STEVE JACKOWSKI

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How I Rehabbed my MCL Tear

10/24/2016

164 Comments

 
PictureSame spot different day
It was a spectacular day on the north coast.  A friend I hadn't seen in years came up to surf with me and there were only four of us out in perfect shoulder-high waves with a few plus sets.  An hour into the session, I raced down the line hoping for a barrel in the section ahead, but at the last second, the water under the section drained with the dropping tide and I tried to turn down and out. 

Unfortunately, the back rail of my board hung up and did an el-rollo with my foot while my knee went in the opposite direction.  I felt a major tearing.  I paddled back into the lineup and talked to the physical therapist who was surfing with us.  He suggested that from the symptoms, it was a MCL tear - one of the most common surfing injuries.  He also said that if the injury didn't involve other ligaments or the meniscus, it likely wouldn't need surgery.  

Ironically, a few minutes later, my friend hurt his back, so we hobbled up the cliff together, disappointed at the number of uncrowded perfect waves we were going to miss.  

I raced home, showered, iced, and elevated my leg, then waited patiently for the arrival of Karen's son and daughter-in-law, both Osteopaths and specialists in Neuromuscular Medicine. They were planning to spend part of the weekend with us.  Two rounds of disc golf were scheduled for the next day and I envisioned being able to play.   Little did I know.

Picture
In the meantime I did research on the internet to understand what the MCL was and what the prognosis might be.  

The MCL is a ligament that runs on the inside of the knee.  It is frequently injured in soccer, football, and rugby in a tackle where the foot is planted and the knee is struck from the outside, tearing the supporting ligament on the opposite side.  

Mine was caused by my foot being pulled upward by the wave as my knee went downward and my body rebounded upward causing the same effect - a tearing on the inside of the knee.   

I also discovered that MCL tears have three classifications:


Grade 1 - a minor strain with recovery times of a week or two
Grade 2 - a significant tearing of the MCL with recovery times of 4-12 weeks
Grade 3 - a complete rupture of the ligament with recovery times of 12-16 weeks.  

The primary test used to diagnose MCL strains is called a Valgus test.  Basically, your knee held steady while your lower leg is pushed outward.  If your leg flops outward with little resistence, little pain, and just keeps going past 45 degrees (even 90 is possible), you have a complete tear (Grade 3) of the ligament.  

If your knee is stable and there is good resistance to the outward pressure, though painful, it is most likely a Grade 1 strain.  

If your knee is unstable and your leg moves independent of the knee, but encounters resistance, it's a Grade 2 tear.

Mine was Grade 2 as there was significant instability in my knee.  I was surprised that there wasn't significant swelling, but it appeared the wetsuit provided good compression and the cool water didn't hurt.  

The Docs arrived and confirmed my diagnosis.  They did some Osteopathic treatment to help realign the knee and to encourage fluid flow.  But according to Karen's son, I was likely looking at 12 weeks for full recovery and certainly wouldn't be playing disc golf any time soon.  Of course I didn't want to believe him.  I'd never had an injury that was that debilitating and I couldn't imagine this one would be.  

That night I tried to sleep in bed, but just the weight of a single sheet was too much if I moved my leg to the side.  For the next two weeks, I slept in a recliner chair with my knee elevated.  


Karen's son also recommended an offload brace.  Unfortunately, the medical supply store didn't have any so I made do with a hinged knee brace.  It helped, but with my now very swollen knee, the hinges pressed on the MCL.  I later saw an offload brace and wished I spent the money (my insurance deductibles are ridiculous).

Partly because of insurance, but even more because I like to think I can solve every problem myself, I decided to do my own rehabilitation.  I must admit that after all I'd read about unnecessary knee surgeries and their complications, I was skeptical of entering that process.  But, I had the opinions of two Osteopaths (see my previous post on Why I Believe in Osteopathy) and a physical therapist, so I wasn't going into this completely blind.   Based on their input and the analyses provided by sports medicine websites, it was almost certain I had an MCL tear with no other complications.  So, from what I can see, it was just (!) a question of rehabilitation.  

Author's Note (12-27-2021): I posted this several years ago and it appears the sites referenced below for rehab exercises have changed.  While I still strongly recommend the Sports Injury Clinic, they've moved to a pay for videos model.  There are a few exercises for free, but if you want all exercises, and especially the progression as you advance, you need to buy the video(s).  For Summit, all of their guidance has disappeared except for this brief chart on one of their Pinterest pages. 

