Medial Collateral Ligament Injury

Like a numpty I slipped and injured my knee about 3 weeks ago. A week later I injured it again sorting the kids Christmas presents on Christmas Eve. It was very sore,swollen and bruised in the inside of my knee and has took a couple of weeks to get movement back. I have also suffered with some muscle loss and a sore back due to hobbling about.
 
I have just got back from the Doctors who diagnosed a Medial Collateral Ligament Injury.
 
His advice was 6 weeks rest and anti-inflammatories.
 
I asked about physio as I have Private Healthcare, but he said I dont need it and should just rest up and reduce the inflammation.
 
Once my rest is up, I obviously cannot just jump back into squatting, running etc and would appreciate some advice on what I should be doing to get my leg back to normal.
 
Thanks
 
 

medial collateral ligaments job role is assisting with knee stability from the inside of the knee, as I am sure you already know
if your sprain is grade 1-2 it can take 6-8 weeks of rest and rehab exactly as you have been told. I doubt you have a grade 3 sprain as that is a complete rupture and you would have bleeding etc. so some but not all of the fibres of your MCL have been damaged
 
anyway you do need to preceed slowly and some of the work should be proprioception, coordination and balance stuff to re-set your system of stability.
it is also important that you stop 'limping' and compensating as soon as you can so as not to cause some imbalances through the rest of your body.
there are some release techniques here that may help ease some tension you may have gained already:
 
http://www.youtube.com/user/biomechcoach
 
best bet it to see a qualified professional who can give you bespoke exercises to help strengthen your knee up again - i would imagine using a resistance tube will be a good starting point once you are ready.
do you have a knee brace while it heals?

Rachfit Thanks for the reply.
 
Stability has been the issue but is a lot better now.
 
I have a knee strap/brace which I showed to the Dr, he was happy with it and recommended its use.
 
I totally agree with the imbalance suggestion as my back has been giving me more grief than my actual knee. I have stopped hobbling about now so the back is much better.
 
Should I continue with icing the area as well as the anti-inflammatories?
 
Regarding starting slowly, is it complete rest for 6 weeks or can start rehab as soon as pain and discomfort subsides?
 
I have managed to obtain some re-hab exercise sheets from the internet which gives advice on exercises etc
 

main focus should be reducing inflammation, if that is gone then icing isnt necessary. if you do still have it then anti- inflammatories and maybe some icing - getting the inflammation down should reduce the pain levels too.
 
while you are in an uncomfortable phase rest is best but you can do some stuff like sitting flat on the floor legs straight in front and together and just aim for full knee extension. dont 'force' it but do aim to get the knee fully extended as soon as possible.
if it already is ok to do that then any basic movements that dont increase pain too much, firstly with no resistance.
you will know when you are ready to do stuff but take your time (this is the hard bit) just make every time you sit and stand into a considered squat movement rather than a twisted avoidance of flexing the knee if you can - if that makes sense
what kind of exercises did you get off the web mate?
 
 
 
 
 

Thanks Rachfit, I am trying my best to ensure that I am walking, getting in and out of chairs as normal as possible - it is stlll a bit sore and stiff but is easing off.
 
The exercises are
 
Stretchs - calf, quad, hamstring
Leg raise - sitting on a chair with leg resting on another and lifting straight leg.
Step up and lateral step ups
Upper thigh strength - towel under knee and lift
Inner thigh strength - towel between kness and squeeze
Lying Hamstring stretch
Lying Straight Leg Lift for Glutes/Hip
Inner and outer thigh/hip strength - side raises with legs
Figure of 8 walking
 
I also read the exercise bike is useful at a high height so you are not flexing the knee too much at the stop.
 
After the exercises is it advisable to ice the area to reduce any exercise induced inflammation?
 
Thanks
 
 

ok all look ok but I wouldnt know how many are specifically relevant to you without assessing you so you must understand the exercises you have written here are generic and therefore some could be a waste of time and others could be inappropriate for the way you are stacked up.
 
Almost everyone has tight calf muscles so this is always advisable but even more so for someone who has suffered an injury relating closely to calf muscles - like yours - hold this stretch for 90 seconds and if you can do 4 times daily.
 
Quad and ham stretches would be usual for anyone whether exercising or injured or not.
 
