Medial Collateral Ligament Sprain

What is a medial collateral ligament sprain?

A sprain is a joint injury that causes a stretch or tear in a ligament, a strong band of tissue connecting one bone to the other. The medial collateral ligament is located on the inner side of the knee. It attaches the thighbone (femur) to the shinbone (tibia).

Sprains vary from minor tears in a few fibers of ligament to complete tears of entire ligaments. Complete tears make the joint very loose and unstable.

Sprains are graded 1, 2, or 3 depending on their severity:

• Grade 1 sprain: pain with minimal damage to the ligaments.
• Grade 2 sprain: more ligament damage and mild looseness of the joint.
• Grade 3 sprain: ligament is completely torn and the joint is very loose or unstable.

How does it occur?

This injury usually occurs when a blow to the outer side of the knee causes stretching or tearing of the medial collateral ligament. It can also be caused by twisting the knee.

What are the symptoms?

Symptoms may include the following:

• You have pain on the inner side of your knee.
• Your knee is swollen and tender.
• You have the feeling of your knee giving way.
• You hear or feel a pop or snap at the time of injury.

How is it diagnosed?

Your healthcare provider will ask how you injured yourself and will examine your knee. He or she will gently move your knee around to see if the joint is stable and if the ligament is stretched or torn. Your provider may order X-rays or a magnetic resonance image (MRI) of your knee.

How is it treated?

Treatment may include:

• Applying ice to your knee for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain and swelling go away.
• Elevating your knee by placing a pillow underneath it (to help reduce swelling).
• Taking an anti-inflammatory medicine or other drugs prescribed by your healthcare provider. Adults aged 65 years and older should not take non-steroidal anti-inflammatory medicine for more than 7 days without their healthcare provider's approval.
• Wrapping an elastic bandage around your knee to keep the swelling from getting worse.
• Wearing a knee immobilizer or knee brace to keep you from moving and further injuring your knee and to minimize the pain of moving your knee.
• Using crutches until you can walk without pain.
• Doing rehabilitation exercises.

Torn medial collateral ligaments rarely need surgery. Grade 3 sprains (complete tears) may be immobilized for several weeks.

How long will the effects last?

The length of recovery depends on many factors such as your age, health, and if you have had a previous knee injury. Recovery time also depends on the severity of the sprain. A mild medial collateral sprain may recover within a few weeks, whereas a severe sprain may take 6 weeks or longer to recover.

You will need to do rehabilitation exercises and continue to keep your leg muscles strong if your ligament has become loose after the injury.

When can I return to my normal activities?

Everyone recovers from an injury at a different rate. Return to your activities will be determined by how soon your knee recovers, not by how many days or weeks it has been since your injury has occurred. In general, the longer you have symptoms before you start treatment, the longer it will take to get better. The goal of rehabilitation is to return you to your normal activities as soon as is safely possible. If you return too soon you may worsen your injury.

You may safely return to your normal activities when, starting from the top of the list and progressing to the end, each of the following is true:

• Your injured knee can be fully straightened and bent without pain.
• Your knee and leg have regained normal strength compared to the uninjured knee and leg.
• Your knee is not swollen
• You are able to walk, bend and squat without pain.

Return to your prior level of activity gradually. Talk to your healthcare provider about a knee brace to wear during sports. If pain occurs, contact your healthcare provider and decrease your activity to a pain-free level.

How can I prevent a medial collateral ligament sprain?

Unfortunately, most injuries to the medial collateral ligament occur during accidents that are not preventable. However, you may be able to avoid these injuries by having strong thigh and hamstring muscles, as well as by gently stretching your legs before and after exercising. In activities such as skiing, be sure your ski bindings are set correctly by a trained professional so that your skis will release when you fall.