So, to get your rehab started, try this link to Tuft's MCL rehab program.  Once you progress (see my progress below), do a search for 'MCL tear rehabilitation exercises'.  You should be able to come up with more advanced rehab including plyometrics and weight work.  sjj


After studying  numerous physical therapy and sports medicine sites, I ultimately settled on the 
Sports Injury Clinic.  I also used Summit Medical Group's exercises.  In particular, the initial stretching and strengthening exercises helped tremendously, particularly the passive knee extension (which hurt like hell), the heel slides, and the leg raises.  I did the knee extension and flexion along with the heel slides several times a day until I got enough consistent flexibility to walk with minimal pain.  Ultimately, I moved on to more challenging exercises.   My progression went something like this:

First four days - RICE - the swelling was so bad I really couldn't do even the most basic exercises.
Beginning day 5 - easy stretching exercises, especially knee extension and heel slides.
Second week - added strengthening exercises with bands - knee stabilization was the most important.  
Third week - started increasing walking distances and began gym workouts (bike and weights).
Fourth week - added Plyometric exercises (one legged jumps).

Picture


By the fifth week, I was feeling pretty good.  The swelling was almost completely gone and although my knee would get stiff if I sat for a while, doing the passive knee extension and flexion after getting up seemed to work well.  I bought a brace with a strap, and decided to try to surf.  The strap is cool because you can wrap it around the weak parts of your knee to provide much more support.  It stretches so you can make it really tight and it velcros to itself.  

I paddled out into easy, mushy rights and lefts.  My first wave was a right (backside for me), and as I started my bottom turn, I felt my knee give and pull.  It hurt like hell but the pain subsided quickly,  I decided to try a left and had no pain at all until I did an aggressive cutback.  I stuck with lefts for the next hour and surfed cautiously.  Unfortunately, I discovered that when you duck a wave, the wave pulls at your legs, sometimes to the side, and when that happened it definitely hurt.  I was sore after the session but I was glad to have surfed.  Still, I knew I wasn't ready.  It wouldn't take much to re-injure my knee in the surf.  Anything unforeseen would do real damage.  

I worked hard with the exercises and the gym the following week and tried again.  This time the waves were small but quick and mostly lefts.  I had a great time until I tried a right.  Again, driving off the back leg hurt.  It wasn't unstable like it was the week before, but still.  

It's now been eight weeks.  This past week, I was able to make full backside bottom turns and aggressive cutbacks on my lefts.  I surfed four really fun days.  On the last day though, I punched through a large set and got tossed around by the last wave.  I really felt it in my knee.  It didn't tear, wasn't any worse later, but I know that I can't let up on the strengthening exercises.  I still have a ways to go for 'full recovery'.  In the meantime, I can hike, dance, and play disc golf (took 4th in a tournament yesterday with no pain).  

Mistakes I made.

Realistically, Karen's son was right.  It's going to be 12 weeks for full recovery, particularly for surfing.  I seriously underestimated how much inward force you put on your knee in a backside turn or frontside cutback.  I seriously underestimated the force of the ocean, which is a very stupid thing to do.  And at the beginning, I tried to do too much too soon.  I'd try to push walking and tried to do the harder strengthening exercises when I wasn't ready.  Each time I did, it set me back a couple of days with renewed swelling and loss of flexibility.  

Overall though, I'm almost there.  Still, perhaps you can avoid some of the mistakes I made.

Set your expectations - it's going to take longer than you think.
Don't do too much too soon.  Be very cautious as you restart any activity.
Spend the extra for the best brace possible.

And, I think the main reason for my successful recovery is the dedication to the daily (or more) stretching exercises, and consistent and progressive strengthening exercises.  

The good news is that if it's an MCL tear with no other damage, you can rehab it yourself. But above all, you need Patience, Patience, Patience!

Update January 2018.

It's been a year and a half since I first injured my MCL as described above.  The rehab program worked, and I was back to full activity with maximal stress (surfing, extreme skiing, etc.) within 4 months (with a lot of hard work in rehabbing it).  Everything seemed fine and then, six weeks ago, while Salsa dancing on a rough surface, my foot caught in a fast turn and I felt my MCL pull.  It was too painful to continue dancing so I stopped.  By time I got home, my knee was hugely swollen.  I started the RICE treatment, but underestimated the severity of the injury.  Yes, it was only a grade 1 injury - there was no looseness under the Valgus test, but almost any activity caused huge swelling.  I consulted my muscular medicine doc and he informed me that re-injuries are often worse from the point of view of healing time.  Unfortunately, he was right. 