Step up is good to strengthen normal functionality and making sure your knee is lined up with 2nd/3rd toes - as per the norm
 
upper thigh strength - this sounds like a leg extension from straight relaxed to straighter and locked out with the towel to support the back of the knee - needed to support the knee stability.
 
I would consider your outer thigh to need working more than inner - if your knee has collapse inwards (medially) then it is more likely the hip abductors that could be dysfunctional - again this is just guessing mate
 
Lying hamstring stretch - as previous stretch but lying is probably safer while in pain as weight is taken off the sore leg.
 
Lying straight leg lift for glutes/hip - I am guessing this is lying face down (prone) - if so be careful not to hyper extend the spine while performing this one. you could also try a bridge type movement where you lie on your back (supine) knees bent and hip width then lift your hips upwards until knees, hips and shoulders are lined up. ensure knees are lined up through mid shin all the way and you could add a resistance tube around knees for added abductor work. do several reps, sets.
 
Side lying leg raises to work the abductors is good for lateral stability. 
 
and some inner thigh work for balance maybe
 
I assume figure of eight is to walk in the shape of an 8?
 
Add in some balance work and I dont mean stand on a bosu, I mean literally stand on one leg and shut your eyes OR stand on one leg and watch a ball as you pass it over head and back.
Balance work should always start on a stable ground surface NOT an unstable one. If anyone advises you to stand on a wobble board or bosu please DONT! Get stable on a stable surface first as trying to condition balance on an unstable surface while unstable can be far too soon for your healing body.
 
hope this is helpful mate

Rachfit thanks very much for such a detailed response.

you're very welcome anytime - thanks for the vote btw!

Sorry to re hash this thread but I think I've damaged mine a bit too!
It must be a grade 1 as there's no swelling or joint instability. I must have twisted it while standing. I can remember feeling it a little as I turned with my foot on the floor. I felt the pain later and then yesterday when I did 30mins of leg pressing the pain was quite bad afterwards. It seems the increased bloodflow is whats causing the pain as once I'm relaxing the pain goes. It's very minimal while I'm walking but I can feel  it for about 5-10 mins once I stop and sit down. Then it goes. It's painful if I press on the area (inside of knee). My question is, do I have to avoid leg exercises? I'm due to do hams tomorrow. It's feels like the back and forth action of the knee isn't doing any further damage and it's just the increased blood flow in the area that is causing the pain. If it was doing extra damage I'd imagine the pain afterwards would stay but it going once the bloodflow settles down. I suppose I should go to the doc. That'll be a week to get an appointment.
If you read this Rachel, do you think leg curls/deadlifts are ok and won't effect my recovery?

Pain is not a good indicator mate as you can be at huge risk with no pain or you can hurt like hell and mechanically its not that bad.
I am concerned that you 'think' it got twisted while standing though!? It must have been at risk prior or previously damaged to have damaged so easily.
Without assessing you it wqould be impossible to comment on what you should do training wise BUT get to see a qualified professional asap!!!
Your legs will be fine if you dont train them the losses are minimal but the risk could be high if you dont know what is going on in your knee joint.
Sounds like there is some inflamed tender tissue if painful to touch. If you see a professional you need to ask WHY to every piece of information they give you - WHY do you have the problem? what caused it? standing and twisting is NOT the original cause, it must have been under stress prior for some reason. If you are not satified cme back to me and I will find you a professional I would recommend in your area.

Thanks for the reply Rachel.
Actually I've always prided myself on my knees and never had a problem before. I do remember feeling a twinge last week when turning but it seems very innocuous at the time. Then I felt it once or twice more. It was painful to the touch on the inside of my knee. Then after the leg pressing a couple of days ago it was more sore and at present it gets sore when walking. Well it's when I stop walking I feel it. Unfortunately my job ( tube driver) means it's stuck in a bent position for long periods. The pain is minimal then though and goes away when resting on the coach (like now! ). I did leg curls today and I don't think it made it worse. But might stay away from the leg presses for a while.
Yeah will have to get it looked at. It's a bummer has my training was flying along!

Something weird!
Just felt it, pressed quite hard all around the area and there's no pain. Weird. It can only be cos I've been resting on the couch for over an hour. So it seems when I'm moving about it gets quite tender and sore to the touch but the pain subsides, even when pressed once I've been off my feet for a while. Must be to do with blood flow!?