Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

MCL Injury

FAQS on Medial Collateral Ligament (MCL) injury

 

Medial collateral ligament or MCL injury forces at least dozen of soccer, football, baseball, basketball, and ice hockey players out of action every year. In athletes and young kids, the tears are more common with the connective tissue is more frequently injured than any other knee ligament. Unless treated, it can result in knee fractures.

What is MCL injury?

MCL injury means “sprain or tear in the medial collateral ligament.” The ligament is responsible to prevent inward bending of the knee. A forceful and quick bending of the knee or its sudden change of direction overcomes the biomechanical limits of the medial collateral ligament causing overstretched sprain, partial tear or complete tear.

There are three types of MCL injuries that one suffers from.

  • Grade one MCL injury meaning overstretched or sprained ligament. No tears or major side effects, as a few fibers are torn. There is pain without impacting knee function.
  • Grade two MCL injury refers to partial tears that can cause knee joint instability, pain, and loss of some functions. Tears appear in a significant number of fibers.
  • Grade three MCL injury indicates all fibers in the ligament are ruptured leading to complete tear. The knee becomes unstable with significant loss of function.

How does MCL injury occur?

An MCL injury is the result of failure of the ligament to withstand disproportionate mechanical load on it. Medial collateral ligament positioned in the inner aspect of the knee connects the femur with the lower leg bone. Short and inclining backward, the ligament keeps the knee stable by preventing its inward bending, side-to-side movements, and “resist forces pushing the knee medially or twisting it”

When there is excessive force, the medial collateral ligament is overstretched in an effort to resist it and sprains or tears occur. Similarly, MCL injury onsets when the ligament is subject to immense force striking the knee joint from outside. The ligament fends against any force trying to buckle the knee joint or pushes bones inside apart. Tears and injuries are likely as it is overstretched to resist the condition.

What are the symptoms of MCL injury? When to see a doctor?

  • Pain inside the knee
  • Swelling and tenderness in the knee inner aspect
  • Knee stiffness following rest
  • Knee joint instability and loss of motion
  • Catching or locking sensation in the knee
  • Knee giving away feeling
  • Discomfort, pain while walking or weight lifting

What are causes MCL injury?

  • Excessive strain on medial collateral ligament
  • Valgus forces on the knee
  • Repetitive stress on the ligament beyond its biomechanical limit
  • Twisting of the knee
  • Rapid change in direction while walking, running, or playing contact sports
  • Forceful, incorrect landing impacting the knee
  • Knee collision
  • Breaststroke kicking by swimmers
  • Anterior cruciate ligament (ACL) injury
  • High impact or traumatic injury impacting the knee
  • Week knee muscles or alignment

How is MCL injury diagnosed?

  • Physical Exmination
  • A thorough analysis of MCL injury symptoms
  • Verification of the knee for swelling and tenderness
  • Inquiry about medical history and any previous knee injury
  • Analysis of patient’s ability to perform passive and active range of movements

 

  • Imaging Tests
  • Ultrasound or MRI to spot injury to ligaments and muscles around the knee joint
  • Knee joint x-rays to rule out any other injury

What are the treatment methods available for MCL injury?

  • Conservative Therapy

This includes rest, self-care methods, icing, and physical therapy. You should change your activities that put stress on the knee. Swelling can be controlled with the knee kept in an elevated position. A brace can be wrapped around the injured joint so that there is no sideways force on the torn ligament. You may also use crutches so that there is minimum weight pressure on the knee joint. Strengthening exercises are good to restore knee joint mobility and build up muscles around it.

  • Anesthetic Injections

Anesthetic medications are injected to provide pain relief for months while the healing occurs. It also controls swelling allowing knee pain-free movements.

  • Prolotherapy

Stem cells or platelet rich plasma is injected to activate the regeneration and repair of the medial collateral ligament. The process is based on regeneration of the body cells.

  • Surgical Treatment

Surgery for MCL injury is rare and most of the tears heal with non-surgical treatment. Repair surgery may be required only if the ligament is torn in such a manner that it need to be re attached.

What are the likely outcomes and chances of MCL injury recovery? How long will it take to heal?

The healing process is subject to severity of the injury and individual medical conditions. A Grade 1 tear heals within 1 to 2 weeks. Grade 2 tears may take 2 to 4 weeks for the repair process to take over and patients can resume activities within after 4 to 6 weeks. Grade 3 tears may require up to 8 weeks to heal. However, if the MCL injury is associated with ACL injuries, it may require a few months for rehabilitation and return to full strength level.

References

Torg, J. Natural history of the posterior cruciate ligament-deficient knee. Clinical Orthopaedics. 1989; 246:208-216

Lysholm, J. Long-term results after early treatment of knee injuries. Acta Orthop Scand. 1982; 53:109-118.

Mark T. Wheaton & Nicole Jensen. The Ligament Injury-Osteoarthritis Connection: The Role of Prolotherapy in Ligament Repair and the Prevention of Osteoarthritis. Journal of Prolotherapy. 2011;3(4):790-812.

Ross A. Hauser & Erin E. Dolan. Ligament Injury and Healing: An Overview of Current Clinical Concepts. Journal of Prolotherapy. 2011;3(4):836-846.

Phinit Phisitkul, et al. MCL Injuries of the Knee: Current Concepts Review. Iowa Orthop J. 2006; 26: 77–90.

Roach CJ, Haley CA, Cameron KL, Pallis M, Svoboda SJ, Owens BD. The epidemiology of medial collateral ligament sprains in young athletes. Am J Sports Med. May 2014;42(5):1103-9.

Albright JP, Powell JW, Smith W, et al. Medial collateral ligament knee sprains in college football. Effectiveness of preventive braces. Am J Sports Med. Jan-Feb 1994;22(1):12-8.

Lundberg M, Messner K. Long-term prognosis of isolated partial medial collateral ligament ruptures. A ten-year clinical and radiographic evaluation of a prospectively observed group of patients. Am J Sports Med. Mar-Apr 1996;24(2):160-3.

Reider B, Sathy MR, Talkington J, et al. Treatment of isolated medial collateral ligament injuries in athletes with early functional rehabilitation. A five-year follow-up study. Am J Sports Med. Jul-Aug 1994;22(4):470-7. [Medline].

Medial collateral ligament; Wheeless’ Textbook of Orthopaedics

Miyamoto RG, Bosco JA, Sherman OH; Treatment of medial collateral ligament injuries. J Am Acad Orthop Surg. 2009 Mar;17(3):152-61.

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