I hate being sidelined from the surf during one of the best seasons we've had in years.  And, not being able to run, dance, ski, etc. is depressing at this time of year.  

So here I am, six weeks later.  The pain is gone.  Most of the range of motion has returned (with lots of stretching), and I'm working on strengthening.  The plyometric exercises are still tough.  I did try surfing and easy front side is okay but I can tell I'm not quite ready for more aggressive turns.  I will be giving skiing a shot this week (now that there's a bit of snow in the Sierra).  In the meantime, I'm working hard on the strengthening and I now realize that to avoid re-re-injuring my knee, I need to keep up these exercises even after I'm back to 100%.  They're going to become part of my daily routine, much like core strengthening has.  Core strenghthening  resolved all of my back problems and I expect I can avoid further knee injuries if I keep up these knee exercises too.  

So, a final word of advice.  Once you're back to normal, don't stop your strengthening and range of motion exercises.  Do them regularly and hopefully, you can avoid a re-injury that will sideline you for several weeks.

If you liked this blog, please check out my novels.
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164 Comments
Karen Noel
10/24/2016 10:54:39 am

This is amazingly thorough and great information. But I feel I must stress the following: I live with this man and I have never seen anyone as dedicated to healing as he is. He was so conscious of what he had to do each moment of the day that, even with his 'mistakes', I imagine his healing has been the fastest and most thorough possible.

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DG
1/17/2018 08:09:55 pm

I got a Grade II MCL sprain three weeks ago skiing, this post helped motivate me and made me be realistic about my recovery timeline. Thanks for writing this, always nice to read other's stories to know that we're not alone with our injury.

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Steven Jackowski link
1/17/2018 08:17:45 pm

Hang in there. Surprisingly, it will heal. However, after a year of resuming my very active lifestyle with skiing, whitewater kayaking, surfing, etc. I reinjured my MCL about 5 weeks ago. This was just a grade I, but it's taking a while to heal. My doc said that reinjuries take longer than you'd expect. After 5 weeks, I can play disc golf and hike. I can surf with a brace if I take it easy (front-side only), and I'm hoping to try it out skiing next week (with a brace to begin with). Ironically, I sprained it again dancing on a rough surface. I think my mistake was not keeping up the strengthening exercises after I felt it was fully healed. This time, I'm making them a part of my regular routine. I don't want to go through this again.

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BF
10/11/2019 05:27:11 am

Same story, left knee MCL Grade 1-II. Its been 7 weeks and I'm still not fit to really run or get back to doing what I want to do. I think the most frustrating bit is reading about how its typically 3-6 weeks to recover. What!?!? Not true. And I've been good about rehab efforts. Its getting there but just taking forever.

Thanks for sharing your story.

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Steven jackowski link
10/11/2019 05:33:26 am

You're welcome. Hang in there and be rigorous about rehab, but patient. It will get better but it takes time. For me, knee stabilization using bands really helped. Good luck!

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Surgeons for sports injuries link
10/17/2019 10:06:55 pm

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GES
11/12/2019 02:25:29 pm

49 yr old male. complete grade III tear of MCL 7 weeks ago playing in my FIRST over-50 soccer game. got immediate MRI, knee brace, and PT. similar PT progression of range of motion and RICE, then stationary bike, then small amounts of weights, then elliptical, then some slightly more progressive/dynamic movements with resistance bands -- all under PT supervision. just left 7 week check up and Dr says its healing nicely. have a big ski trip in 11 weeks (will be 18 from injury) so i am working toward that. Dr said i should be able to play all sports in spring without a brace. he said i can't really re-injure it in short term, if i wear the brace when working out. i don't wear it just walking around. he said i could push the workouts, and just let pain be my guide. my advice - give it these injuries time. wear brace whenever in doubt. i have played all sports my whole life - ski, surf, soccer, golf, tennis, swimming, EVERYTHING, and hate to be sidelined...but again, my advice is take your medicine, give it time to heal, and then COME BACK STRONG!

