Medial Collateral Ligament Injuries: Recovery Tips and Home Care

Medial collateral ligament (MCL) of the knee?

Hello, Doctor.
When I was 14 years old (now I'm 16), I suffered a torn anterior cruciate ligament and a meniscus tear while playing basketball (I had an MRI done), but I did not undergo surgery.
Since then, sometimes when I play basketball, my knee feels unstable and hurts a bit, but after straightening it out, the pain goes away, and I can continue to exercise.
Last October, while training for track and field, I injured my medial collateral ligament.
I consulted a doctor, who said there was no bone injury and diagnosed me with a knee contusion.
This week, I gradually resumed track training, and I don't feel pain during daytime training.
However, at home in the evening, I do stretching exercises, and one of them targets the quadriceps.
After stretching, I heard a "pop" in my knee, and it felt like the medial ligament shifted to the center, causing sudden pain and difficulty straightening my leg.
The next day, it still hurt a lot, especially when getting up from a seated position or walking.
Now it's been six days; I've been consistently icing and massaging the area.
Although it has improved significantly, I still experience some pain while walking, and it is difficult to fully straighten my leg when getting up from a seated position, with some pain afterward.
What could be the issue? Besides resting, are there any methods I can do at home to improve my condition? Should I continue icing, or is it time for heat therapy? Lastly, thank you very much for your response!

Xing, 10~19 year old female. Ask Date: 2017/02/12

Dr. Shi Guozheng reply Orthopedics

In addition to rest, applying heat is advisable, and it is currently not suitable to engage in vigorous exercise.
Typically, it is best to rest a ligament injury for about six weeks.

Reply Date: 2017/02/12

More Info

It sounds like you are dealing with a complex situation involving multiple knee injuries, including a previous anterior cruciate ligament (ACL) tear and a recent injury to your medial collateral ligament (MCL). Given your age and active lifestyle, it's crucial to approach your recovery with care and a structured plan.

Understanding Your Condition
From your description, it seems that you have experienced instability in your knee, particularly when engaging in sports activities. The "pop" sound you heard during the quadriceps stretch could indicate that the MCL is under stress or that there may be some irritation in the joint. The pain you feel when trying to stand up or walk could be due to inflammation or strain in the knee joint, particularly affecting the ligaments and surrounding muscles.

Recovery Tips
1. Rest and Activity Modification: It's essential to allow your knee to rest, especially after experiencing pain and instability. While it's great that you want to continue training, you may need to modify your activities to avoid further strain on your knee. Consider low-impact exercises that do not put excessive stress on the joint, such as swimming or cycling.

2. Ice and Heat Therapy: Continue using ice for the first 48-72 hours after the injury to reduce swelling and inflammation. After that, you can switch to heat therapy to promote blood flow and relax the muscles around the knee. However, if you notice swelling returning, revert to ice.

3. Gentle Stretching and Strengthening: Focus on gentle stretching exercises for your quadriceps, hamstrings, and calves. Strengthening exercises for the muscles around the knee can help provide stability. Consider isometric exercises, where you contract the muscles without moving the joint, to build strength without stressing the knee.

4. Physical Therapy: If possible, consult a physical therapist who can provide a tailored rehabilitation program. They can guide you through specific exercises that will help strengthen your knee and improve your range of motion while minimizing the risk of further injury.

5. Knee Support: Using a knee brace during activities may provide additional support and stability, especially if you are returning to sports. However, ensure that it fits well and does not restrict your movement excessively.

6. Pain Management: Over-the-counter anti-inflammatory medications (like ibuprofen) can help manage pain and swelling, but consult with a healthcare professional before taking any medication, especially if you have allergies or other health concerns.

7. Gradual Return to Activity: As you start to feel better, gradually reintroduce activities. Pay attention to your body; if you experience pain, it may be a sign to scale back.
8. Monitoring Symptoms: Keep track of your symptoms. If the pain persists or worsens, or if you experience significant swelling, instability, or difficulty walking, it’s essential to seek medical attention. An MRI or further imaging may be necessary to assess any underlying issues.

Conclusion
Your recovery from MCL injuries, especially in conjunction with previous knee injuries, requires a careful and structured approach. Prioritize rest, use ice and heat appropriately, engage in gentle stretching and strengthening, and consider professional guidance from a physical therapist. Always listen to your body and adjust your activities accordingly. If symptoms persist, do not hesitate to consult with a healthcare professional for further evaluation and management. Your health and safety should always come first, especially as you continue to pursue your athletic interests.

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