Ask Dr. Geier – Knee Braces for MCL Injuries
I want to issue an apology to a handful of my readers who have posed Ask Dr. Geier questions. I have probably 8-10 questions that I have not answered publicly (although I have sent most of you messages by email with some thoughts – again, not specific medical information, just general thoughts). All of these questions deal with injuries or problems I don’t really treat.
You see, about 90% of “sports medicine” surgeries involve the knee or shoulder. That’s just the nature of the field and its injuries. The other 10% are mostly elbow and ankle injuries. While I see a number of other injuries in the clinic/office setting or on the sidelines and treatment rooms, most of those are either not surgical or they are not really my area of expertise. Specifically, the subjects of these readers’ questions are the three main areas I do not treat – hand injuries, spine injuries/pain, and joint replacement. Most patients with these problems never see me in the office because we have fellowship-trained orthopaedic surgeons in each of those three specialties. If somehow they do (patients insist on seeing a sports medicine doctor for a sports-related injury), I try to refer them to the appropriate specialist. Those fields are too technical and different from what I do, and for legal and many other reasons, fellowship-trained specialists in those fields really should evaluate hand, spine, and joint replacement issues.
As for the Ask Dr. Geier questions, I will answer them with advice from specialists in those fields. It’s just hard to find people as enthusiastic about blogging and answering readers’ questions outside of work and after hours as I am. Also, I have had so many terrific questions in fields that I do specialize that there haven’t been many free weeks.
Having said all of that, please keep any and all questions coming. I love interaction with a truly enthusiastic base of readers! As always, please refer to my disclaimer about giving specific medical advice by email or online.
David
Manny in Chicago, Illinois asks:
Hi, Dr. Geier,
Sorry for the interruption but I just have a brief question. I am currently a Division 3 soccer player, and I have a recurring injury on my right knee – an MCL sprain. I am hoping you can suggest a knee brace for me. Thanks for your time.
Manny
I have written previously about the use of knee braces to prevent injuries in football. That post looked at using knee braces to prevent injuries in athletes with no prior injury to the knee. This question is slightly different in that the reader has a recurring injury, so there is a more defined role for a brace in this setting.
An injury to the medial collateral ligament, or MCL, is very common in contact and collision sports, such as soccer and football. The injury almost always heals on its own without surgery, assuming that it is an isolated injury without a coexisting injury to either the ACL or PCL or a meniscus. I will say that if this is a recurring problem, I think that it is important to ensure by evaluation with a sports medicine physician and possibly x-rays and an MRI that there isn’t more going on.
Brace for MCL injury?
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The treatment for an MCL sprain is typically a brace to prevent valgus stress on the knee. This is a stress that tends to open up the medial side (inside) of the knee. A hinged-knee brace that allows the knee to bend but prevents side-to-side motion can do that. Unfortunately those braces are not really designed to be worn for playing. There are off-the-shelf braces from several companies that protect the MCL against valgus stress while playing sports. For an injury that typically heals in 2-6 weeks, one of those braces is usually adequate.
Custom-made braces to protect healing ligament injuries can be an option for playing for some athletes.
It is important to remember that no brace completely eliminates the risk of reinjury or even makes playing possible in all settings, so I always recommend discussing return to play and the use of knee braces with a physician.
C. David Geier Jr., M.D.
5 Comments
I have a strained mcl and I have a knee brace but but doesnt really help. Can you give me a suggestion on what knee brace I should wear?
And it has to be functional. I’m a cheerleader.
Custom knee braces, like those worn by NFL offensive lineman, can be helpful for MCL injuries. They fit much better and are usually low profile enough to be worn during sports. A doctor orders them, and then a representative for the brace company usually takes measurements to have the brace made to fit the athlete’s knee.
What are the percentages of players in a contact sport ,such as american football, have knee injuries and return to play?
Return to play depends on so many variables, especially what structures are damaged and to what extent, that it is really impossible to determine a percentage for all knee injuries. Hope that helps!