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Angie
12/5/2019 11:32:53 am

I was in pain early September and got an MRI on both knees. Showed overused, mild/moderate MCL sprain. I've been doing PT once a week since Sept 9th. The first 3-4 weeks I was feeling good and thought I am getting better. Took the boys sledding, shovelled snow, walked around Halloween and my pain came back. I'm almost 3 months out doing PT and do strengthening at home. Although I can walk and tolerate the pain, twinges etc. I am still not completely close to healing. The past week I am sleeping uncomfortably and feeling stiff, locked on my left knee in the middle of the night especially on the lateral side which is the worse knee btw. I can bend my knees, do the stretches and strenghten from PT work out fine, but I'm wondering if you ever felt your lateral side locking or stiff at night where it wakes you up. Does it usually feel like it's a meniscus tear after 3 months of PT or in general. I definitely can't ski this season, but just trying to find some comfort. Please advice Thank you.

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Steven Jackowski link
12/5/2019 08:51:46 pm

Hi Angie,

You may be a victim of doing too much too soon. I would have to say yes to both of your questions. I did feel my left knee locking from time to time, almost always stiff, and it definitely woke me up, At three months I thought I was substantially better but quickly discovered (in my failed attempts to surf), that I'd set myself back. I'm not sure what PT you're doing, but twice a day, I did heel slides, leg lifts (forward, side, and back), toe raises on stairs, squats, single leg hops, side to side hops, stationary bike and more. However, the most effective were the knee stabilization exercises with resistance bands. And, as I mentioned, I did reinjure it and that recovery took longer than the first. Since then, I regularly do the knee stabilization exercises for maintenance. I'd also suggest a brace when you're doing anything other than linear movements - at least for a while. Don't lose faith, but do keep in mind that it take longer than you want it to.

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Wayne
1/10/2020 07:03:09 pm

Thanks for sharing your rehab story, Steve! It was really helpful. I torn my MCL (Grade 2) 3 weeks ago skiing and recovery is slower than expected (the doctor said 4 to 8 weeks). May I know your MCL pain is near the femur or near the tibia? Mine is near the tibia and from some Websites it seems like it's harder to heal. Thanks!

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Steven Jackowski
1/10/2020 10:51:27 pm

Hi Wayne,

Most of my pain was dead center, though I had a lot of pain near the femur for quite a while. Be patient and find a good physical therapist or go with the sites I mentioned in my article. Mine was closer to 16 weeks and the second injury took almost as long. Since then, I'm religious about my knee stabilization exercises and have had no problems. Still, don't push it. It may take longer but you'll have a better outcome if you're faithful to the exercises and don't return to full activities until you're really confident.

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Wayne
1/11/2020 09:34:59 am

Thank Steve!

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Angela Clarke
4/18/2020 06:52:33 am

This post is extremely helpful-it's very depressing to not be able to run during Quarantine. I will start using the strengthening exercises regularly as you suggest once I'm back to 100% to prevent re-injury. I came for the post on your MCL, but wow, what an interesting life you have! Hope you and your family are safe and well and thank you for the great info.

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Steven Jackowski link
4/18/2020 08:27:18 am

Hi Angela,

Thanks for the kind words. It's been a couple of years and I've had no further problems. Aside from the limits of shelter in place with all the park closures, I continue with full activity. Oddly, the thing I miss most is the Salsa Dancing at the Santa Cruz Wharf with Karen. We do some dancing at home but dancing outside is hard to beat.

Once you're at 100%, I strongly recommend adding at least the lateral stabilization exercises to your daily routine. I think that's why have been injury free, even with a few more bad surfing falls.

Take care and be patient (both with the rehab and the confinement).

Steve

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Steve Baker
4/25/2020 11:37:27 am

Great article Steve, I am an active 73 year old and am just not ready to sit around...not willing to let the old man in, as Clint Eastwood said....Grade one mcl tear. Started out with RICE and am slowly getting better,with some exercises and stretches but need to step it up and do them really consistently, which your article gives me the confidence to do them. My pain is less daily, but doing too much and then a little more pain afterward scares me that I am doing more damage than good. I don't overdo it. I guess my question is how much pain while exercising etc is okay and not doing damage. Does the old adage apply...no pain no gain...Thanks, oh yeah, is the stationary bike okay and good even with a little pain....

