Ask Dr. Geier – Knee Braces for MCL Injuries

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.

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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.
For an injury that keeps happening (and does not need more aggressive treatments or even surgery), then I might suggest a custom brace. These custom braces can protect the MCL (and some help protect the ACL and PCL) while being fairly comfortable during sports. Usually measurements of the patient’s thigh and calf are taken, and then the brace is made and shipped to the athlete a few days later. Also, custom braces are often more expensive, so checking with the insurance company might be a good idea.

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.

27 Responses to Ask Dr. Geier – Knee Braces for MCL Injuries

  1. 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?

    • 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.

    • 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!

  2. I hurt my knee and i was walk on ice and i lost my step then i land on my knee :/ and i have being warm my knee brace and i hurt my knee last Saturday !!! I think i need to get a new knee brace

  3. I am an ice hockey goalie. I tore my MCL on my right knee. I have gotten back into the sport with a brace while playing. I have having trouble with the metal of the brace digging into my knee pretty severly when I drop into the butterfly to make a save. I am finding bruises and other injuries from the brace, even though it is inside my goalie pad. Is there a brace I can wear that will not dig into my knee when dropping onto the inside of my knee (a necessity when playing goal)?

    • I think you would have to try different braces and find one that works for you. There are custom braces that protect the ACL that are specifically designed for sports participation, but hockey and being a goalie could be a problem. Also if an athlete’s MCL has healed, he or she might not need to wear a brace at that point.

  4. I’ve torn my mcl 12 times since the age of fourteen, all grade one and two. In the last 6 months its happened twice, both with little contact. My physio tells me its healed and not to wear a brace or support. and yet this problem reoccurs. Can you please give me some information and advice on braces or alternative action.

    • I can’t give any specific advice without being involved in your care. I do think that custom braces potentially can decrease the chance of an athlete suffering an MCL sprain, as has been shown in several studies. If an athlete has suffered a ligament injury, especially a recurrent one, seeing an orthopaedic surgeon to determine if there are surgical options as well.

    • I can’t recommend specific brands or types on my blog, but there are off-the-shelf and custom braces designed for MCL injuries from the different brace companies. Your orthopaedic surgeon can recommend options for you.

  5. I had ACL reconstruction on my right knee and then had issues with scar tissue (arthrofibrosis). In the interim, I sprained my MCL and we decided to hold off on pursing any MRI or additional diagnostic until after the LOA on my right knee and my right knee became strong again. In total, the MCL sprain was 4 months ago and I’ve had instabilitities about 20-30% of the time. Well I had the LOA on my right knee about three weeks ago and have been pounding away at PT (gotta get that extension back!) and my MCL on my left is toast – my left knee keeps giving out, especially after long days and PT.

    Is a brace even advisable at this point for the MCL or just continue to try RICE? Would a functional brace even help? I plan to bring up the MCL issues again with my surgeon at my 6 week visit (in 4 weeks) but determined not to give up in the interim. It’s only been a year of surgeries and PT!!

    • I can’t really say specifically, so I agree with you asking your orthopaedic surgeon. I don’t think there is much downside to a brace for an MCL injury, but I can’t say how helpful it would be for you.

  6. About ten years ago, I had an odd accident and completely blew out my mcl. I had surgery to clean it up, but not a full repair. From time to time I feel it go out on me. Most of the time it’s a wiggle , sometimes it’s a full hokey pokey, where it feels like it comes out, forward and turn back around to where it should be. This recently happened when I ca, to a quick stop crossing a finish line and had to avoid plowing over the mass of people standing there. I’ve iced it, and it’s not getting better after 4 days. Suggestions? Brace? It definitely gets worse through out the day as I use it . Very swollen all around.

    • I really cannot give you a specific answer to your question, as I haven’t seen you as a patient or examined you or seen any radiographic studies. Generally, though, there are surgical procedures to reconstruct the MCL if nonoperative treatment has failed and a patient’s knee is unstable. There are also braces that can help rpovide knee stability.

