By: Jared S. Ernest MPT
To correctly estimate the time of recovery you first have to classify or grade the MCL tear. This classification of an MCL tear is based on how severe the tissue damage is. There are three levels of classification for an MCL tear, grade 1, grade 2, and grade 3.
A grade 1 MCL tear is when only a few of the tissue fibers of the MCL are damaged. You will usually have tenderness on the inside of the knee. Bruising and localized swelling may develop. Walking and running will be limited during the early stages of injury.
The initial stages of treatment involve modalities and ice for pain control/swelling. Also, strength and range of motion (ROM) are performed in a very controlled manner. Progression to more functional strength and mobility activity may then be instituted. Recovery to normal activity to be expected in about 3-4 weeks.
A Grade 2 MCL tear involves much more tissue fiber damage but the MCL is still functionally intact. The inner knee is usually very painful to include bruising and swelling. The knee in most cases may feel unstable.
Modalities such as Ultrasound and laser are used to promote fiber healing. A brace is usually prescribed to promote stability and protect the joint during rehab. The first part of rehab focus is to return pain-free ROM and strength. Progression than is to functional activity with recovery in 4-8 weeks.
A grade 3 MCL tear the ligament ruptures meaning complete tearing of the fibers of the MCL. Since this is the most severe type of MCL tearing there is usually a significant amount of swelling and pain. The knee also becomes very difficult to bend. The knee will feel wobbly or unstable. In most cases, you will not be able to walk on the knee.
Protective bracing is a must with a Grade 3 MCL tear. Also, crutches will be used until you are able to walk with a normal gait pattern. Modalities and controlled ROM are used in the initial stages to allow.
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