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Steve Jackowski link
4/25/2020 02:16:12 pm

Hi Steve,

As noted in the article, mine was a grade 2+ - my knee would move outward more than 45 degrees - so my experience may be different. As for pain, my suggestion is that you avoid it as much as possible, particularly during the first few weeks. Work on flexibility and range of motion taking it to the point of tightness but not to the point of pain. Or, just to the point of pain and then back off. Heel slides and sitting with legs outstretched, ultimately a pillow under the heel for the stretch. The exercise that worked the best for me was knee stabilization - I tied surgical tubing bands to an object and to my uninjured ankle, then stood with my injured knee slightly bent and did reps of moving my good leg forward, back, and to each side. This forced my injured leg to strengthen the supporting muscles.

As for biking, that should be okay - again assuming it doesn't cause pain. Lateral motions are the problem. Ultimately you can do plyometric exercises like hopping on one foot - forward backwards and to the sides, and do side to side jumps. But again, if it starts to hurt, you've done too much.

The good news is that the MCL will heal itself (even a grade 3). The key is to let it heal, but to maintain range of motion so the fibers don't shorten too much.

But as I said in the blog, the biggest risk is doing too much too soon. I, too, am older and my fear of prolonged inactivity (and the associated loss of strength), made me push it, setting me back each time. You will get the best results and the fastest complete recovery if you exercise patience, patience, and more patience! Work on range of motion and strengthening without pain.

Steve

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Julian Martinez
6/20/2020 08:53:08 am

what knee stabilizer exercises did you do during rehab and currently after healing

Steven Jackowski
6/20/2020 09:03:42 am

Hi Julian,
Not sure why I can't reply to your comment, but hopefully you'll see this one. For knee stabilization, I used bands (actually tubing), attached to a low object (e.g. a furniture leg). The main exercise is to put the band on the good ankle facing where you attached it and then pull your foot back 10-20 times, turn 90 degrees and pull to the side 10-20 times, turn 90 degrees and pull forward 10-20 times, then turn again and pull to the opposite side 10-20 times. Your weak leg will work really hard to do this and if you're feeling pain, ease up on the tension on the band. I usually do the opposite leg (hoping I won't injure that one by keeping it strong), then repeat for 2-3 sets. you can vary the intensity by standing closer or further away from where the band is attached. Even now, years later, I try to do this every other day or so.

Steve Baker
4/25/2020 04:25:27 pm

Got a MailerDaemon back from my replys...

Thanks for your reply. It gives me confidence that somebody has gone before me and had success. It sounds spot on to me. You have
the best site dealing with the aftermath of the injury, and the fact you have gone through it, and made the mistakes of pushing to hard, and also having g ot it right.
Like you stated at the end of your article PATIENCE PATIENCE PATIENCE. God, give me patience.... and I want it now!!!
Thanks again,
Steve
Steve
I have another question for you. What do you know about healing a meniscus tear? Have you ever had one? Would you know if they harder or easier to heal than the mcl. Is the rehab the same for the meniscus tear as a mcl tear? Mine might be a meniscus tear instead of the mcl.
Thanks,
Steve

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Steve Jackowski link
4/25/2020 06:43:40 pm

Hi Steve,

Hopefully it's not a meniscus tear. My physical therapist friend and my two muscular medicine docs said that in most cases if there's a significant meniscus tear, surgery is required. Minor tears can heal themselves with RICE. Apparently, they don't heal well by themselves though I have heard about platelet injections that may help. From what they said, an MCL tear is often complicated by a meniscus tear and without an MRI, it's hard to know if you have one or both. I'd suggest giving yourself six weeks of conservative MCL treatment and if it's not getting better, then check on the meniscus tear. On the other hand if an MRI is available that may be the best way to be sure.

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Melinda Perritano
5/16/2020 03:17:08 pm

Hi Steve — My PT opined I have a grade 1 or 2 MCL tear (my insurance wouldn’t approve an MRI. I did everything you recommended (rice). It’s been 3 weeks and I can’t walk normal because my leg won’t pick up or flex at the backend of a step so I’m walking straight legged. It’s very painful when I attempt to force it to do so and I’m not successful. How many weeks until you were able to bend your knee and walk without a limp. Any other advice? Thank you!

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Steve link
5/16/2020 04:07:44 pm

Hi Melinda,

Hopefully you've been doing the heel slides and knee extensions. I did these multiple times a day during the first few weeks to gain mobility/flexibility. Never go past the point of pain. If you feel pain, back off.

The flexibility is the most important to being able to walk. Once you have essential range of motion, you can start strengthening. However, if you go to fast, you're subject to reinjury. I made that mistake more than once. Hence my recommendation to accept that it's going to take longer than you think. The slower you go, the faster you'll ultimately heal.

