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MCL Tear

Causes, Symptoms, Treatments, & Other Resources

What is the MCL?

The medial collateral ligament AKA MCL is a thick, strong band of connective tissue on the inside portion of your knee.  It connects the top part of the tibia (shin) to the bottom part of the femur (thigh). This is a vital ligament that works along the lateral collateral ligament (LCL), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL) to bring stability, structure, and movement to the knee. The MCL provides support and stability for the inside (medial) aspect of the knee.

What are the Causes of MCL Tears?

MCL tears are a common injury in sports such as football, hockey, and skiing. The ligament can be stretched or even torn due to direct blows, but it usually happens when you hit the outer aspect of your knee at high speeds. Other causes could include:

  • repeated stress on the joint without adequate time for healing
  • abrupt change in direction or speed
  • a sudden contraction of muscles with high force

Like other tears to knee ligaments, a doctor will ask you about your symptoms and then perform a physical examination. They may also order some tests, such as an MRI or an X-ray scan, to help diagnose the tear. An in-office ultrasound is an effective imaging modality to evaluate the presence and severity of an MCL tear.  An additional advantage is that it does not require pre-authorization or a separate appointment.

Orthopedists categorize MCL tears into 3 grades:

Grade 1 Tears

A partial-thickness MCL tear is where only a portion of the MCL is torn.  On ultrasound or MRI, a portion of the MCL would be torn but the remaining fibers would be normal. 

Grade 2 Tears

A grade 2 MCL tear involves a tear that extends across the entire MCL and therefore is referred to as a full-thickness tear.  The ligament has not pulled apart or snapped back upon itself and therefore is referred to as non-retracted. These types of tears can be treated with ultrasound-guided PRP or bone marrow concentrate.

Grade 3 Tears

A grade 3 tear is a full-thickness tear that extends across the MCL and unlike a Grade 2 the ligament has pulled apart. This means that the two pieces of the ligament have pulled apart or maybe even snapped back like a rubber band.  This type of tear requires surgery

Some home remedies that can be used for MCL tears are as follows:

  • Rest the knee: This is one of the most important things that you can do when you have a MCL tear. Taking a break from strenuous activities will help the knee to heal.
  • Use heat which promotes increased blood flow to the area.
  • Fish oil and Turmeric which can help with the swelling and pain
  • Avoid the use of Ice as it restricts blood flow and can limit inflammation. Remember inflammation is the first step in healing.

Symptoms of MCL Tears

Burning Pain on Outside of Knee When Kneeling

There are many possible causes of burning pain on the outside of the knee while kneeling. One possibility is that you may have patellofemoral syndrome, which is a condition that results in pain around the kneecap. This pain can be aggravated by activities such as kneeling or squatting. Other potential causes of this type of pain include iliotibial band syndrome, runners knee, and meniscal tears. If you are experiencing burning pain on the outside of your knee while kneeling, it is important to see a doctor for evaluation. Some of these conditions can be treated with conservative measures such as rest, ice, and physical therapy…

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Can’t Straighten Knee

Your knee is capable of moving in a number of directions. The most common are flexion and extension. Flexion is when you bend your knee and the shin bone moves towards the buttock. Knee extension is when you straighten out your knee. The extension is the opposite of flexion. PT, trainers, and physicians alike measure the degree of knee flexion and extension. When lying flat on an examination table or hard surface your knee should be able to extend so that there is no angle between the thigh and shin bone. The inability to straighten the knee is also known as an extension lag and is a reason for concern.

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Knee Hurts When I Bend It and Straighten It

Your knees bend countless times throughout the day. Running up the stairs, down the hall after kids, and getting into the car. You straighten the knee as you walk, descend stairs or get into and out of the car. Bending and straightening the knee are necessary for daily activities. Knee pain with bending or straightening may be a mild, transient irritation or may indicate a more significant problem. Learn more below and avoid further injury and dysfunction. Knee pain can vary significantly depending upon many factors including the actual source of the pain, the severity of the injury, general health, and level of activity…

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Knee Locking & Catching

Knees have the ability to bend forward and back, as well as rotate slightly. When a knee is unable to execute these actions, it impairs mobility and the capacity to complete daily chores such as sitting, standing, squatting, or kneeling. A locked knee occurs when a knee cannot be bent or straightened so it gets stuck or feels locked in a certain position for an extended period of time. There are two forms of locked knees: one that is due to inability to move because of an actually physical or mechanical restriction and there is one that feels locked due to the pain involved in moving it. When a person has their knee joint effectively frozen into place and cannot move, this is known as a true locked knee….

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Knee Pain

Knee pain can be caused by many factors. Overuse injuries, direct trauma to the knee and arthritis are the most common causes of knee pain. Damage to the knee structures may cause swelling, scar tissue formation (fibrosis), and loss of function of the joint. Pain is often accompanied by difficulty walking, weakness, and instability. When the knee is overused, the thigh and shin bones (femur and tibia), cartilage, or tendons may experience stress. This leads to pain and discomfort as well as stiffness in the knee. Overuse injuries are common among athletes who participate in sports that involve running, jumping…

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Knee Popping

Knee popping can be a sensation that something is moving around in the knee. There may also be an audible sound associated with the popping, which in medical terms is called crepitus. This can also cause what we call mechanical catching or locking, which may make the knee feel like it is stuck in an extended or flexed position, and you have to move it in certain ways to get out of that. This knee popping sensation or sound or could be a very simple issue or it could be a sign that more serious damage is going on in the knee, so determining what is causing it is very important. So, the knees may pop and get in a certain position….

