The majority of mcl tears are isolated injuries and many times are treated nonoperatively. The first six weeks after injury grade 2 and 3 three weeks after injury grade 1 the knee should be protected with a shorthinged brace for 3 to 6 weeks, depending upon the severity of the injury. Mcl sprains are very common, especially in sports that require quick sidetoside movements, such as hockey, skiing, soccer, and american football. See more ideas about knee exercises, mcl injury and knee strengthening exercises. Most people think of the tibiofemoral joint when thinking of the knee. Rehabilitation guidelines for posterior cruciate ligament reconstruction the knee has three jointsthe patellofemoral joint knee cap, the tibiofemoral joint and the tibiofibular joint. The mcl is located on the inner side of the knee, and it prevents the knee from collapsing inward. Joints are named for the two bones that articulate with each other. Crutches and restricted weight bearing may be needed, as instructed by dr. The medial collateral ligament mcl is the most commonly injured ligament of the knee.
Increased blood flow means more nutrients, proteins. Rehabilitation after injury to the medial collateral ligament of the. The mcl is one of the most common injured ligaments within the knee. Our sports medicine specialists can usually diagnosis an mcl sprain through a clinical evaluation and by discussing your symptoms and sports history. Strengthening, flexibility, and balance activities should be continued to prevent future injuries. Mcl knee sprain grade iii adopted 298, revised 204, revised 109 1 general principles. Mcl tear and contraindicated exercises healthy living. An mcl sprain is an injury sustained by the medial collateral ligament mcl. To complete my experience on my mcl sprain recovery i am glad to report that now, 2 months later, my knee is perfectly fine and i enjoy the perks of having two soccer matches per week. How to treat knee pain medial collateral ligament sprain mcl meniscus with kinesiology tape duration. Mcl injury rehabilitation considerations the prehab guys.
Trauma, falls, or sports injuries can produce forces that tear, over stretch or compress the joint or the soft tissue. Strain in the medial collateral ligament of the human knee. Rehab for this type of an injury is time consuming, and its important you dont do any activities to aggravate the knee. Knee pain is often caused by ligament sprains, muscle strains, or irritateddamaged cartilage. Is a broad ligament within the middle layer of the medial compartment of the knee. Most of you can be started in physical therapy to rehab your knee soon after the injury. If multiple diagnoses are being considered or the knee injury is severe, an mri or arthroscopy may be recommended. When your mcl is damaged, your knee can overextend itself, or bend too far in a direction that its not supposed to bend. Elevate the leg and use elastic stockings if the leg is swollen. Signs and symptoms of a medial collateral ligament mcl injury include swelling, pain, stiffness, and a feeling that the knee may give way. The superficial mcl is the primary restraint to valgus stress of the knee, whereas the deep mcl acts as a secondary stabilizer. Mcl grade iii sprain rehabilitation program the gundersen. Pdf primary repair of the medial collateral ligament. Because the mcl has better healing capacity than the acl, the general.
Patient will wear immobilizer for 2 weeks following injury, except in p. An mcl sprain is marked by pain on the inside of the knee and sometimes by minor swelling. The mcl runs along the inner knee and connects the lower femur thigh bone to your upper tibia shinbone. A sprain of the mcl can range from a mild injury to a complete tear of the ligament. The medial collateral ligament mcl is composed of superficial and deep fibers. This protocol is intended to provide a general guideline to treating an mcl sprain. Continue with treatment as indicated by week 1 to 2. Grade 3 injuries might require a longer period of bracing and in some instances a grade 3 complete mcl tear might require surgery to repair the tear. Associate professor of orthopaedics chief division of sports medicine tel. A medial collateral ligament, or mcl, is a loop of tissue that connects the inner aspect of the knee to the femur, also called the thigh bone.
Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. Connecting the femur and the tibia this ligament stabilizes and limits the sideways motion, or opening the inside, of the knee joint. The medial collateral ligament mcl is commonly injured in the setting of anterior cruciate ligament acl injuries. Utilize the latest physical therapy modalities and rehab devices to reduce swelling and decrease pain. Easy stationary bike for range of motion roms, quads, straight leg raises slrs, calf raises. Do this exercise if you are unable to extend your knee fully. These can be a result of a traumatic injury or stress over time. Sit with your affected leg straight and supported on the floor or a firm bed. You speed up and dodge one way, then quickly dart back the other while falling to one knee. Mcl injury rehabilitation and management considerations. Independent weight bearing as tolerated gait pattern with use of crutches and brace on if appropriate.
Ryan tannehill suffered an acl and mcl sprain on sunday in the teams win over the cardinals, dolphins head coach adam gase announced. You may heal on your own with basic care, rest, and rehab. An mcl injury can be very painful and is caused by a valgus stress to a slightly bent knee, often when landing, bending or on high impact. As you work through the initial stages of recovery, and your knee begins to heal, start to introduce some very gentle movements, using light stretches and rotations to reduce the build up of scar tissue and allow greater flexibility at the injured part. Your other leg should be bent, with that foot flat on the floor.
