What is an MCL tear, or medial collateral ligament injury, of the knee? What is the treatment, and should you wear a brace for an MCL tear? I address this question in my latest Ask Dr. Geier column.
Manny in Chicago, Illinois asks:
Hi, Dr. Geier,
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.
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.
Mechanism of injury
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.
Treatment of an MCL tear
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.
Brace for an MCL tear of the knee
For an injury that keeps happening (and does not need more aggressive treatments or even surgery), then I might suggest a custom brace for an MCL tear. 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.