MCL Tear: Causes, Symptoms, Treatment and Cost

MCL tear, or Medial Collateral Ligament (MCL) tear, is an injury to the bands of tissue that connect the thighbone and shinbone at the knee joint. An MCL tear may be caused by a traumatic incident, such as a hit to the outside part of the knee.

There are four different types of MCL tears that can occur: grade 1-grade 4 tears.

• Grade 1 Tear: This type of tear is usually a minor injury consisting of a slight stretching or microtearing of fibers. It may cause pain at the inner aspect of the knee but have no substantial limitation to movement.
• Grade 2 Tear: This tear involves further stretching and partial tearing of some fibers and results in pain at rest and with activity. The patient may experience instability when attempting to turn, pivot, or squat.
• Grade 3 Tear: A grade 3 tear occurs when all fibers are completely ruptured resulting in instability which causes the knee to 'give out' during activities such as turning, pivoting, or squatting. Swelling and extreme stiffness in the knee may also be present.
• Grade 4 Tear: This is an uncommon injury which is essentially two separate injuries occurring at once such as torn MCL along with tears in adjacent structures like ligaments, cartilage or meniscus often seen in athletes.

• MCL tears usually occur due to a direct force or trauma applied to the knee, such as forcible hyperextension, or twisting on a flexed knee.
• MCL tears are often brought on by contact sports injuries, falls, and vehicle accidents.
• Repetitive movements that stress and weaken the tissue over time can also cause MCL tears.
• Excessive pronation of the foot during running or walking can lead to repetitive strain of the knee joint and MCL tears over time.
• Tight calf muscles and weakness in other muscles around the knee joint may contribute to tears as well.

• Pain and swelling in the knee, usually on the inner side of the joint.
• A sense of instability or weakness in the impacted knee.
• Movement restriction because bending or straightening the knee causes pain.
• Popping or snapping sensation at the time of injury.
• Possible bruising across the entire length of the affected MCL.

• Strengthen your leg muscles: Include exercises such as squats, lunges and leg extensions into your exercise program that strengthen your quads and hamstrings.
• Increase flexibility: Use dynamic stretching to target the muscles around the knee joint including quadriceps, hamstrings and calves prior to physical activity.
• Improve technique in movements: Slow down quick movements and ensure proper foot placement to avoid overstressing your knee joint.
• Wear appropriate footwear: Shoes with adequate cushioning, grip, support and traction will help protect the knee joint from overstressing during physical activities.
• Wear a brace or wrap: When performing activities with cutting motions or side-to-side impact (such as skiing or volleyball), wearing a supportive brace can help limit sudden movement of the knee joint that can cause an MCL tear.

• Physical examination: Upon physical examination, your doctor can palpate the knee joint to determine if there is tenderness, swelling, or instability of the joint. He/she may also check for range of motion and can assess whether the patient experiences pain when certain movements are attempted.
• MRI of the knee: MRI of the knee can be used to diagnose a MCL tear. An MRI is able to identify the presence of any tear in the medial collateral ligament, as well as any associated damage in other parts of the knee joint. The MRI image can also provide information about how serious the MCL tear is and how much rehabilitation may be needed for a full recovery from the injury.
• X-ray: An X-ray of the affected area may be necessary in order to accurately diagnosis a tear in the MCL. An X-ray can help determine if there are any fractures present, or if there is any noticeable swelling or deformity of the area, which may indicate a tear.
• Ultrasound: Ultrasound can be a useful tool in diagnosing an MCL tear. It allows the doctor to see in detail the structure and condition of the knee joint and surrounding ligaments. Ultrasound can help to assess if the MCL is torn, partially torn, stretched or intact.
• CT scan: A CT scan can be used to diagnose a McI Tear, by showing any damage or abnormalities in the soft tissues in the area. It may also be able to show any areas of calcification or bone inflammation, which can indicate a tear.

• Pain and swelling: damage to the MCL leads to immediate pain and swelling in the knee.
• Instability: MCL tears often lead to instability of the knee, which can cause difficulty with regular activities or sports.
• Loss of flexibility: Because of the instability, people may have a decrease in knee flexibility or range of motion.
• Risk of further injury: With an MCL tear, individuals may be at risk of other serious injuries to their knee or leg due to poor coordination while walking or running on an unstable joint.
• Muscle imbalances: Damage to the MCL can lead to muscle imbalances around the knee joint, which can affect movement and balance capabilities and potentially cause further injury down the line if not corrected through physical therapy or manual techniques like mobilization and taping techniques.

• Turmeric: Soak one teaspoon of turmeric in one cup of milk and consume it twice a day to reduce the pain associated with MCL Tear.
• Ginger: Ginger, when taken in the form of capsules or pills, can help reduce inflammation and heal the MCL tear.
• Hot and Cold Therapy: You may alleviate the discomfort, swelling, and inflammation from the tear by alternating 15-minute applications of hot and cold compresses.
• Panchamrit: Make a mix of five-spice herbs (cumin seeds, fenugreek leaves, coriander seeds, aniseed powder and black salt) in water as a decoction for medicinal purposes to soothe an MCL tear.
• Massage Therapy: Massage therapy helps stimulate blood circulation around the affected area which helps reduce pain and improve joint mobility associated with an MCL tear.