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Knee Swelling

Swelling of the knee, also known as water on the knee, is a condition in which fluid collects around the knee joint. Swelling can occur for a variety of reasons and affect patients of any age. Some swelling can be treated with over-the-counter medicines, but persistent and continuous swelling might result in tissue damage, bone softening, and cartilage deterioration. Over-the-counter medicines will assist relieve pain for individuals with a history of osteoarthritis and swelling following physical activity, such as exercise or running. During and after activity, the patient may apply compression sleeves to reduce the inflammation. Ice is another method…

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Loose Knee Joint

Ligaments are fibrous bands that connect the bones together. If the ligaments inside your knee become damaged, your knee could feel loose (with or without pain). While walking, exercising, or simply standing, it may feel like your knee could collapse at any moment. If the knee muscles are damaged, they will be unable to contract properly, resulting in lack of strength and discomfort. Swelling might have a similar result. What Causes Laxity in the Knee Joint? Knee injuries are generally sports-related, although they may occur during any physical activity that puts stress on the knee and causes bending or trauma…

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Loud Pop in Knee followed by Pain

If you hear a loud pop in your knee and then experience pain, it is possible that you have torn a ligament. Ligaments are the bands of tissue that connect bones to other bones and help stabilize the joint. There are four main ligaments in the knee: the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL). The ACL is the most commonly injured ligament in the knee. It runs diagonally across the front of the knee and is responsible for rotational stability. A tear in the ACL can cause severe pain, swelling, and instability in the knee….

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Tightness in Knee

What could tightness in your knee mean? When fluid builds up inside the knee as a result of an injury, overuse, or medical problem, the knees become swollen and tight. Swelling might be mild, so you may not always notice it unless it is serious damage. You may feel this as stiffness in the knee since swelling may not be visible. Swelling restricts movement since there is less room in the knee. Fluid buildup can be caused by irritation, internal bleeding, and injuries to the knee. Arthritis, gout, tumors, and baker cysts are all causes of swelling. Pain and swelling are the responses of your body to damage. Together they can lead to stiffness in your knee…

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Weak in Knees

Weakness in the knee can be a symptom of many different knee conditions. Some of the most common causes of weakness in the knee include ligament tears, meniscus tears, and arthritis. Another important but often overlooked cause of knee weakness is irritation or injury of the nerves in the low back. If you are experiencing any type of weakness in your knee for long durations of time (3 weeks), it is important to see a doctor to determine the cause. Some of the most common symptoms of knee weakness include difficulty standing up from a seated position, difficulty walking, climbing or descending stairs…

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Treatment Options for MCL Tear

The MCL is the most injured ligament of the knee and the ACL is the most commonly injured ligament in conjunction with the MCL. Most MCL injuries can be treated non-operatively (1). Even though the MCL can spontaneously heal without any additional treatment, the healing that does take place is typically incomplete (2) which can increase the risk of re-injuring the ligament over time.

Treatment options include:

  • Physical therapy
  • Rest, Ice, Compression, and Elevation (RICE)
  • MCL surgery / knee ligament surgery
  • Precise injection of bone marrow concentrate
  • Precise injection of platelet-rich plasma (PRP)

A precise concentration of bone marrow concentrate can be a better alternative to waiting for the body’s natural healing response to kick in. You can see before and after treatment that there is near complete healing of the MCL below:

Knee Ligament Surgery

Knee ligament surgeries have become quite common, ACL (anterior cruciate ligament) surgeries average 250,000+ surgeries alone every year! These invasive surgeries have come under investigation in recent years, wondering the necessity, or need to be done. Your knee has 3 points of contact or compartments that house the cartilage of your knee: the patella-femoral compartment, lateral (outside) compartment, medial (inside) compartment. These compartments are held together by a network of ligaments that hold each bone together and allow the knee to move properly. The main knee ligament surgery…

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NSAIDs

The other day I was evaluating a patient and reviewing the treatment options for their spine condition.  After discussing prior treatments, we got to the topic of medications taken for pain relief. She explained that she mainly utilized anti-inflammatory (NSAID) medications and then she told me to hold much she takes and has been for many years…..she takes close to 2 grams (2000 milligrams) on a daily basis which equated to about 9-10 capsules of medication per day.  I was shocked, considering she was pre-diabetic and with high blood pressure plus the kicker of it is that her PCP (primary care physician) is ok with this…

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PRP for MCL Tears & Sprains

Physical therapy and RICE are the first-line treatments for MCL injuries. Prolotherapy is also an option in less severe cases, but where ligaments are more severely damaged, PRP and/or bone marrow concentrate (containing stem cells) may be called for as the next nonsurgical treatment option. Platelet-Rich Plasma for MCL Tears & Sprains “PRP” is short for platelet-rich plasma, and it is autologous blood with concentrations of platelets above baseline values (1). Platelet-rich plasma has been growing in popularity since it was discovered to have the potential to improve overall joint function, decrease pain and inflammation, and help the body repair itself via injections into damaged or diseased joints.

