Optimising Cycling Performance. North Yorkshire


Medial Colateral Ligamnet (MCL) Strain

 Nemanja Vidic sustaining a force to his right knee that could lead to MCL injury

Nemanja Vidic sustaining a force to his right knee that could lead to MCL injury


What is an MCL sprain?

Your medial collateral ligament, commonly abbreviated to MCL is the thick band of fibrous tissue on the inside of your knee joint. This can be seen on the knee anatomy picture here. Its primary role is to provide stability for the knee joint. Ensuring that movement that cannot be controlled by your muscles does not occur. The knee is often referred to as a hinge joint, it has good control of bending and straightening, but needs your collateral ligaments (your MCL works along side your lateral collateral ligament) to control side to side movement. Specifically your MCL controls movement where your foot moves outward in relation to your knee, or your knee is pushed inward in relation to your foot. This results in the MCL being stretched. We tend to categorize MCL strains based on the amount of damage caused.

Mild or grade 1 - Usually get better in 1 to 3 weeks. Resulting from mild force causing inflammation of the MCL but no significant structural damage.

Moderate or grade 2 - Often get better in about a month. When compared to a grade 1 the force in a grade 2 does actually cause a partial tear or partial rupture of the MCL. You may need to wear a hinged knee brace.

Severe or grade 3 – Where as grade 1 and 2 could be termed a sprain, really a grade 3 is a total rupture. The force this time causes a complete disruption of the ligament. You may require wearing a hinged brace for a few months.

Due to the types of force and the internal anatomy of the knee joint MCL sprains can also be seen in conjunction with ACL rupture and meniscal tear.

What are the symptoms of MCL sprain?

As you can imagine the amount of symptoms you may get depend on the amount of force and thus the severity of the injury. It is virtually always possible to pinpoint the time and reason for the onset of symptoms.

Symptoms of pain, tenderness and stiffness are common. These are usually felt over the MCL itself on the inside of the knee.  It is also common for the knee to swell up after a number of hours. If the knee appears to swell up immediately this would be unusual, raising the possibility of another type of injury, such as ACL rupture or fracture.

It is common that over the first few days the knee might stiffen further. You may also develop bruising dependent on the severity of the injury.

As time progresses and you start to return to some normal activities you may find that your knee feels a little unstable, as if you cannot trust it so well.

What can I do for myself?

Early management - MCL strain is a soft tissue injury, as such following the advice regarding acute soft tissue injuries here is a great place to start. It would be fair to suggest that early good quality injury management means that you should improve as quickly as possible. This is a service we are able to offer.

If you have significant pain and certainly bruising it is worthwhile seeking a specialists opinion. These features may suggest a grade 2 or 3 injury were it would be a good idea to be assessed as to whether you need a brace or not. Also the kind of force that can produce significant swelling, bruising and pain may have led to a different significant injury.

In the first instance when you have undertaken the acute soft tissue treatment you should try to regain your range of motion. The ability to full straighten and fully bend your knee. These exercises may be of help.

Recovery phase – Once you have noticed your knee starting to feel somewhat easier with the early management it is a good idea to start to think about recovery:

  • Regaining full flexibility
  • Regaining full strength
  • Returning to previous levels of activity

As well as these flexibility exercises, you should also start to work your muscles. These simple exercises may be of use at the beginning.


Once you start this journey how far you continue depends on what you wish to get back to doing. If you have a specific sport or hobby that you wish to return to then gaining the help of a rehabilitation specialist would be advised. This is something we would be able to help you with.

What other treatments are available?

Physiotherapy is the mainstay of the treatment of MCL sprain. With a good rehabilitation program you should regain all your previous abilities.  It is not very often that there is a surgical need in the treatment of MCL sprain. However if this is required we are in an excellent position to be able to advise you.