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4 Things to Know
About a Medial Collateral
Ligament (MCL) Injury

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The medial collateral ligament (MCL) is one of the key ligaments that help stabilise the knee joint. Positioned on the inner side of the knee, it connects the femur (thigh bone) to the tibia (shin bone), acting as a critical support structure to prevent the knee from buckling inwards. In this article, we share four things that you should know about an MCL injury.

By Arete Orthopaedic Centre
Medically Reviewed by Dr Wang Lushun

1. Common Causes: Sports and Sudden Directional Changes

MCL injuries often happen when the knee is forced sideways, putting stress on the ligament. Some of the most common situations that cause this are:

A direct blow to the outside of the knee: This is common in contact sports, like a football tackle, where an impact pushes the knee inward.
A sudden twist or pivot of the knee: This can happen when an athlete changes direction quickly while their foot is planted on the ground, common in sports like soccer or basketball.
Awkward falls or missteps: This can be as simple as tripping on uneven ground, causing the knee to twist in an unnatural way.

2. Symptoms Vary Depending on Severity

Symptoms of an MCL injury can vary widely, ranging from a minor ache to a feeling that your knee is about to give out. Common signs and symptoms include:

Pain and tenderness along the inside of the knee
Swelling that may develop immediately or over a few hours
A feeling of instability, as if your knee is "giving way" when you stand or walk
Difficulty bending or straightening the knee
Bruising around the joint, which often appears in more serious cases

3. It Can Be Classified into 3 Grades

Doctors classify MCL injuries into three grades to determine the severity and guide the appropriate treatment.

Grade 1 (Mild Sprain): This involves a slight overstretching of the ligament. You will likely feel some tenderness and minor pain, but your knee will remain stable.
Grade 2 (Partial Tear): This is a partial tearing of the ligament fibres. This grade often results in more pain, swelling, and a feeling of looseness or "giving way" in the knee joint.
Grade 3 (Complete Tear): A complete tear of the ligament. This is the most severe type, causing significant pain and marked instability of the knee.

An accurate diagnosis by an orthopaedic surgeon is key to helping you determine the grade of your injury and create an effective treatment plan.

4. MCL Tear Treatment Depends on the Injury Grade

MCL injury treatment depends on the severity of the tear. Mild to moderate injuries (Grades 1 and 2) are usually managed with non-surgical methods, while severe tears (Grade 3) might require surgery.

Non-Surgical Treatment (Grades 1 & 2)

Many MCL tears are treated without surgery. The initial focus is on reducing pain and swelling, followed by restoring strength and function.

RICE Method: The first line of treatment involves rest, ice, compression, and elevation. This helps to reduce inflammation and pain in the immediate aftermath of the injury.
Bracing: A knee brace or support is often used to stabilise the joint, protect the healing ligament from further strain, and allow for a more comfortable recovery.
Physiotherapy: A physiotherapist will guide you through specialised exercises to regain the knee's range of motion, strengthen the surrounding muscles (like the quadriceps and hamstrings), and improve overall stability.

MCL Surgery in Singapore (Grade 3)

Surgery for an MCL injury is less common than for other knee ligaments (like the ACL). It is typically reserved for very specific situations:

Complete Tears: Surgery may be considered for a severe tear, especially if the knee remains unstable despite non-surgical efforts.
Combined Injuries: Surgery may be needed when the MCL tear is part of a more complex injury involving other ligaments, such as the anterior cruciate ligament (ACL).

The recovery period varies significantly. Mild injuries may heal in three to four weeks, while severe tears could take around 12 weeks or more. Post-surgical recovery can take 9-12 months of dedicated rehabilitation.

When to See a Doctor for MCL Injury in Singapore

If you notice any of the following signs and symptoms, please seek prompt medical attention as early intervention can go a long way in improving treatment duration and outcomes:

Knee pain that affects movement
Swelling or bruising around the knee joint
Difficulty walking or putting weight on the leg
Feeling that your knee may “give way”

Not all knee pain is an MCL tear, but seeing an orthopaedic specialist can help you find out the cause quickly and accurately. For more information, please contact Arete Orthopaedic Centre to discuss your symptoms and treatment options today.

Dr Wang Lushun

Senior Consultant Orthopaedic Surgeon

MBBS (S’pore), MRCS (Edin), MMed (Ortho), FRCS (Ortho) (Edin)

With over 18 years of experience, Dr Wang Lushun is an orthopaedic surgeon who specialises in treating a wide range of sports injuries and musculoskeletal conditions. He has in-depth experience in minimally invasive surgery and advanced robotic surgery. Dr Wang provides orthopaedic care to athletes and everyday individuals throughout their journey to recovery.