What is an Mcl Tear?
Mcl Tear is a thick tissue in the knee that connects the tibia, also known as shinebone to the bottom of the femur, also referred to as the thigh bone. Its function is mainly to hold bones together, preventing them from bending inwards. It also stabilizes the knee and allows it to rotate.
Injuries to these ligaments can lead to MCL tear or stretch. The injuries mostly occur when one hits the outer knee very hard, hence causing the MCL or other ligaments in the knee like the anterior cruciate ligament (ACL) to tear.
MCL tear is very common to sportsmen such as football and rugby players as their profession involves a lot of falling and hitting the knee, a lot of going and stopping movements, or sometimes even jumping.
Types
Grade 1
This is minor and the least severe where the ligament only stretches, but does not get torn. It is more easy to treat compared to the other grades.
Grade 2
In this type, the ligament becomes partially torn upon impact causing instability in the knee joint.
Grade 3
In this case, the ligament is usually completely torn. It is a more serious type and it also causes joint instability, and can be seen as wobbling.
Causes
When one puts repeated stress on the knees by kneeling or hitting the knee against hard surfaces, it can make the MCL lose its elasticity and become worn out.
In everyday life, it can occur that one slips and his the ground so hard, landing on the knees. This impact or twist to the knee can lead to tearing of some or all the fibres. This may lead to medial cartilage meniscus injury. In the process it may also lead to the tearing of anterior cruciate ligament.
Signs and Symptoms
The signs and symptoms of MCL tear depend on the severity of the injury, though the common ones include:
- Pain, tenderness, stiffness and swelling along the inner part of the knee.
- Upon injury, one might feel a pop sound in the knee
- Problem of knee instability may be visible in grade 2 and 3 injuries
- In some cases, it may be difficult to make knee movements
Grade 1 symptoms
This usually presents mild symptoms where one may experience mild tenderness but no swelling. The knee usually becomes bent at angle of about 30 degrees. When force is applied on the knee, some mild pain is felt. The joint does not become loose and less than 10% of the fibers become torn.
Grade 2 symptoms
Just like in grade 1, one may feel some tenderness in the knee, but unlike in grade 1, there will be swelling. Applying stress or pressure in the area will result to mild to moderate pain.
Grade 3 symptoms
This is more serious compared to grade 1 and 2, as there is complete tear of the ligaments. The pain may be worse compared to grade 2 and when a valgus test is done, it will confirm positive to significant joint laxity. One has an unstable knee making it wobbly.
Diagnosis
First the doctor would like to know how the injury happened, and how you felt afterwards. He or she would like to know of any history of knee injuries so as to come up with the diagnosis.
The doctor will further press along the inner side of the knees to check for pains and tenderness while the leg is straight and bent. The patient might experience some pain when this is being done.
Imaging tests such as an X-ray can also be performed on the bones of the knees to narrow down to the exact problem. Also, the doctor can have magnetic resonance imaging (MRI) to scan the image of the knees to get a clear picture.
Treatment
1. Self-care
Most of the MCL injuries heal on their own, hence one can rest the knee at an elevated angle while pressing ice against it for about 15-20 minutes for 3 times a day. This is the P.R.I.C.E principle that involves resting, icing, compressing, and elevation. This helps to reduce the swelling and the pain.
One can wear a lightweight cast or a brace to prevent sideways movement, reduce swelling, protect the knee as well as restrict the amount of movement or knee bending. You can also use crutches to reduce the amount of weight exerted on the injured knee.
The injured can take pain medication such as ibuprofen and aspirin to relieve pain and also take nonsteroidal anti-inflammatory drugs (NSAIDS) such as naproxen (Aleve) to also help with the pain and swelling.
You can also do non vigorous exercises such as stretches or strength exercises as advised by the doctor.
Surgery
Surgery is done in serious cases where the ligament is torn in such a way that it cannot repair itself. To know the extent of the injury and other associated injuries, the surgeon will use arthroscopy. This is a small and thin camera that is inserted through an incision to check the injury.
The surgeon will make an incision along the inner part of the knee and after examination, the torn ligament can be attached by either using a metal screw, large stitches, bone scalpels or suture anchor. If the ligament is torn in the middle, the surgeon will stitch it.
Electrotherapy
This is where the doctor uses ultrasound treatment. High frequency sound waves are used on the injured area. The use of an interferential machine or A Tens involves applying electric currents to relieve pain and swelling.
Taping
Taping the knee can also be a technique to provide support and protection. However, over time, the tape slightly stretches and may need good maintenance such as reapplying.
Recovery
Since grade 1 is minor, it takes a few days to heal. Grade 2 can take up to a month and grade 3 takes the longest time of about 8 weeks or more to heal. It is recommended that you call your doctor if the symptoms persist, that is, if the pain and swelling are getting worse.
Reference List
- MCL tear.www.ucfhealth.org/conditions/mcl_tear/
- MCL treatment. www.webmd.com/fitness-exercise/tc/medial-collateral-ligament-mcl-injury-topic-overview
- Diagnosis of MCL tear.www.healthline.com/healthline.com/health/medial-collateral-ligament-mcl-injury-of-the-knee?s_con_rec=false&r=00
- Symptoms of MCL tear.www.sportsinjuryclinic.net/sport-injuries/knee-pain/mcl-strain
