MCL Injury

Injury Description 

The medial collateral ligament (MCL)attaches the femur to the tibia on the inner side of the knee.


It helps to restrain the knee from opening up through the inner part. Hence, it plays a role in maintaining knee stability.


A tear of the medial collateral ligament usually results from a force causing the inner part of the knee to open up. It often happens while the knee is slightly bent. There may be an indirect cause such as in downhill skiing or a direct cause such as a player falling onto the outside of the knee.



Medial collateral ligament tears are graded:

Grade I: minimal fibres torn, pain but no laxity

Grade II: up to 50% of fibres torn, pain, slight localised swelling, laxity of about 5mm, knee is unstable when slightly bent but stable when it is fully straightened

Grade III: fibres are completely torn, hence there may not be any pain but increased swelling and instability is likely to be present. Grade III tears are usually associated with an ACL injury.



Patients recover well with Physiotherapy treatment and should expect to be able to return to normal sports/ activities.


Injuries to the medial collateral ligament that is lower down usually takes longer to rehabilitate than a tear that is higher.



  1. Initial management, if an MCL tear is suspected, should involve ice, elevation and compression bandage. Diagnosis by a Physiotherapist or Doctor.
  2. Physiotherapy aims to restore pain- free range of movement with capacity to return to normal activity through soft tissue releases, strapping, knee motor control and strengthening exercises, stretches and proprioceptive exercises.
  3. Grade III tears may sometimes require surgical repair if it has not responded to conservative management.