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Medial Collateral Ligament Sprain

February 26, 2010


What is a medial collateral ligament sprain?
How does it occur?
What are the symptoms?
How is it diagnosed?
How is it treated?
When can I return to my sport or activity?
How can I prevent a medial collateral ligament sprain?

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What is a medial collateral ligament sprain?
A sprain is a joint injury that causes a stretch or a tear in a ligament, a strong band of tissue connecting one bone to the other. The medical collateral ligament is located on the inner side of the knee. It attaches the thigh bone (femur) to the shine bone (tibia). Sprains are graded I,II, or III depending upon the severity of the sprain:
– Grade I sprain: pain with minimal damage to the ligaments
– Grade II sprain: more ligament damage and mild looseness of the joint
– Grade III sprain: complete tearing of the ligament and the joint is very loose or unstable

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How does it occur?
The injury usually occurs when a blow the outer side of the knee causes stretching or tearing of the medical collateral ligament. It can also be caused by a twisting injury to the knee.

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What are the symptoms?
You will have pain on the innermost side of your knee. Your knee may be swollen and tender. You may have the feeling of the knee giving way. You might hear or feel a pop or snap at the time of injury.

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How is it diagnosed?
Your doctor will examine your knee. Your doctor will gently move your knee around to see if the joint is stable and if the ligament is stretched or torn. He or she may order x-rays or a magnetic resonance image (MRI) of your knee.

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How is it treated?
Treatment may include:
– Applying ice to your knee for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days or until the pain and swelling goes away
– Elevating your knee by placing a pillow underneath it
– Taking an anti-inflammatory medication or other drugs prescribed by your doctor
– Wearing a knee immobilizer or knee brace to keep you from moving and further injuring your knee and to minimize the pain of moving your knee
– Using crutches
– Doing rehabilitation exercises
While you are recovering from your injury, you will need to change your sport or activity to one that does not make your condition worse. For example, you may need to swim instead of run.

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When can I return to my sport or activity?
The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your knee recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have symptoms before you start treatment, the long it will take to get better. You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:
– Your injured knee can be fully straightened and bent without pain
– Your knee and leg have regained normal strength compared to the uninjured knee and leg
– Your knee is not swollen
– You are able to jog straight ahead without limping
– You are able to sprint straight ahead without limping
– You are able to do 45-degree cuts
– You are able to do 90-degree cuts
– You are able to do 20 yard figure-of-eight runs
– Your able to do 10-yard figure-of-eight runs
– You are able to jump on both legs without pain and jump on the injured leg without pain
If you feel that your knee is giving way or if you develop pain or have swelling in your knee, you should see your doctor.

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How can I prevent a medial collateral ligament sprain?
Unfortunately, most injuries to the medial collateral ligament occur during accidents that are not preventable. However, you may be able to avoid these injuries by having strong thigh and hamstring muscles, as well as by maintaining a good leg stretching routine. In activities such as skiing, be sure you ski bindings are set correctly by a trained professional so that your skis will release when you fall.

Pierre Rouzier, M.D. THE SPORTS MEDICAINE PATIENT ADVISOR

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