If you haven't already, do check out the link to the exercises near the top of the post: <a href="https://www.sportsinjuryclinic.net/sport-injuries/knee-pain/acute-knee-injuries/medial-knee-ligament-injury-exercises">Sports Injury Clinic</a>.

Above all, patience, patience, patience!

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Steve link
5/16/2020 04:09:19 pm

Melinda, sorry - the HTML didn't go through. Please copy and paste this link to the exercises:

https://www.sportsinjuryclinic.net/sport-injuries/knee-pain/acute-knee-injuries/medial-knee-ligament-injury-exercises

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Steve
5/16/2020 04:11:13 pm

And, sorry for the typos (e.g. to vs too).

Steve

Eileen Blackburn
9/19/2020 05:06:47 am

I broke me tibia and injured my MCL July 4th. I put no weight on for 7 weeks. The MCL hurt much more then the break. I didn’t start using the brace until week 9 (second opinion). 11 weeks today and still as much pain as day 1. It hurts when sitting. Hurts with knee straight hurts with knee bent. For the first two weeks I did not know it was broken and carried on as usual. Nail slides hurt a lot. So I haven’t been doing them. Dr said if pain is a 5 don’t do it. Help!

KC
5/30/2020 10:41:44 pm

I love this post. I have been rehabbing a ? grade II-III MCL tear from surfing sustained in Costa Rica in March. I am doing the PT myself due to coronavirus. I did not get an MRI, but I had a crazy fall/wax malfunction/heard a pop, and experienced pain and swelling, esp. day 2-3. To answer your question above, I could not walk until 7 weeks, and I still feel some occasional twinges when walking. I was straight leg walking/limping until that point. I actually tried some light jog/walking at 8 weeks, and I felt pain on the femur MCL attachment point (so I stopped). Now I'm at 10 weeks and tried some light swimming in the ocean today. Reverse breathstroke and forward breathstroke both def hurt and surprised me with twinges. I was hoping to be able to surf by 11 weeks. Not sure. May try skateboarding at 11 and surfing at 12. Considering an IndoBoard to help train... Good luck!!

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Steve
9/19/2020 11:48:51 am

Hi Eileen,

I'd suggest you check out the video links I posted above. First and foremost is getting range of motion, then strength. I would start with just straightening your leg as far as you can - reach the point of pain and back off just a bit. Hold for 60 seconds are repeat. Do this several times a day. As you get some range of motion and the pain decreases, start the heel slides. Again, you don't have to fully extend at first. Do this multiple times a day and over the course of a week or two you should see improvement in range of motion. At that point, you can begin the strengthening exercises. In my experience, getting stronger really reduced the pain. But if I went too fast and as your therapist suggested, the pain went beyond a 5, I lost ground. Still, you can't expect to get through this with zero pain. If you don't work on range of motion and then strength, you won't improve. Unfortunately, as far as I know, this injury won't heal itself completely without these efforts. I know it can be discouraging, but stick with it and just expect that it will take much longer than you hope.

Anthony Byrne
6/7/2020 03:25:18 pm

Steve & everyone,

This post was a perfect one to stumble on. Exactly a month ago to the day I had a pretty rough skydiving accident. MRI confirmed a high grade 2 MCL tear with a torn MPFL and some torn cartilage with some additional strain on the tendons. I started working out again last week and definitely over did it. Looks like I’ll be taking it easy and doing my PT for months to come!

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steve
6/7/2020 11:00:38 pm

My one last piece of advice is patience, patience, patience! If you take it slower, you'll ultimately heal faster with better results. It's too tempting to think we can work harder to improve. Not in this case. Good luck!

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Mari
6/15/2020 06:44:10 pm

I injured my MCL while Hiking uphill in Hawaii and had an x-ray and the first doctor I saw told me I had MCL tear and started immediately wearing a brace and RICE. One week later started PT for exactly 8 weeks, then... got worst. It hurts everyday and I m barely able to walk. I started doing some aerobic exercises in the pool almost everyday plus PT exercises and I m still with lots of pain. Now I am waiting for next week to get a second opinion with a different doctor because I think I also injured the meniscus when I fell.
Do you think I should stop the pool exercises?
Thanks

