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 the ligament. 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. You may need X-rays or an MRI of your knee.

How is it treated?

To treat this condition:

• Put an ice pack, gel pack, or package of frozen vegetables, wrapped in a cloth on the area every 3 to 4 hours, for up to 20 minutes at a time.
• Raise the knee on a pillow when you sit or lie down.
• Take an anti-inflammatory medicine such as ibuprofen, or other medicine as directed by your provider. Nonsteroidal anti-inflammatory medicines (NSAIDs) may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days.
• Wrap an elastic bandage around the knee to keep the swelling from getting worse.
• Wear a knee immobilizer or knee brace as directed by your provider.
• Use crutches until you can walk without pain.
• Follow your provider’s instructions for doing exercises to help you recover.

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

How long will the effects last?

How long it takes to recover depends on your age, health, and if you have had a previous knee injury. Recovery time also depends on the severity of the sprain. A mild sprain may recover within a few weeks, but 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 depends on 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 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?

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.