The knee joint is a complex joint made up of three bones namely a part of thigh bone (femur), lower leg bone called tibia and the kneecap (patella). Knee joint is large joint in the body and is extremely important for mobility. The bones in joint are connected with each other by ligaments. Ligaments are bands of fiber. There are 4 main ligaments in the knee joint which keeps the knee joint stable.
In majority of cases knee ligament injury is caused while playing contact sports such as football and hockey. Among them the medial collateral ligament (MCL) injury is most common.
Causes Of Medial Collateral Ligament Injury
Medial collateral ligament (MCL) is an important ligament of knee joint. It is located in the inner side of knee. MCL connects the lower end of femur (thighbone) with upper end of shinbone in the knee. MCL is thick and strong band of tissue. This ligament holds the bone tight and together to maintain strength and stability of the knee joint. It also prevents extreme inward extension of the leg and facilitates easy rotation of the leg.
In majority of cases medial collateral ligament injury occurs due to direct hit on the outer side of knee. The blow causes stretching on the inside or medial ligament. If the blow is severe it can result in tear of the MCL. MCL injury is mainly seen among athletes and sports persons. People playing football, hockey or any contact sports are vulnerable to suffer from MCL injury. However, MCL injury can also occur due to repeated stress. In majority of cases along with MCL injury the anterior cruciate ligament is also injured or torn.
Symptoms Of Knee Medial Collateral Ligament Injury
MCL injury is graded according to its severity.
- Grade 1– This is a minor injury where person complains of tenderness over the medial part of knee joint. The ligament is stretched beyond its limit but there is no tear.
- Grade 2– The MCL is partly torn which leads to some form of instability of knee joint. Patient complains of mild to moderate pain and tenderness. There is occasional swelling.
- Grade 3– It is a severe form of ligament injury. Patient complains of excruciating pain in inside part of knee. There is immediate swelling after the tear and patient is not able to move his leg. Joint become unstable and patient is not able to stand erect on his leg.
The common feature of MCL injury whether it is just a damage or complete tear are as follows:
- Sudden pain in inside part of knee with popping sound.
- Sudden swelling and stiffness of knee.
- There is marked tenderness over the injured area on medial side of the knee.
- Patient feels as if the knee is popping out when he puts his leg on ground and tries to stand on the knee.
- Locking of the knee joint.
Diagnosis And Treatment Of MCL Knee Injury
MCL is diagnosed by a medical practitioner, especially by the orthopedic surgeon. The doctor while examining will be able to tell whether there is ligament injury by performing certain maneuvers. History of trauma while playing sports also helps in diagnosis of the condition to certain extent. However, X-ray of the knee joint, CT scan and MRI of knee are three important imaging techniques that help to conclude and pinpoint the damage to the ligament.
The treatment of MCL injury will depend on its severity. Most mild cases of MCL injury heal with few days of rest. However, severe tear or grade 2 and 3 injury requires intensive treatment. After the injury patient may need immediate help. In such cases the primary aim is to alleviate pain and make the knee joint stable. Apply ice fomentation over the injured knee area for five to ten minutes. This will help in reducing pain and swelling.
Help the patient to keep his leg elevated above the level of his heart when he is resting. Painkiller medicines will be effective in reducing pain. Compression bandage and avoiding standing or walking on the injured knee is important for early healing. Patient can use crutches for few weeks or days.
Once the patient starts recovering from the injury, the next step after few weeks is to strengthen the knee joint. This will require a rehabilitation program which consists of physiotherapy exercise for improving the mobility of the joint. Wearing knee brace while walking and performing regular tasks and limiting sports activity is essential.
In case of severe injury such as complete MCL tear, patient has to undergo corrective surgery.