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Steve
6/15/2020 10:52:02 pm

I'm not sure what specific pool exercises you're doing but generally, if you're not pushing too hard, I would think they could be helpful. As I indicated in my blog, the biggest problem is thinking you can work harder to get better. This injury takes patience - patience that most of us don't have, particularly if we're really active. For me, the things that helped the most were the heel slides and knee extensions. I did these 2-3 times a day until I had a full range of motion without pain. At that point I started strengthening exercises. Progressing without pain (aside from the extensions) is critical. If you have pain, you should probably back off. If the pain got worse, you probably have the wrong physical therapist. Although I strongly believe in physical therapy, you need to have a good therapist who looks at your particular physiology and doesn't just offer a standard protocol for improvement. At this point, I'd suggest starting over. Go slowly. Work on the extensions and flexibility and then move slowly towards strengthening. I think my example (including my mistakes and setbacks) is a good place to start. Convince yourself this is going to take 3-4 months (as hard as that may be), and work incrementally towards a longer term recovery. Not only will the recovery be more solid, you'll likely do better than you expect. If you think it will be sooner, I can guarantee it won't.

I'm now a few years past my last (re) injury. I'm diligent about my exercises even though I don't have a problem, and so far, have been able to continue my (extreme) sports without reinjury. Be patient, work on flexibility, take it slowly and then work on strengthening.

Good luck!

Steve

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Matthew
8/19/2020 10:03:21 pm

I am so grateful to have stumbled upon this post. Surprisingly, there is no YouTube content on specific MCL tears from surfing. July 18th, my right/front foot slipped off the deck of my surfboard while I was pumping hard, and I went down right into a splits with my right leg. I didn’t hear the “pop,” but felt the immediate and excruciating pain.

MRI 28 July: full thickness tear of the superficial MCL at its femoral insertion / sprain of ACL / cartilage fraying at the patella.

I, too, have made the mistake of going at it too hard. In fact, I’ve made things worse to the point that other parts around the injury are starting to hurt. I’m into week 5 right now, and it’s been hell on my mental state. I’m 41 but still really active, and it kills me to be indoors all day. I do some minor exercises. My range of motion still sucks. I sleep with a pillow under my leg since I can’t fully extend it yet. I’m a “straight legger.”

Part of me is worried that I’ll be like this for the rest of my life and never surf again, but to read all the comments, it’s nice to know that I still have a long way to go and that there’s hope for improvement.

Around November will be the 4 month mark. I’ll be psyched if I can start walking again in September. I’ll be even happier if I can be on a wave again on Christmas.

Thank you again for posting your article.

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Steve
8/20/2020 06:01:08 am

I'd never had this kind of injury that kept me out of the water and couldn't imagine not surfing daily let alone stopping for months. But I'm fully recovered though I regularly do the strengthening and stretching exercises as a preventative.

Hang in there. Do the stretches for range of motion, then begin to strengthen. Work hard on the patience. You'll get there.

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Brad
5/23/2022 09:09:21 am

Hey, reading up on old posts. How’s the MCL doing nowadays?

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Louise Johnston link
8/24/2020 05:22:56 pm

That was a cracker of a read thank you for sharing, the comments are all super helpful too. I did a grade II Wake Surfing 7 weeks ago and 3 days (but who’s counting). I felt it go & thought - ooooh yep that didn’t tickle, but it was manageable. Then I woke up 2am beside myself in pain. Couldn’t roll over in bed, even breathing hurt haha I was in agony. My husband likened it to the carry on I made during labour contractions haha.

For me it’s not so much about getting back into the water or being able to play this season of footy etc.. it’s more my morning runs which set my days up beautifully once the kids are at school. I just got back from a 6km walk which is the furthest I’ve gone & it’s feeling good. I do however every now & again feel like something gets “caught” or snagged under my kneecap when taking a step - did you experience this? Do you have a recommendation for a brace for running? I was the same as you, the pressure on the MCL was too much for the rigid brace, it’s been strapped for the entire time however.

I’m treating it with respect & being as patient as I’ve ever known myself so I don’t set myself back. Thanks again for the read.

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steve
8/24/2020 05:36:54 pm

Hi Louise,

For the catching under the kneecap, I had that and sometimes pain over the kneecap when my IT band got too tight. This was before the MCL tear and intermittent over the years. Still, it's possible that you have a Meniscus tear which I've heard has similar symptoms. It it continues or causes pain, you might consider an MRI to check it out.

As for the brace, I used the one I described to help me with lateral stress in the early stages. You seem to be far enough along to where you may not need a brace if you start on relatively level soft surfaces and avoid downhills.

