About Physiatry

Medial and Lateral Collateral Ligament Injuries

Condition: The medial and lateral collateral ligaments (MCL and LCL) are bands of tissue that connect the thigh bones to the lower leg bones at the knee and serve to stabilize the knee. The MCL is on the inside of the knee, while the LCL is on the outside of the knee. Injury to these ligaments can include strains, sprains, or tears.

Background: Injury to either ligament can be caused by twisting or sudden blows to the knee. These injuries typically occur in contact sports, such as football and soccer, or in sports that involve rotation, such as skiing and ice skating. The MCL is the most commonly injured knee ligament, and LCL injuries are usually associated with more severe knee injuries.

Risk Factors: Males experience twice the injury rate of females. Individuals who ski or play football, soccer, or rugby also have increased risk of collateral ligament injury.

History and Symptoms: The mechanism of injury (twisting or a blow to the knee), location of the injury, and exacerbating/alleviating factors are important to determine. Pain, swelling, bruising, instability, and a locked joint are often present.

Physical Exam: A physical exam will be performed to examine the knee for any obvious deformity, the ability to bear weight on the injured leg, range of motion, swelling, tenderness, looseness in movement of the ligaments, and sensation in the leg.

Diagnostic Process: MRI and ultrasound are typically used to assess collateral ligament injuries, although X-rays can also be used to assess for fractures and aid in diagnosis.

Rehab Management: Isolated knee collateral ligament injuries typically heal in weeks to months, depending on the severity of the injury. Bracing of the knee may be beneficial early in rehabilitation, and symptoms may be treated with PRICE (protect, rest, ice, compression, elevation) principles. Strengthening of leg muscles is helpful, and aerobic exercise and conditioning is recommended as soon as possible. Specific sports training should begin when pain and instability no longer occur. Surgical repair may be necessary for severe injuries.

Other Resources for Patients and Families: The patient and family should be advised that healing of these injuries is typical; however, premature return to sports may lead to chronic problems. Athletic trainers can be useful resources for rehabilitation.


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