The medial collateral ligament (MCL) on the inner side of the knee is most often torn when there is a force that strikes the outside of the knee. The MCL attempts to resist the knee bending sideways and tears if the force is too great. When this happens, you may face a recovery time of days to months, depending on the grade of the MCL tear.
Treatment of an MCL tear depends on the severity of the injury. Treatment always begins with allowing the pain to subside, beginning work on mobility, followed by strengthening the knee to return to sports and activities. Bracing can often be useful for the treatment of MCL injuries.
Fortunately, most often surgery is not necessary for the treatment of an MCL tear. In some specific circ*mstances, surgery may be recommended. Most often, surgery is used for the treatment of specific types of severe MCL injuries.
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Treatment of Grade I MCL Tears
With grade I MCL injury, minor pain and tenderness are usually felt and you may need to use crutches for a short time.
Treatment consists of:
- Resting From Activity
- Icing the Injury
- Anti-Inflammatory Medications
- Knee Exercises
Grade I injuries of the MCL often resolve within a few days to about two weeks.
Treatment of Grade II MCL Tears
When a grade II MCL injury occurs, the use of a hinged knee brace can be useful in early treatment. The hinged knee brace will allow you to bend the knee, but provide support to the injured ligament.
Otherwise, the treatment principles are similar to those for patients with a grade I MCL tear. Athletes with a grade II injury can return to activity once they are not having pain directly over the MCL or symptoms of instability.
People with a grade II MCL injury may be able to return to activities within two to four weeks after their injury.
Treatment of Grade III MCL Tears
When a grade III MCL tear occurs, there is looseness in the knee, significant pain and tenderness, and sometimes swelling. The knee should be braced and crutches used until the pain has subsided. The knee can be immobilized for a few days initially, but enabling range of motion as soon as possible will help in the recovery process.
Once the patient can begin bending their knee, early range-of-motion exercises should commence, including stationary bicycling. Normal walking and progression to jogging can begin as pain allows. Use of a hinged knee brace is usually very helpful to support the knee, especially in the earlier stages of rehab.
Most people return to normal activity within four to eight weeks after a grade III MCL tear.
Surgery for MCL Tears
MCL tears often do not need surgery. Many studies document successful nonsurgical treatment in nearly all types of MCL injuries. Most surgeons agree that for patients who complain of persistent knee instability, despite appropriate nonsurgical treatment, surgery is reasonable.
Some surgeons advocate surgical treatment of grade III MCL tears in elite athletes or those athletes with multiple ligament injuries in the knee. In these circ*mstances, you should discuss the optimal management of your injury with your healthcare provider.
Recovery time from MCL surgery depends on the knee injury but is generally between nine and 12 months.
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Orthobullets. MCL Knee Injuries.
University of California San Francisco. MCL Tear.
USF Health. MCL Tear.
Andrews K, Lu A, Mckean L, Ebraheim N. Review: medial collateral ligament injuries. J Orthop. 2017;14(4):550-554. doi:10.1016/j.jor.2017.07.017
Laprade RF, Wijdicks CA. The management of injuries to the medial side of the knee. J Orthop Sports Phys Ther. 2012;42(3):221-33. doi:10.2519/jospt.2012.3624
Encinas-ullán CA, Rodríguez-merchán EC. Isolated medial collateral ligament tears: an update on management. EFORT Open Rev. 2018;3(7):398-407. doi:10.1302/2058-5241.3.170035
Additional Reading
Miyamoto RG, et al. Treatment of Medial Collateral Ligament Injuries. J. Am. Acad. Ortho. Surg., March 2009; 17: 152 - 161.
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By Jonathan Cluett, MD
Dr. Cluett is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the U.S. national soccer teams.
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