -  If exercise alone does not improve symptoms then physiotherapy treatment may be required.  A physiotherapist can use specific treatments including, ultrasound, deep friction, massage, interferential, acupuncture or taping to help relieve pain and aid recovery. Click here for more information about Physiotherapy.
 
Injections  -  In some cases your GP or Consultant may recommend an injection.  These can be used to reduce inflammation and pain when the symptoms are severe and constant.  This is not a 'cure' and it is important to follow the exercises and modify activities.  A 'Cortisone Injection' can help reduce inflammation in the tendon, whilst a 'PRP Injection' (Platelet Rich Plasma) can help to stimulate healing.
 
Surgery  -  This is an option in severe cases of a Medial Collateral Ligament Strain. In some cases when symptoms are persistent surgery may be considered.    
 
Remember an important part of treatment for a Medial Collateral Ligament Tear is your home exercises and modifying activities.