Ski season is upon us here in the high country. One of the most common ski injuries we see is a medial collateral ligament sprain (MCL) in the knee.
This injury is also common in cutting sports such as soccer and basketball and can even happen with a simple slip and fall.
The MCL is one of the main support ligaments in the knee. It attaches on your femur crosses the joint and inserts on the tibia on the inside or medial side of your knee. The function of this ligament is to provide static stability to your knee and is especially stressed with lateral movements. The way this ligament gets sprained is when a valgus force is placed on the knee. In English that means the knee is pushed toward the inside. This can happen from a force being placed on the knee, like a tackle in football, or with the foot being planted and the body falling while the foot sticks. Many ski falls happen like this. Especially when a ski is caught in deep or heavy snow or someone falls and the skis split apart and don’t come off.
If you have sprained your MCL the most likely symptoms are as follows:
- Pain and tenderness on the inside of the knee
- Some swelling can occur over the inside of the knee
- Instability or pain over the medial knee especially with lateral and rotational movements
- Knee stiffness, especially in the morning or after sitting for an extended period
Mileage may vary with symptoms as everyone presents differently, and other injuries such as ACL tears and meniscus tears can happen along with MCL tears. If you have a trauma as described and knee pain and swelling you should get it checked out by a physician or physical therapist. A physical exam can determine if it is the ligament and rule in or out other possibilities which may need imaging to diagnose.
If you have sprained your MCL, then you need to protect it and control swelling to allow it to heal properly. If the ligament is stressed too early it can heal improperly and affect the long term stability of the knee. Full ligament healing can take 6-12 weeks depending on the severity of the injury, the health of the individual, and other variables. To protect the ligament in the acute stages you need to avoid frontal plane (think side to side) movements and rotational movements. Most people feel fairly comfortable with sagittal plane movements (think straight line) fairly quickly. In some cases using a simple hinged knee brace can be helpful in protecting from lateral stresses. Initial exercises in the knee should be pain free at the ligament and in the sagittal plane. Usually spinning a bike, heel raises, dead lifts and mini squats are early exercises that can be safe. Any lateral movements should start away from the knee such as hip exercises. Once enough healing occurs these lateral and rotational movements can be gradually added back in with protected exercises ramping up to full speed. Prior to returning to sport you should be able to perform all lateral and rotational movements at full speed in a protected environment.
MCL sprains can put your sporting activities on the shelf for a while, but most will heal very well if given the proper treatment. If you have any questions about an MCL injury or other knee issues drop us a line.