Bracing can often be useful for the treatment of mcl injuries. Injuries to the collateral ligaments tend to occur when a person is bearing weight and the knee is forced inwards or outwards, such as slipping on ice or. Mcl injury rehabilitation and management considerations. Regaining a full range of motion of the knee joint is the first priority in this phase of the rehabilitation process. The gundersen health system sports medicine mcl grade i sprain. Talk to your doctor or physical therapist about which exercises will best help you meet your rehabilitation goals. We always recommend seeking professional advice before starting any medial ligament strengthening exercises. Easy stationary bike for range of motion roms, quads, straight leg raises slrs, calf raises. Do this exercise if you are not able to extend your knee fully. It should be stressed that this is only a protocol and should not be a substitute for clinical decision making regarding a patients progression. Injury to the mcl is often called an mcl sprain or tear. Signs and symptoms of a medial collateral ligament mcl injury include swelling, pain, stiffness, and a feeling that the knee may give way. This protocol is intended to provide a general guideline to treating an mcl sprain. Rehabilitation guidelines for knee multiligament repair uw health.
Rehabilitation guidelines for elbow ulnar collateral. Treatment of an mcl tear depends on the severity of the injury. It helps add stability and strength to the knee joint. While lying on your back, place a rolledup towel under the heel of your injured leg so the heel is about 6 inches off the ground. Rehabilitation after injury to the medial collateral ligament of the knee phase 1. All mcl injuries are likely to heal so treatment is usually conservative. Most isolated collateral ligament injuries can be successfully treated without surgery. Medial collateral ligament mcl sprain rehabilitation exercises therapy. Conservative treatment following ulnar collateral ligament. There are two collateral ligaments, one either side of the knee, which act to stop side to side movement of the knee.
To ensure that this program is safe and effective for you, it should be performed under your doctors supervision. Lunging exercises are progressed by means of altering surfaces, providing manual perturbations, and. Mcl knee sprain grade iii adopted 298, revised 204, revised 109 1 general principles. Nearly 78% of patients who sustained a grade iii mcl injury had an. This protocol was designed to provide the rehabilitation professional with a guideline of postoperative care. Medial collateral ligament injury of the knee mcl tear. A guide for patients with collateral ligament sprain of.
With a proper mcl injury rehabilitation protocol, even a complete mcl tear should completely heal. These exercises can be used from the early stages onwards. Mcl grade iii sprain rehabilitation program the gundersen. Extended use of the knee immobilizer should be limited to avoid quadriceps atrophy weakness. If the collateral ligament is torn in such a way that it cannot heal or is associated with other ligament injuries, your doctor may suggest surgery to repair it. Recovery from an mcl injury is very dependent on the grade of your mcl tear. After an injury or surgery, an exercise conditioning program will help you return. This leaflet gives you advice and exercises to help your knee to recover after your injury. It helps to connect your shin and thigh bones to keep your knee stable and working properly. The following schedule serves as guidelines to help in the expediency of returning a patient to his or her preinjury state.
It is not intended to substitute clinical judgment regarding the patients post injury care, based on exam treatment findings, individual progress, andor the presence of concomitant injuries or complications. The goal is to be weight bearing as soon as possible without a limp. You are encouraged to bear as much weight on the leg as is comfortable unless otherwise directed by your physician. Helping your knee to recover after a ligament sprain or rupture pdf.
Slowly let the foot of your affected leg slide down the wall until you feel a stretch in your knee. Medial collateral ligament injuries occur following a traumatic valgus force, often while the knee is slightly flexed. The majority of mcl tears are isolated injuries and many times are treated nonoperatively. Madison, wi 53718 rehabilitation guidelines for posterior cruciate ligament reconstruction the knee has three jointsthe patellofemoral joint knee cap, the tibiofemoral joint and the. Gudeman commonly examines the healthy knee first and then compares it to the injured knee. An ankle sprain occurs when a ligament connecting the ankle bones is stretched or torn. Stretching helps maintain flexibility which also protects the joint. Generating an epub file may take a long time, please be patient.
Place a towel or cloth between the skin and the ice to prevent skin injury. Mcl sprain rehab protocol for a grade 1, 2 and 3 medial knee ligament sprain. Ligaments can be partially or completely torn due to sudden stretching. Medial collateral ligament sprain rehabilitation exercises. In the midst of some form of activity, you likely twisted or turned your knee at a bad angle, and heard a loud pop. Edson 2006 provides a comprehensive overview of the current recommended conservative management of mcl injuries, i highly recommend all physiotherapists read this article. Medial collateral ligament mcl rehabilitation protocol. The mcl, unlike other ligaments like the anterior cruciate ligament acl, has a great blood supply. Following an mcl injury, it is important to strengthen the surrounding muscles to help take the strain off the ligament. Acute stage, subacute stage and late stage sports specific rehabilitation. Rehabilitation after injury to the medial collateral. Early movement will help regain your range of motion and decrease muscle weakness. Logerstedt, pt, phd david scalzitti, pt, phd may arna risberg, pt, phd lars engebretsen, md kate e. Medial collateral ligament mcl knee sprains can be a painful and debilitating injury to deal with.
