Will a brace protect an athlete’s knee while he heals from a knee injury? My latest Ask Dr. Geier column addresses this question about one of the most common knee injuries in sports and exercise – medial collateral ligament (MCL) injuries. Should you wear a knee brace for an MCL tear?
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. In the mean time I have been doing some knee strengthening exercises. Will a knee brace or sleeve be a good idea when returning to sport?
Mechanism of injury
MCL injuries, or injuries of the medial collateral ligament, often result from a valgus force directed to the knee. Essentially valgus refers to a force that causes the ankle and foot to move laterally (away from the midline of the
body) while the knee is forced medially (toward the midline of the body). A valgus force causes the medial side of the knee to open and potentially injures structures on that side of the knee. A blow to the outside of the knee while the foot is planted is a classic example. This type of blow to the knee often causes MCL injuries in contact or collision sports like football.
Treatment of an MCL injury
Assuming an athlete has an isolated MCL injury and no other ligament or meniscus damage, treatment for an MCL injury almost always involves nonoperative measures. Surgery for an acute MCL injury is only required for rare injuries.
The location of injury does play a role in the length of time it takes an isolated MCL injury to heal. If the ligament injury occurs on the side of the femur, it can heal in as little as 1 to 2 weeks. Early knee range of motion to prevent stiffness can be important for these injuries. The athlete and surgeon would note tenderness at the medial femoral epicondyle (bony prominence on the inside of the knee above the joint line).
On the other hand, an MCL injury at the tibial attachment can take longer to fully heal, often 4 to 6 weeks. The athlete and surgeon would notice tenderness on the medial side of the knee below the joint line.
Knee brace for an MCL tear
Healing often requires the athlete to wear a brace for an MCL injury that prevents valgus stress on the knee and its healing MCL. The brace has hinges that prevent side-to-side motion, but it allows full flexion and extension. Functional braces that serve that function but allow more aggressive physical activity do exist, and the orthopedic surgeon can order one for the athlete. A knee sleeve or off-the-shelf brace from a drugstore would not provide the necessary stability for the knee.
The athlete can usually exercise early in the healing process. Non-impact exercise like cycling, elliptical training, and swimming might be less stressful to the knee. Closed-chain strengthening with squats or leg presses can be started as the ligament heals. Once the MCL has healed sufficiently, he can usually start jogging and progress through sport-specific activities as tolerated. Physical therapy can be useful to help him regain strength and range of motion and guide him through a return-to-sports program.
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