  7. Hi, I injured my mcl (I think) while playing soccer last week, a guy hit my knee on the outside, it has been 4 days since the injury the pain has gone, I can bend my knees completely now with no pain at all, but still when I stand up the inner side swells a bit after a while… is there any reason to be concerned? I am thinking of returning to sport next in the mean time has been doing some knee strengthening exercises, will a knee brace or sleeve be a good idea when returning to sport?

    • James, it is impossible for me to really say without examining you. MCL injuries typically heal without surgery, and a hinged-knee brace can often prevent stress on the knee that slows healing. Generally some of the signs that worry me after a knee injury (that could suggest a serious injury) include significant pain, locking or catching of the knee, and the knee giving way or buckling.

  8. I had both my knees scoped for meniscus tears, realignment and shaving down the knee caps. I do not have any cartilage so my ortho surgeon took an instrument and poked holes in my knee caps to create scar tissue. The arthritis in my knees was rated 3 out of 4. I was on crutches 6 weeks at a time and 8 hours a day on ACM. Shortly thereafter I experienced severe pain and went on to receive Hyalgan shots. That worked great and I was able to retun to full activities for several years. Recently my knees went
    into full pain mode. I am experiencing pain MCL in both knees to center, popping and slipping. I have taken OTC meds, ice several times during the day, elevate both legs day/night and have recently been trying to do some strengthening exercises but nothing seems to help. Unfortunately I have a high deductible insurance plan and cannot afford to go see my ortho doc till Jan. Is there anything else I can do to help alleviate my pain? I also have been taking Move Free with MSM + D3 and hyaluronic acid orally. Any suggestions and advice would be GREATLY appreciated.

  9. Hello,
    I had an MRI this past week and I have torn my MCL and meniscus. I do not know how long it will be before I get an appointment with the Orthopedic surgeon. I am wondering if I should try an over the counter Elite knee brace or just wait until I see the doctor. Turning while sleeping is very painful. I have been icing constantly and taking quite a bit of Ibuprofen. Every time I get up after sitting I cannot put any weight on my knee. The longer iI sit the worse it is. Any information would be really helpful at this point.

    • I can’t really give you specific advice, and I don’t know that particular brace. My general impression is that over the counter braces offer little support. Plus few braces, if any, help pain from a meniscus tear.

  10. I am 15 and a goalie for an elite travel soccer team. the other days I was mid air when a girl ran into me on the inside of my knee, and her whole body followed. I hyper extended and twisted my leg and the trainers so I could have partially torn my mcl or acl, and it was looser than my other knee. it was sprained and the target area was my joint. I’ve been following the RICE method for the past few days now, advised by my mother (she’s a nurse) and I haven’t really been able to move or put weight on my leg until now, 3 days later. I m returning to school tomorrow, where I have to walk about a mile every day and then soccer practice later at night. would you suggest a slip on knee brace or a hinges knee brace? I can’t stand straight on my left leg because it feels like it could keep going backwards and I’ve almost fallen over a few times. my parents won’t allow me to use my crutches and want my muscles to heal, but I haven’t walked more than 20 feet at a time. the only problem with a slip on brace is that I feel it won’t be enough support and the hinged brace might not be suitable for playing. what do you suggest?

    • Generally I recommend that an athlete who cannot put weight on his leg and feels like his knee is buckling or giving way should consider seeing an orthopaedic surgeon to learn the nature of the injury and plan treatment options. The surgeon can also assess the need for a brace. Without knowing the nature of a patient’s injury, it is hard to recommend a knee sleeve or brace.

  11. HELP dr. i fell down 10 days ago and the swelling and pain all went away but i sometimes feel like my knee bones sliding over the other.i went to the doctor and he said that it was MCL or ACL and that i should get a MRI.should i get one? or just wear a knee brace with little to no physical work.also i professional soccer and want to avoid surgery.what should i do?

    • I can’t say, honestly, so I would defer to your orthopaedic surgeon. Generally an MRI can help determine the presence of any structural damage suffered by an athlete after a knee injury.

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