Managing a MCL Tear
It is crucial to rest in order to treat a MCL tear to prevent further damage to the ligament and to stay away from any activity that could strain the knee or cause any more discomfort or pain. Continuing strenuous activity or even resuming sport will not only slow down the healing process but it could potentially increase the risk of further damage to the ligament and surrounding tissue. It is important to apply the RICER method as soon as possible to reduce swelling and inflammation of the area. This should be done within the following 72 hours after the injury has occurred. RICER involves Rest, Ice, Compression, Elevation and Referral. This should be done for all Grade 1, Grade 2 and Grade 3 MCL tears. Rest: Rest the injured site for 24-48 hours before engaging in active rehabilitation depending on the severity of the tear. Without rest, the injured site is under stress and this prolongs recovery and interferes with the healing process of the knee. Ice: To control the swelling of the knee, apply ice for 15 minutes every two hours for the first two days. The rest of the week the frequency can be reduced to three times a day. This also helps maintain the ability to straighten and bend the knee more than 90 degrees. Ice decreases swelling, bleeding and pain to the injured site. Compression: Apply an elastic wrap or bandage to the knee continuously for 72 hours. This is an important factor in reducing swelling as it reduces the space available for swelling to increase. Elevation: Elevate the knee as often as possible during the first 72 hours to reduce bleeding, swelling and pain. Elevating above the level of the heart will provide the best benefits. These also include eliminating blood pooling and draining other fluids from the injured site. Referral: Always refer to a doctor or physiotherapist. |
For an initial assessment of a suspected MCL tear the following should be done:
Observation: Observing the joint for swelling or bruising and feel around the area for tenderness, warmth etc. Range of motion: Bend and straighten the knee yourself and relax. Range of motion is often only affected in patients with more severe tears. Resisted muscle tests: Bend and straighten against resistance which causes the muscles to contract. This pain upon contraction suspects a muscular injury. Valgus stress test: The knee is slightly bent whilst stabilising the thigh, applying an outward pressure on the lower leg which will stretch the medial ligament. If there is pain on the inside of the knee indicates a MCL tear. |