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PRP Knee Injections

PRP stands for Platelet-Rich Plasma. Platelets are blood cells that prevent bleeding. They contain important growth factors that aid in healing. Plasma is the light yellow liquid portion of our blood. So PRP is simply a concentration of a patient’s own platelets that are suspended in plasma and are used to accelerate healing. PRP is NOT stem cell therapy. Regrettably, blood contains few circulating stem cells. Rich sources of stem cells are bone marrow and fat. PRP is rich in growth factors. There are many different types of growth factors with different properties. VEGF is a very important one as it can increase the blood flow to an area.

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Doctors That Assist with MCL Tears

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Matthew William Hyzy, D.O.

Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Mairin Jerome, MD

Mairin Jerome, MD

Dr. Mairin Jerome is a physiatrist with subspecialty fellowship training in Interventional Orthopedics and Regenerative Medicine. This subspecialty serves to fill the gap for patients who are interested in therapeutic options that lie between conservative treatment and surgery. Dr. Jerome uses regenerative medicine techniques, including prolotherapy and orthobiologics, via X-ray or ultrasound guidance to precisely deliver injections to areas of musculoskeletal injury or degeneration. Orthobiologics refers to tissue harvested typically from a person’s own body, such as platelets (platelet-rich plasma, PRP) or bone marrow, for use in treating painful musculoskeletal conditions. The goal is to stimulate the body’s healing mechanisms to improve pain, function, and decrease inflammation.

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Other Resources for MCL Injuries

Free Download: The Knee Owner’s Manual

This e-book by Dr. Chris Centeno examines the knee and its role in the human musculoskeletal system and the body as a whole. The Knee Owner’s Manual provides a series of tests and clearly defined exercises that you can perform on your own to assess and monitor your own knee health. It will allow you to look for trouble spots where your own body may be having difficulty with stability, articulation, symmetry, and neuromuscular function. You’ll be able to see how these deficits in other regions of the body relate to the knee.

The Knee Owner’s Manual also discusses how Regenexx is pioneering the development of interventional orthopedics, a new branch of medicine that employs regenerative biologic therapies such as adult bone marrow concentrate and platelet-rich plasma to help repair and strengthen damaged tissues in other areas of the body.

This is contrasted with invasive knee surgeries, which often remove important tissues or replace the entire knee itself when it becomes damaged. With hyperlinks to more detailed information, related studies, and commentary, this book condenses a vast amount of data, images, and resources into an enjoyable and informative read. This is the first edition of The Knee Owner’s Manual, a companion book to Orthopedics 2.0.

  • ACL Tear Treatment Without Surgery: Our New Publication!

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  • How to Avoid Knee Replacement: A Quickstart Guide

    Your knee pain initially was intermittent and mild.  Unfortunately, It is now constant and debilitating.  Your doctor recommends knee replacement surgery. What is the knee composed of?  What are the most common knee injuries?  What is knee replacement surgery? What are the different types of knee replacements?  What is knee replacement surgery success? What are … Continued


  • What Is Neural-Prolo?

    What Is ProloTherapy? “Gateway drug for regenerative autologous ortho-biologics (stem cells and PRP)” “Prolo” is shorthand for proliferative therapy. Its origins can be traced as far back as the ancient Egyptians and Hippocrates when they used cauterization to induce scaring for laxity.  Modern day prolotherapy was first described for orthopedic use in the 1930 when … Continued


  • Regenexx ACL Repair vs Reconstruction Surgery for Knee ACL

    Regenexx ACL Repair vs Reconstruction Surgery for Knee ACL Today I’d like to highlight a patient named Joe’s story.  Joe is unique in that he has had the non-surgical Regenexx Perc-ACLR procedure which uses your own cells injected via a small needle, and a surgical ACL reconstruction, so he can compare the two. So let’s … Continued


  • ACL Tear Treatment Without Surgery: The Truth You Need to Know!

    The Anterior Cruciate Ligament (ACL) is a key stabilizer in the knee that is frequently injured. Dr. Schultz discusses what an ACL is, the major causes of tears, symptoms associated with a tear, what ACL surgery is, its risk, and effective ACL tear treatment without surgery. He shares a recent clinical success with a 14y/o soccer player who avoided ACL surgery by using her own stem cells at the Centeno-Schultz Clinic.


References:

  1. Shelbourne KD, Wilckens JH, Mollabashy A, DeCarlo M. Arthrofibrosis in acute anterior cruciate ligament reconstruction. The effect of timing of reconstruction and rehabilitation. Am J Sports Med. 1991;19(4):332‐336. doi:10.1177/036354659101900402
  2. Wan C, Hao Z, Wen S. The effect of healing in the medial collateral ligament of human knee joint: A three-dimensional finite element analysis. Proc Inst Mech Eng H. 2016;230(9):867‐875. doi:10.1177/0954411916656662

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