MCL Tear

What an MCL tear is

The medial collateral ligament runs down the inner side of the knee, from the end of the thigh bone to the upper shin bone. It is a flat, broad band rather than a cord, lying outside the joint capsule, with deeper fibers that blend into the capsule and attach to the inner meniscus. Its job is to resist forces that push the knee inward and keep the joint from opening on the inner side.

Because it sits outside the joint and has a reasonable blood supply, the MCL behaves differently from the cruciate ligaments inside the knee: many MCL injuries have a genuine capacity to heal, and treatment reflects that. The usual mechanism is a force applied to the outside of the knee that drives it inward, which is why the injury is common in football, hockey and skiing; a twisting injury with the foot planted can do the same. Injuries are graded by how much the ligament is stretched or torn and whether the joint opens on examination. An MCL tear can occur alone or alongside injury to the anterior cruciate ligament or medial meniscus.

Symptoms that often bring people in

• Tenderness along the inner side of the knee, often at a specific point
• Swelling on the inner side rather than filling the whole joint
• A sensation that the knee is opening up or wobbling inward under weight
• Pain when the knee is stressed sideways, as in turning or side-stepping
• Difficulty straightening the knee fully after the injury

How it is evaluated

The examination is central here. The surgeon feels along the ligament to find where it is tender, since the location indicates whether the injury is nearer the thigh bone or the shin bone, then applies a gentle sideways stress with the knee straight and slightly bent to see how much the joint opens and whether there is a firm endpoint. The cruciate ligaments and the meniscus are checked as well. X-rays exclude a fracture, which matters particularly in young people whose growth plates are still open. MRI may confirm the grade and show associated damage inside the knee.

Treatment options in general terms

Isolated MCL injuries are commonly managed without surgery, which may involve:

• Protected motion. A hinged brace that lets the knee bend and straighten while limiting sideways stress on the healing ligament.
• Rehabilitation. Restoring motion, then rebuilding quadriceps and hip strength.
• Graded return to loading. Progressing from straight-line activity toward cutting and contact as tolerated.

Surgery is less often required, but may be discussed when:

• The injury is severe or combined. A complete tear alongside a cruciate ligament injury, where both may be addressed together.
• Instability persists. The inner side continues to open up after adequate healing and rehabilitation, in which case repair or reconstruction may be considered.
• The ligament is displaced or avulsed. Certain tear patterns, including those where a fragment of bone has pulled away.

What to expect when you consult Dr. Wolfson

Dr. Wolfson is board certified in the United States and Canada and has treated sports injuries throughout his career. A consultation covers the mechanism of injury, an examination that grades the ligament and checks the rest of the knee, review of imaging, and a plan for bracing and rehabilitation where appropriate. Complimentary phone consultations are available for patients outside the Bay Area.

This page provides general information about MCL tears and is not medical advice. It is not a substitute for examination, imaging and diagnosis by a qualified physician. Every case is different and requires individual evaluation. If you have severe pain, an obvious deformity, loss of function, fever, or an injury from a significant accident, seek medical care promptly.

Contact Dr. Wolfson if you would like to setup an appointment. If you are a new patient, please book all in-person appointments with Dr. Wolfson via telephone.

If you live outside of the San Francisco Bay Area, you can request a complimentary phone consultation with Dr. Wolfson to assess your case. Please call or e-mail us to set up your complimentary consultation.

Call: (415) 221-4400

E-mail: [email protected]