Patient will wear immobilizer for 2 weeks following injury, except in p. As you work through the initial stages of recovery, and your knee begins to heal, start to introduce some very gentle movements, using light stretches and rotations to reduce the build up of scar tissue and allow greater flexibility at the injured part. Mcl sprain exercises should form part of a rehabilitation program. Lie on the floor close enough to a wall so that you can place both legs up on the wall. This guideline is intended to provide the treating clinician a frame of reference for rehabilitation. Madison, wi 53718 rehabilitation guidelines for elbow ulnar collateral ligament ucl reconstruction the elbow is a complex system of three joints formed from three bones. Here are some things to consider when rehabilitating your ankle. Do this exercise if you are unable to extend your knee fully. Strengthening exercises for medial collateral ligament mcl. Management of the patient with an aclmcl injured knee ncbi. Rehabilitation after ankle sprain center for sports. Its frequently sprained in sports like basketball, football, soccer and skiing.
The anatomy of the medial knee has been divided into 3 layers, consisting of the deep fascia of the thigh, the superficial medial collateral ligament mcl and the deep mcl and posteriomedial joint capsule1. Ankle sprains need to be rehabilitated properly to prevent re injury or a chronic problem from developing. Click here to download pdf activities and exercises after injury to the medial collateral ligament mcl of the knee phase 1. Conservative treatment following ulnar collateral ligament sprains of the elbow phase i immediate motion phase post injury days 0 7 goals 1. Rehabilitation guidelines for posterior cruciate ligament. Mcl sprain rehabilitation protocol medial knee ligament. Once your range of motion and strength have recovered most grade 1 mcl injuries can anticipate a full return to sports. The medial collateral ligament mcl is located on the inner aspect, or part, of your knee, outside the joint. The first six weeks after injury grade 2 and 3 three weeks after injury grade 1 the knee should be protected with a shorthinged brace for 3 to 6 weeks, depending upon the severity of the injury. However, surgical treatment is necessary in cases of severe medial or. Rehabilitation of isolated mcl sprains this program may be accelerated for grade i mcl sprains or may be extended depending on the severity of the injury. More severe, grade iii sprains, and combined ligamentous injuries may use conservative treatment, but surgical interventions may be necessary. You may do the remaining exercises when you have less pain and swelling in your knee.
No patellofemoral joint pain gross manual muscle testing strength 90100% of contralateral side. Webster, phd julian feller, md lynn snydermackler, pt, scd michael j. Mcl rehabilitation from ruin to return to play rayner. Clinical practice guidelines revision 2017 a2 november. The gundersen health system sports medicine mcl grade i sprain rehabilitation program is an evidence based and soft tissue healing dependent program. When cleared, patient is to use functional brace for 6 months.
See the full rehabilitation program for details of when the. Hopefully my story will help many of you successfully heal your mcl sprain. Grade iii tears may have an immobilization period prior to. It is designed for rehabilitation following a pcl injurytear, typically grade i and ii. Grade 1 mcl injury with or without meniscus damage acl surgery within one week.
The mcl medial collateral ligament is a band of tissue that runs along the inner edge of your knee. Your hips should be as close to the wall as is comfortable for you. Pcl non operative rehabilitation guideline sanford health. Following the acute injury you should use a knee immobilizer and crutches until you regain good muscular control of the leg. Ankle dorsiflexion df and plantarflexion pf with manual resistance. Chattanooga, tn 423 6242696 the injury ankle sprains are very common ankle injuries, usually the result of the ankle turning inward. Recovery from a grade 1 mcl injury can be as short as a few weeks. The medial collateral ligament mcl is located on the inner part, of your knee. The incidence rates of acl and mcl injuries are high in physically.
After an mcl sprain, depending on severity, the knee loses some of its sidetoside stability and the knee feels like it buckles or is unstable. Often, with a tear of the mcl, the anterior cruciate ligament acl may also be torn. Medial collateral ligament mcl rehabilitation protocol weeks post injury 12 weeks initiate physical therapy. Rehabilitation after ankle sprain brett sanders, md center for sports medicine and orthopaedic 2415 mccallie ave. When diagnosing a collateral ligament injury, he puts pressure on the side of the knee to determine the degree of pain and looseness of the joint. Knee sprains and strains university of california, berkeley. Physical therapy management of a medial collateral. Conservative treatment of mcl injuries has shown to be successful with isolated mcl injuries. Knee ligament sprain academy of orthopaedic physical therapy. Youre likely reading this because you are on the receiving end of a pretty crummy feeling. The majority of patients who sustain an mcl injury will achieve their. Progress should be modified on an individual basis. They should include mobility, strengthening, proprioception and functional or sports specific exercises. Treatment always begins with allowing the pain to subside, beginning work on mobility, followed by strengthening the knee to return to sports and activities.
But you dont have to be a pro athlete to suffer an mcl injury a pickup game in hoops or football can leave. No competitive or pivot sports until cleared by surgeon. Nonoperative mcl tear rehabilitation protocol the intent of this protocol is to provide the clinician with a guideline for a nonoperative rehabilitation course of a patient with an isolated medial cruciate ligament injury. The medial collateral ligament is the most commonly injured ligament of the knee, with injury generally. Physical therapy management of a medial collateral ligament summary of condition. The above program may be accelerated for first degree mcl sprains or may be extended depending on the severity of the injury. Mcdonough, pt, phd knee stability and movement coordination impairments. To complete my experience on my mcl sprain recovery i am glad to report that now, 2 months later, my knee is perfectly fine and i enjoy the perks of having two soccer matches per week. If there is any increase in pain or swelling or loss of rom, these can serve as signs that the progression of the.
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