How to Treat an MCL Sprain

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The medial collateral ligament (MCL) is an important structure that provides stability to the inside of your knee. Running from the thigh bone (the femur) to the lower leg bone (the tibia), this ligament prevents the knee from buckling inward into a knock-kneed (valgus) position.

MCL injuries frequently occur while participating in sports. They are usually caused by twisting, cutting (making quick directional changes), or bending movements. Depending on the movement causing the injury is, the MCL may become sprained or torn.

If the MCL is sprained, it can cause knee pain, swelling, and reduced mobility of the joint. In this article, we'll discuss treatment options, including home interventions, medication, and physical therapy.

Woman holding her knee in pain


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Overview of an MCL Sprain

If your MCL is overextended or overtaxed, then the ligament can become sprained or torn. This injury commonly occurs while participating in sports and is usually caused by twisting, cutting, or bending movements. Additionally, a blow or tackle to the outside of the knee can also cause this condition.

An MCL sprain can cause several different symptoms, including:

  • Buckling, instability, or giving way of the leg
  • Pain on the inner portion of the knee
  • Bruising
  • Warmth, redness, or swelling in the joint
  • Difficulty fully straightening or bending the knee

Typically, your doctor will use the following classification scale to diagnose this injury:

  • Grade 1: A mild sprain causing local tenderness, but not notable instability on the inside of the knee
  • Grade 2: A partial tear to the MCL, with more diffuse pain in the knee and some instability at the joint
  • Grade 3: A complete tear of the MCL, with marked instability during valgus stresses

An MCL sprain is a significant injury that can dramatically limit your ability to play sports or go about your daily life. But, fortunately, there are treatment options that can get you back to feeling like yourself.

Treatment Options for an MCL Sprain

Shortly after an MCL sprain, your knee will be painful, swollen, and inflamed. During this acute phase, several treatments can help reduce these early symptoms. Depending on the severity of the injury, your doctor may also recommend physical therapy or surgery. Treatment options may include the following:

RICE Principle

Following your injury, the RICE principle is commonly recommended to get the inflammation around the sprained ligament under control. RICE stands for:

  • Rest
  • Ice
  • Compression
  • Elevation

This treatment starts with taking a break from physical and potentially irritating activities. Next, ice can be applied to the knee, and the leg is elevated above your heart for 10–20 minutes at a time. This may be done every hour or so for the first three days after the sprain. Finally, a compressive bandage or sleeve can be used to help control the swelling. It is important, however, to ensure that the pressure is not so snug that it cuts off your circulation.

NSAIDs

After an MCL sprain, taking nonsteroidal anti-inflammatory medications (NSAIDs) usually is recommended to help control the acute symptoms. This over-the-counter (OTC) option, which includes Advil and Motrin (ibuprofen) and Aleve (naproxen), helps to reduce the pain and inflammation caused by this type of injury.

It is important to speak to your doctor before using NSAIDs to manage the pain. This class of drugs can potentially lead to side effects like gastrointestinal bleeding, stroke, or even a heart attack in certain individuals.

Bracing

After sustaining an MCL sprain, it is important for the injury to be evaluated by a doctor for proper diagnosis and treatment. In the case of grade 1 and certain grade 2 MCL sprains that are not accompanied by damage to other structures in the knee, nonsurgical treatment is usually effective. Early on, this therapy typically involves placing the leg in a supportive brace.

These devices help prevent further damage to the sprained ligament by keeping the injured knee from moving inward into a knock-kneed position. In addition, the braces are usually hinged to allow the knee to bend and straighten as you go about your day. This helps reduce the stiffness that frequently accompanies an MCL sprain. Typically, braces are worn for multiple weeks until ligament healing occurs and the leg has regained its strength and stability.

Physical Therapy

Along with issuing a brace, your doctor may also prescribe physical therapy (PT) to help you recover from grade 1 and some grade 2 MCL sprains. Early on in rehab, your physical therapist will focus on safely regaining the range of motion in your knee. Modalities like electrical stimulation or vasopneumatic compression (wearing a pressurized garment to manage swelling and inflammation) may also be utilized as needed to help control your pain and swelling.

Related: Physical Therapy Techniques for Knee Pain Relief

As therapy progresses, the focus will shift to building strength in the leg and improving your overall balance and stability. When your doctor clears you to discontinue the brace, PT can also help you regain a more normal walking pattern and wean you from any assistive devices (like crutches) you’ve been using.

Finally, the later stages of PT typically center around higher-level activities like running, jumping, or cutting. Instruction on proper mechanics is usually provided. These more demanding tasks also are reintroduced in a gradual fashion to minimize the chances of a reinjury. This entire process can last three months (or more) depending on the severity of the MCL injury.

Surgery

In the case of a more unstable grade 2 or a grade 3 MCL sprain, surgical treatment is usually needed. This is also the case if the injury is accompanied by damage to another knee structure—most commonly the anterior cruciate ligament (ACL), a key ligament to help stabilize the knee.

Related: Risks and Complications of Knee Arthroscopy Surgery

In these situations, the damaged MCL is often able to be either repaired or reconstructed during a minimally invasive procedure known as arthroscopic surgery. In this procedure, the surgeon uses a narrow scope with a camera on the end and special surgical tools to access the joint through a tiny keyhole incision.

Occasionally, the ligament can be repaired by a surgeon and reanchored to the area of the bone from where it detached. In other situations, the ligament is beyond repair and is reconstructed using a graft from another area of your body or from a cadaver. In either case, the use of a brace and extensive physical therapy are usually required for you to return to your normal activities.

A Word From Verywell

After sustaining an MCL injury, it is vital to know the treatment options at your disposal. Following a thorough examination, your doctor will properly diagnose your condition and guide you through the
interventions that are appropriate for you.

While this type of injury can significantly impact your ability to function, it is important to remember that a full recovery is possible. Whether it’s a milder grade 1 sprain or a severe grade 3 injury, a safe return to the activities you love is possible with the treatments outlined above.

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4 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Laprade RF, WijdicksCA. The management of injuries to the medial side of the knee. J Orthop Sports Phys Ther. 2012;42(3):221-233. doi: 10.2519/jospt.2012.3624

  3. Gentile JM, O’BrienMC, Conrad B, Horodyski M, Bruner ML, Farmer KW. A biomechanical comparison shows no difference between two knee braces used for medial collateral ligament injuries. Arthroscopy, Sports Medicine, and Rehabilitation. 2021;3(3):e901-e907. doi: 10.1016/j.asmr.2021.03.004

  4. Varelas AN, EricksonBJ, Cvetanovich GL, Bach BR. Medialcollateral ligament reconstruction in patients with medial knee instability: asystematic review. Orthopaedic Journal of Sports Medicine. 2017;5(5):232596711770392. doi: 10.1177/2325967117703920