The medial collateral ligament (MCL) is a strong band of tissue located on the inner side of your knee, connecting the thigh bone (femur) to the shinbone (tibia). This ligament provides stability to the knee joint, preventing it from bending too far inward. If the MCL is torn, walking may still be possible for some individuals, but this depends significantly on the tear’s severity and the person’s pain tolerance. Seeking a professional medical evaluation is important to understand the extent of the injury and determine the appropriate course of action.
Understanding MCL Tears and Walking
MCL tears are classified into three grades, each impacting walking ability differently. A Grade 1 tear, considered mild, involves minimal stretching or tearing of the ligament fibers, typically less than 10%. Individuals with this type of injury usually experience slight pain and tenderness on the inner knee, but often maintain good knee stability and can walk with little to no noticeable limp. While some discomfort may be present, particularly when bearing weight, full mobility is usually retained.
A Grade 2 tear signifies a moderate injury where the MCL is partially torn. This level of damage often leads to more pronounced pain, swelling, and tenderness along the inner side of the knee. People with a Grade 2 tear may experience a noticeable feeling of instability or the knee “giving way,” making walking more difficult and often resulting in a limp.
A Grade 3 tear is the most severe, involving a complete rupture of the MCL. This injury causes intense pain, significant swelling, and marked instability of the knee joint. Individuals with a complete tear often find it very difficult or impossible to bear weight on the injured leg and typically cannot walk without assistance like crutches. Other knee ligaments, such as the anterior cruciate ligament (ACL), can sometimes be injured alongside a Grade 3 MCL tear.
Recognizing an MCL Injury
An MCL injury often presents with distinct symptoms that can help in its identification. Pain is typically felt along the inner side of the knee, directly over the ligament itself. The intensity of this pain can vary from mild to severe, depending on the tear’s grade.
Localized swelling on the inner knee is another common indicator, which may increase and spread to the rest of the knee joint within a day or two following the injury. The injured area will also likely be tender to the touch. A noticeable feeling of instability or the knee “giving out” is frequently reported, especially with more severe tears.
Some individuals might hear or feel a “popping” sound at the moment the injury occurs, which often suggests a more significant tear. Difficulty bending or straightening the knee fully, along with stiffness in the joint, can also limit range of motion.
Treatment and Recovery Path
Diagnosing an MCL tear typically begins with a physical examination of the knee. A healthcare provider will assess for pain and tenderness along the inner knee and perform specific tests, like the valgus stress test, to check for joint laxity or looseness. Imaging tests are often used to confirm the diagnosis and determine the tear’s severity, with magnetic resonance imaging (MRI) being highly accurate for visualizing soft tissue damage. X-rays may also be used to rule out any associated bone fractures.
Most MCL injuries, particularly Grade 1 and 2 tears, respond well to non-surgical treatment due to the ligament’s good blood supply, which supports the healing process. Initial care often involves the RICE protocol: Rest, Ice, Compression, and Elevation. Rest helps prevent further damage, ice reduces pain and swelling, compression with a bandage or brace controls swelling, and elevation promotes fluid drainage. Pain management may include over-the-counter anti-inflammatory medications. A knee brace can provide support and limit side-to-side movement, while crutches may be used to reduce weight-bearing on the injured leg.
Physical therapy plays a significant role in recovery, focusing on restoring a full range of motion, strengthening the muscles around the knee, and improving balance. Exercises typically begin with gentle movements to prevent stiffness, gradually progressing to more challenging activities like quadriceps sets, hamstring curls, and single-leg balance exercises. The duration of rehabilitation varies based on the tear’s severity.
Surgical treatment for an MCL tear is less common and typically considered for severe Grade 3 tears, especially if other knee ligaments like the ACL are also injured, or if conservative treatments fail to restore stability. Surgical procedures may involve repairing the torn ligament by reattaching it to the bone or reconstructing it using a graft from the patient’s own tissue or a donor. Recovery timelines for MCL tears vary: Grade 1 tears may heal within one to three weeks, Grade 2 tears generally take four to six weeks, and Grade 3 tears can require six weeks or more, potentially longer if surgery is performed.