Medial collateral ligament is a strong band of fibrous tissue on the medial aspect of the knee. One of the main functions is to resist excessive valgus strain (inward force) on the knee. Injuries to the medial collateral ligament (MCL) are usually seen in sports like skiing, football, rugby, etc. It usually get injured along with anterior cruciate ligament (ACL) or the menisci of the knee.
Mechanism of injury
Usually an excessive force on the outside of the knee causing the knee to buckle inwards excessively causes injury to the MCL. Also, excessive force from the inside causing the ankle to move outwards can cause a similar injury.
Other mechanisms of injury can involve forceful rotational movement along with hyperextension of the knee and excess valgus strain. This then involves injury to the menisci in addition to the ACL along with the MCL. This classic clinical picture is called the O'Donoghue's Triad.
Sympmatology
Usual symptoms during presentation are: pain over the medial aspect of the knee, swelling and a feeling of the knee being unstable or wobbly. Joint effusion (due to collection of blood) can occur immediately or in a while.
Grade of Injury
Depending on the severity of injury, MCL injuries are classified from grade I to grade III; grade I being minor strain due to over stretching and grade III being total disruption of the ligament. Needless to say, treatment and rehab depends upon the grade of injury.
Treatment
'PRICE' treatment is the initial treatment of choice. Further treatment is guided by the grade of injury as well involvement of other ligaments. Injuries to the MCL in combination with the menisci usually require surgical intervention.
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