Knee Ligaments Part 1 - MCL & LCL

There are four main ligaments that stabilize the knee joint which are the medial collateral ligament (MCL), lateral collateral ligament (LCL), anterior cruciate ligament (ACL), and posterior cruciate ligament (PCL). This week we’ll examine the MCL & LCL and next week with round off the knee by focusing on the ACL and PCL.

The MCL is the most commonly injured ligament of the knee, whereas, the LCL is the least commonly injured. As their names state, the medial collateral ligament is located on the medial/inside aspect of the knee, while the LCL is located on the lateral side.

The MCL can be divided into two bands, the superficial and deep. The superficial band runs from the medial femoral condyle to the medial proximal tibia and the deep band is continuous with the joint capsule and runs from the inferior medial femoral condyle and attaches to the proximal medial tibial plateau. The deep band of the MCL also attaches to the medial meniscus. The MCL injuries are usually the result of impact on the lateral side of the knee (valgus) and commonly occur when the foot is planted and unable to move. Because of the deep fibers attaching to the joint capsule and medial meniscus, it’s common for medial meniscus and ACL injuries to also occur when the MCL is injured.

The LCL is more cord-like and is located outside of the knee joint capsule. It runs from the lateral epicondyle of the femur and joins with the biceps femoris tendon before attaching to the fibular head. The most common mechanism of injury is a force to the antero-medial knee combined with hyperextension and a medial to lateral force (varus). LCL injuries are commonly seen in sports with high velocity pivoting and jumping such as soccer, basketball, skiing, football, or hockey. LCL injuries commonly occur with damage to other structures such as the ACL, PCL, or posterior-lateral corner.

Ligament injuries can be classified on the severity of the injury with grade 1 sprained, grade 2 partially ruptured, and grade 3 completely ruptured. The symptoms for MCL & LCL injuries are the same except for the location (medial knee for MCL and lateral knee for LCL).

Grade 1: mild pain, possible swelling, mild antalgic gait, edema, tenderness

Grade 2: moderate pain, swelling, antalgic gait, instability

Grade 3: severe pain, swelling, knee gives way

Conservative care is usually the first treatment of choice with initial focus on decreasing pain and swelling and gradually restoration of motion before progressing to higher level strengthening, balance, and functional activities. For Grade 1 & 2 injuries, patients can usually manage with non-operative care. Grade 3 injuries usually occur with injury to other surrounding structures including ACL, PCL, and menisci commonly and usually will require surgical intervention to repair or reconstruct followed by lengthy protocol to safely return the individual to their normal activity or sport.

If you are interested in learning more or about treatment options, don’t hesitate to call/text 701-318-4731 or email connectptnd@gmail.com to learn how we can help. Don’t forget to follow on Facebook and Instagram to stay up to date on the happenings at Connect Physical Therapy.

- Alison Fuhrman, PT, DPT, CMPT, OCS