• MCL tears can cause pain, swelling and instability in the knee, so eating foods that reduce inflammation can help address the problem.
• If you've just suffered an MCL tear, you may find relief by eating more anti-inflammatory foods including fruits, vegetables, healthy grains, nuts, and fatty fish.
• Having enough protein to help repair and restore muscles is also crucial.
• In particular, foods high in omega-3 fatty acids, such salmon, tuna, and sardines, help repair MCL tears by reducing inflammation.

• Avoid foods high in saturated fat such as butter, lard, cream and fatty meats.
• Avoid processed or fried foods and foods high in sodium such as French fries, chips, canned soups and lunch meats.
• Stay away from carbonated drinks or drinks that contain alcohol or caffeine, since these can further irritate the inflamed joint area.
• Restrict your intake of white flour-based dry goods like crackers and pretzels.

• Rest: Allow the injured area to rest and avoid activities that increase pain.
• Ice/Heat: The swelling and pain in your knee might be alleviated by using either ice or heat.
• Compression: Utilize a compression bandage for additional support and to restrict swelling.
• Elevation: Keep affected area elevated above the heart level when possible to reduce inflammation
• Medicines: Take medications prescribed by a doctor, to manage pain and inflammation.
• Physical Therapy: Strengthen weakened muscles with physical therapy exercises and improve range of motion with stretches, therapeutic massage, ultrasound, or cold laser therapy
• Arthroscopic Surgery: Arthroscopic surgery is often used to diagnose and treat a MCL tear. It involves making small incisions around the knee in order to insert a thin camera called an arthroscope in order to look inside the joint and repair any damage that has been caused by the tear.
• Open Reconstruction: Open reconstruction can be used if a MCL tear is severe or if other treatments have not been successful in healing a MCL tear. During this procedure, larger incisions are made and specialized techniques are used in order to reconstruct and tighten the ligaments of your knee as well as repair any other tissue that may have been damaged during the tear.

An orthopedic surgeon should be consulted for a MCL tear, which is an injury to the inner ligament of the knee.

If you suspect that you have a MCL tear caused by force or a twisting or rotational motion, it is important to seek medical attention right away.

• Non-steroidal anti-inflammatory drugs (NSAIDs): NSAIDs are a type of medicine that is often used to treat the pain and swelling caused by a MCL tear. Examples of over-the-counter NSAID medications are ibuprofen (Advil, Motrin IB) and naproxen sodium (Aleve).
• Corticosteroid injections: Corticosteroid injections are a common treatment for MCL tears, as they can reduce inflammation and swelling in the affected area. The doctor will inject the medication directly into the affected area of your knee to reduce pain and inflammation quickly.

Depending on how severe the injury is, it usually takes 6–8 weeks for an MCL tear to heal. Exercises may be used to strengthen the muscles around the knee and improve its range of motion. Surgery is sometimes necessary for severe tears and may add an additional 3-4 months to the recovery process.

• In most cases, the treatment results for an MCL tear can be permanent.
• Depending on the degree of tear and severity of the injury and treatment, there may be some minor problems that may arise over time.
• Recovery can take anywhere from a couple weeks to a few months.
• Following proper rehabilitation guidelines is key to ensure long-term relief from MCL issues.

Post-treatment guidelines for an MCL tear include:

• RICE Method: The RICE method (Rest, Ice, Compression, and Elevation) should be used immediately after treatment to help minimise swelling and inflammation and protect the joint.
• Medications: Always follow your doctor's advice while taking medication.
• Exercise Therapy: Exercise programs are designed to restore full range of motion, muscle strength and coordination in the joint through specific strengthening exercises administered by a physical therapist.
• Bracing/Splinting: A knee brace or splint may be prescribed following treatment to provide stability for the joint during exercise and reduce chances of re-injury or further damage to the ligament.
• Follow Up Appointments: It is important that a patient continues to follow up with their doctor or physical therapist regularly after their initial surgery or injury in order to monitor progress and ensure proper healing occurs over time.

The cost of MCL Tear treatments in India can vary, depending on the severity of the injury and other factors such as the type of medical facility.

However, on average, a simple MCL Tear treatment can cost anywhere between Rs.3000 to Rs.20000.

In more serious cases where surgery is required, the cost can be even higher and can reach up to Rs.100000 or more.

Discomfort and swelling in the injured leg: Most treatments for an MCL tear such as rest, physical therapy, and bracing will cause some degree of swelling and discomfort in the area of the injury.

Loss of strength: Resting, bracing or immobilization can lead to a decrease in muscle strength in the affected leg while it is healing.

Loss of range of motion: Again depending on the severity of injury and type of treatment, some loss of range in motion when bending or extending the knee may occur with MCL injuries.

If you are experiencing any symptoms that may be associated with an MCL tear, you should make an appointment with a local physician as soon as possible. MCL tears can cause complications such as 'loss of flexibility, muscle imbalances, and instability,' the treatment for which can last anywhere from a few months to years based on the severity of the situation.