Green Bay Packer fans held their collective breath during the opening week of the NFL season when their star quarterback, Jordan Love, went down with what initially looked like a serious knee injury. Fortunately for the Packers, Love’s injury was not season ending. It was a medial collateral ligament (MCL) sprain.
The MCL is one of the four ligaments that stabilize the knee, along with the anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), and lateral collateral ligament (LCL). The MCL is located on the inner side of the knee, and it prevents the knee from collapsing inward.
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Any athlete can injure the MCL, says Faheem Ahmad, MD, a family practice physician with OSF HealthCare, who completed a fellowship in sports medicine. But certain sports create a higher risk of injury, including football, soccer, hockey or figure skating, because of the twisting of the knee that is involved. Chicago Bears wide receiver Rome Odunze and San Diego Chargers lineman Joe Alt have also battled MCL sprains early in the NFL season.
“It can happen to anyone, under any circumstances, but that positioning puts you at significantly high risk,” Dr. Ahmad says. “When your foot and your lower leg are planted, and it's held in that position, your knee goes into a knock position. That's when your MCL is stretched. And there comes a point the stretch is too much.”
The symptoms of an MCL sprain include pain along the inner part of the knee, swelling and bruising of the inner part of the knee, pain when putting weight on the knee and hearing or feeling a popping or tearing sensation along the inner side of the knee. Dr. Ahmad explains an actual MCL tear is a disruption in the fibers that connect the femur, which is the thigh bone, and the shin bone (tibia).
The severity of an MCL injury is determined by four grades. “The first one is when the MCL is stretched but there is no tearing. The second grade is when there is partial tearing in the MCL,” says Dr. Ahmad. “The third is the MCL is completely torn or disrupted. And the fourth is where the MCL is torn completely, but there's also internal derangement, such as the ACL is disrupted or injured, or some of the other main ligaments are injured.”
An MCL sprain is diagnosed by examining the knee and testing such as X-ray, ultrasound or MRI. Dr. Ahmad says the best treatment option for a sprain is RICE (rest, ice, compression and elevation). Knee braces and crutches can also help.
“After a week of that, we start having you do some range of motion, exercise and light exertion,” says Dr. Ahmad. “And then we progressively increase your weight-bearing exercises and increase your sports activities.”
Most athletes who sprain their MCL can fully return to action without surgery sometime between four to six weeks. If symptoms subside and the doctor doesn't find any instability, the athlete can return sooner.
Still, it’s important not to rush the athlete back to competition too soon. Love has missed two games, and he’s expected to return to the starting lineup in the next couple of weeks. While Dr. Ahmad didn’t treat Love’s injury, he says it could have been a whole lot worse.
“He heard a pop and when you hear a pop around in knee joint injury, we worry about some of the major internal stabilizers in the knee, including the (ACL) anterior cruciate ligament,” he says. “And if you rupture that, then you're looking at six to nine months of recovery time. If he comes back within another week or two, that's very fortunate.”
And that’s good news for football fans, especially Packer backers.
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