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Treatment of MCL Tears

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Updated April 10, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

MCL Tears:

Treatment of an MCL tear depends on the severity of the injury. Treatment always begins with allowing the pain to subside, beginning work on mobility, followed by strengthening the knee to return to sports and activities. Bracing can often be useful for treatment of MCL injuries.

Fortunately, most often surgery is not necessary for the treatment of an MCL tear. In some specific circumstances, surgery may be recommended. Most often, surgery is used for treatment of the most severe MCL injuries.

Grade I MCL Tears:

Grade I tears of the MCL usually resolve completely within a few weeks. Treatment consists of: Most patients with a grade I MCL tear will be able to return to sports within one or two weeks following their injury.

Grade II MCL Tears:

When a grade II MCL injury occurs, use of a hinged knee brace is common in early treatment. The hinged knee brace will allow you to bend the knee, but provide support to the injured ligament. Otherwise, the treatment principles are the same as those for patients with a grade I MCL tear.

Athletes with a grade II injury can return to activity once they are not having pain directly over the MCL or symptoms of instability. Patients with a grade II injury often return to sports within three or four weeks after their injury.

Grade III MCL Tears:

When a grade III MCL tear occurs, patients should brace their knee and use crutches until pain has subsided. The knee can be immobilized for a few days initially, but early range-of-motion will help in the healing process.

Once the patient can begin bending their knee, early range-of-motion exercises should commence, including stationary bicycling. Normal walking and progression to jogging can begin as pain allows. Use of a hinged knee brace is usually very helpful to support the knee, especially in the earlier stages of rehab. Most athletes return to sports about three months after a grade III MCL tear.

Surgery for MCL Tears:

Surgery for MCL tears is controversial. There are many studies that document successful nonsurgical treatment in nearly all types of MCL injuries. Most surgeons agree that for patients who complain of persistent knee instability, despite appropriate nonsurgical treatment, surgery is reasonable.

Some surgeons advocate surgical treatment of grade III MCL tears in elite athletes or in those athletes with multiple ligament injuries in the knee. In these circumstances, you should discuss the optimal management of your injury with your doctor.

Sources:

Miyamoto RG, et al. "Treatment of Medial Collateral Ligament Injuries" J. Am. Acad. Ortho. Surg., March 2009; 17: 152 - 161.

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