Following a wellstructured conditioning program will also help you return to sports and other. Rehabilitation after injury to the medial collateral. The next morning, you wake up and cant walk on that leg. You may do the remaining exercises when you have less pain and swelling in your knee. Massage therapy acl mcl sprain answers on healthtap. As the pain lessens and the swelling decreases, try. Most mcl injuries are contact related, and rarely noncontact injuries. The following schedule serves as guidelines to help in the expediency of returning a patient to his or her pre injury state.
Conservative treatment following ulnar collateral ligament sprains of the elbow phase i immediate motion phase postinjury days 0 7 goals 1. Here are some examples of exercises for you to try. Mcl sprain rehabilitation protocol medial knee ligament. Tighten the thigh muscles of your affected leg by pressing the back of your knee down into the towel.
Deep tissue massage or foam rolling of the local muscles stage 3. With a proper mcl injury rehabilitation protocol, even a complete mcl tear should completely heal. After an injury or surgery, an exercise conditioning program will help you return to. The mcl, unlike other ligaments like the anterior cruciate ligament acl, has a great blood supply. When pressure is applied to the knee from the side, or when the knee is twisted, a tear in the medial collateral ligament can result. When walking, bear weight according to your doctors instructions. Phase 1 begins immediately following injury and may last 4 weeks. The medial collateral ligament mcl is located on the inner aspect, or part, of your knee, outside the joint. Apply ice for 510 mins three times a day to keep down the swelling for the first 72 hours stage 2. Rehabilitation after injury to the medial collateral ligament of the knee. Medial collateral ligament mcl rehabilitation protocol weeks postinjury 12 weeks initiate physical therapy. He reluctantly said i could squat but only with low weights. Distal knee medial collateral ligament repair with suture. Hold for about 6 seconds, then rest for up to 10 seconds.
Be careful getting out of cars, or catching your toe on a rug. You feel a pop on the inside of your leg, next to your knee. In a valgus stress test, you will keep your leg extended with the knee straight while the doctor puts one. Due to the stabilizing responsibilities of the mcl the primary mechanism of injury is a valgus stress to the knee, but can also be due to an anterior translation that would more than likely involve the acl. The primary goal of this protocol is to protect the reconstruction while steadily progressing towards and ultimately achieving preinjury level of activity. Doctor answers on symptoms, diagnosis, treatment, and more. Medial collateral ligament injury of the knee mcl tear. Rehabilitation after injury to the medial collateral ligament of the knee phase 1. Mike ryan is an expert in the sports medicine field.
To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Emphasis on increased resistance using either fins, cuffs, or tethers. Conservative treatment following ulnar collateral ligament. Medial collateral ligament mcl reconstruction repair postop rehabilitation protocol the following is a protocol for postoperative patients following acl reconstruction. Medial collateral ligament mcl rehabilitation protocol. Rehabilitation guidelines for posterior cruciate ligament. The most common knee structure damaged in skiing is the medial collateral ligament, although the carve turn has diminished the incidence somewhat. The medial collateral ligament mcl of the knee is a thick ligament found along the inside of the knee. It is attached to the bottom of the femur thighbone, runs down the inside of the knee, over the joint, and attaches at its other end to the top of the tibia shinbone. For grade 2 and particularly grade 3 mcl sprains, it is important that the ends of the ligament are protected and left to heal without continually being disrupted. Progress should be modified on an individual basis. It provides stability to the inner knee and helps limit outward twisting of the shinbone. This protocol was designed to provide the rehabilitation professional with a guideline of postoperative care. Hopefully my story will help many of you successfully heal your mcl sprain.
It should be stressed that this is only a protocol and should not be a substitute for clinical decision making regarding a patients progression. Home recovery admin december 12, 20 5 replies a quick synopsis of my situation after a slip in a wet soccer field and a series of soccertennis matches i ended up suffering from an mcl sprain probably grade i that was making it almost impossible even to jog find more here. Injury to the mcl is often called an mcl sprain or tear. As a 26 year certified athletic trainer and registered physical therapist veteran in the national football league nfl, mike has outstanding firsthand sports medicine experience in the fields of injury prevention, injury rehabilitation and performance enhancement of elite athletes. The medial collateral ligament mcl is a thickening of the medial or inner knee joint capsule. After two days of swelling, stiffness, and soreness, the orthopedic surgeon diagnosed me with a grade 2 mcl tear and gave me a brace. Regaining a full range of motion of the knee joint is the first priority in this phase of the rehabilitation process. In the midst of some form of activity, you likely twisted or turned your knee at a bad angle, and heard a loud pop.
The mcl is one of the most common knee injuries in competitive and recreational sports and can occur from impact in contact sports or. Advancing too quickly in your sport or activity can. Hamstring rehabilitation and prevention protocol university of delaware sports and orthopedic clinic 415 o stool scoots athlete sits on wheeled stool. It may be difficult to apply pressure on the injured leg for at least a few days. This ligament is one of the four main ligaments that stabilize the knee joint. Uc san diego health offers expert diagnosis and care for mcl sprains and tears. Recovery from an mcl injury is very dependent on the grade of your mcl tear. Mcl injury campus recreation university of nebraskalincoln. The knee should be to be protected with a hinged brace for 3 to 6 weeks, depending upon the severity of the injury. If you suspect that you have a sprained mcl, the doctor will most likely perform a valgus stress test to check for a more serious injury, such as a completely torn ligament. Pdf knee medial collateral ligament injuries researchgate.
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