Nonoperative MCL Rehabilitation Protocols

The medial collateral ligament, or MCL, can be a painful ligament to injure. Typically if the ligament is not completely ruptured, a rehabilitation regiment can bring the knee back to complete health without surgery. Rehab time frames depend on the severity and nature of the injury, and may cause some pain as the knee rebuilds strength.

After the Injury

• Many MCL tears and strains are the result of a force that pushes the knee inwards, shearing the ligament. First and foremost, the knee should be placed in an immobilizer to prevent the same sideways motion from occurring again, as the knee has already had its stability compromised. Ice is recommended to mitigate swelling, though chemical ice should be wrapped in a cloth rather than applying it directly to the skin. Furthermore, until the knee gains enough stability through tissue rebuilding, you should keep weight off of the knee through the use of crutches.

Range of Motion

• It is important to regain complete range of motion before strength training. This is a painful step in the rehab procedure, as the knee is often swollen, and the swelling can result in tissue cells attaching themselves to the torn part of the ligament, which is still very tender. It can also attach to other parts of the knee, commonly the meniscus. When the knee bends, it tugs at this tissue, which will cause pain. The sooner the tissue is loosened up, the better chance it will fully recover.

  Often the knee is placed in an immobilizer after an injury, and until the scope is determined through an MRI and/or X-rays, it is wise to keep it immobilized. Once your MCL injury is diagnosed, you can work on bending your knee on a table. Sitting on the edge and bending your knee downward as well as laying on the table and sliding your foot back toward your body along the table can help regain your range of motion.

Strength Building

• Once you have your range of motion regained, it is time to begin rebuilding muscles in your knee. Isometrics such as leg raises and quad sets can help the muscles remember how to contract, but they do not build muscle. Light weight training, including knee presses and quad lifting, will reconstruct muscles and will help stability. Machine training is preferential to free weight training, as motion can be more easily controlled.

  Once you have rehabbed enough to return to sports, according to the American Academy of Orthopedic Surgeons, you may be advised to wear a knee brace to stabilize the knee during lateral movement.