The medial collateral ligament, or MCL, is the ligament that runs on the inside of your legs (medial) from your femur (thigh bone) to your tibia (shin bone). MCL is one of four major ligaments and plays a vital role as a stabiliser for the knee by keeping your shin bone in place. MCL is also referred to as a tibial collateral ligament and is the largest ligament on the medial side.
An injury of the MCL is one of the most common forms of knee ligament injury. Often referred to as a sprain, an MCL injury significantly impacts one’s stability and mobility. Injury can manifest in the form of a stretch, partial, or full tear of the ligament and often occurs together with anterior cruciate ligament (ACL) injuries.
MCL injury is classified into 3 different grades:
Grade 1: minor sprain where the ligament looks normal and the tear is superficial.
Grade 2: severe sprain where there is a severe tear at the medial to the ligament.
Grade 3: complete tear of the ligament from the bone.
An MCL injury can be categorised into 3 grades depending on its severity.
What causes medial collateral ligament (MCL) injury?
MCL injuries occur most commonly during sports and the causes can be attributed to improper forms of movement which include:
Referred impact in which there is an impact or blow to the outer part of the knee
Forcefully shifting directions
Landing incorrectly causing an upward force on the ligament
Repeated stress on the knee leading to inelasticity of the ligament
What are the symptoms of medial collateral ligament (MCL) injury?
Some of the signs that you have an MCL injury include:
A loud “pop” or “snap” when an injury occurs
Swelling and locking of the affected area
Pain and tenderness
Generally feeling unstable and the sensation of your leg “giving away” or buckling
If you notice any of the symptoms, make an appointment with an orthopaedic specialist to get an accurate diagnosis and treatment.
MCL injuries occur as the result of awkward and hard landings, causing the MCL to tear or rupture.
If you notice any of the symptoms, make an appointment with an orthopaedic specialist to get an accurate diagnosis and treatment.
Dr Puah KL is our Senior Consultant Orthopaedic Surgeon at Artisan Sports & Orthopaedic Surgery. He used to serve the sports service of Singapore General Hospital - the highest volume trauma centre for orthopaedics in Singapore.
Is medial collateral ligament injury (MCL) painful?
Yes. Individuals with MCL injury have reported pain ranging from mild to excruciating pain.
Pain is usually felt on the inside edges of the knee, especially when any form of pressure is applied. Pain is also often accompanied with palpitating sensation.
Who is at risk of medial collateral ligament (MCL) injury in Singapore?
A consistent risk pattern has been noted in MCL injuries which include:
Athletes: MCL injuries are common among contact sports athletes such as football, rugby, and basketball.
Age: MCL injuries are commonly noted among those in the age range of 20-34 and 55-65.
Gender: MCL injuries are significantly more prominent among men than women.
MCL injuries are common among rugby players.
How is medial collateral ligament injury (MCL) diagnosed?
MCL injuries are diagnosed using the following:
Physical examination and medical history: inform your orthopaedist of the potential activities that may have led to an injury such as trauma, exercise, or sports. Typically a pressure or stress will be applied to the area to see how loose it is.
Arthroscopy: arthroscopy, a minimally invasive procedure where a small camera is inserted into the knee joint to visualise the structures inside may be used in the diagnosis of MCL injuries.
What are the treatment options for medial collateral ligament injury (MCL) in Singapore?
MCL injuries typically encompass conservative treatment, rarely requiring surgery as MCLs tend to have higher recovery capabilities compared to other ligaments at the knee.
Treatment options for MCL injuries include:
Rest: you would be advised to observe complete rest to relieve pain and reduce swelling.