An excellent physical therapist and well-known competitive runner who I saw for another problem suggested I get to where I could walk a 10K at a rapid pace and then start alternating walking and running - very slowly - starting with 2 minutes of walking followed by 30 seconds of running and every week increasing the running by 30 seconds. This means a very long rehab, but it will allow you to assess the condition of your MCL. If it hurts, reduce the running - back off and build slowly.

By my calculations, you're likely less than half way through what you need to be fully functional. Work hard on the patience. The last thing you need is a reinjury - that can take as long or longer to heal.

Good luck and feel free to post your progress. We all benefit from each other's experiences.

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Augusto Medelius
8/28/2020 08:18:17 am

What brace did you use during your recovery and reinsertion to mild activity levels?

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Steven Jackowski
8/28/2020 08:31:53 am

Hi Augusto,

I used a hinged brace but I wouldn't recommend it. The hinges on the inside of the knee caused a lot of irritation of the MCL and the healing area. The local medical supply shop didn't have an offload brace and they seemed expensive, but if you can find and afford one, I'd highly recommend it for the early stages. Afterwards in the water and on hikes, I used the brace pictured in the blog. It's pretty standard but it had a strap you could use to tighten the area around the MCL to get more support. There seem to be quite a few on the market now, just do a search on knee brace with strap. Good luck and above all, go slow and be patient!

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Kailey Allen
9/23/2020 10:06:17 am

I suffered a knee injury almost 3 weeks ago now in a freak equestrian accident (horse spooked, started to bolt, and girth started sliding on me! Bad combo!). I saw an orthopedic around a week after (I'm a college student and scheduling everything is a pain), and I still don't have an "official" diagnosis. The earliest they could do an MRI is tomorrow (this friday makes 3 weeks after injury), although the doctor is very confident it's some kind of MCL injury. Although there's slight instability, the doctor expressed some concern that there's a chance I've got very nearly a full tear in there. He said he's seen many cases, especially in equestrian accidents, where the torn MCL ends up kind of wrapping around parts of the kneecap, which makes your knee actually feel more stable when you walk, but can cause a lot of pain when moving your knee all over. Has anyone ever heard of this before??? I get my MRI done tomorrow and consultation on Friday, so hoping it's a milder grade II, as I originally suspected! Also, within these 3 weeks, I've slowly worked on flexing and bending my knee gently, and have made sure to walk around some with my hinge brace on, but the only difference I'm seeing is in the swelling. My swelling has gone down A TON, but I'm still not able to flex or bend it much further than when it was all swelled up. Any thoughts on this, or ideas of gentle exercises I could do to help? Thanks guys, and I hope anyone with an MCL injury on here gets well soon! We're in this together!

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Steve
9/23/2020 02:40:20 pm

Hi Kailey,

I strongly suggest you follow the links in my original blog for initial stretching exercises, particularly the Summit Medical exercises. Heel slides, leg lifts, clam, etc. are critical for regaining range of motion before you start strengthening. As for the 'wrap around' possibility, I've spoken with doctors and physical therapists and none have heard of that but then again, maybe it is unique to equestrian activities. From what you've described, it does sound like a mild grade II. Unless there's additional injury, if you're religious about following the rehab program - increase mobility, the strengthen - you should recover well. But do be patient. It will take longer than you think and working harder will only set you back. Good luck!

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Kailey Allen
9/24/2020 03:11:17 pm

Thanks for the insight and reply! I was pretty skeptical when the doctor talked about that whole "wrapping" thing too, so who knows! My MRI went well today, and I have my consultation about the results tomorrow morning. I'm pretty confident it's a milder grade II tear as well, but I'll know for sure tomorrow. As eager as I am to be back in a saddle, all the research I've done on ACL and MCL injuries in equestrians has FOR SURE led me to the conclusion that this is NOT something I want to rush! I read some stories about people having grade I mild tears that got back in the saddle too soon, and now they deal with chronic knee pains and aches because of it (of those who ignored recommendations for more serious tears, some even gave themselves permanent knee damage)! Crossing my fingers for a diagnosis that gives me a shorter recovery time! Thanks again for your response!

Jon
10/1/2020 03:29:39 pm

Kailey, how’d your consultation go? My daughter is just about a week behind you on her injury (September 13). She twisted her leg sliding into home in softball. I guess Her cleat got stuck and her bottom leg (tibia) twisted Outward away from her upper Leg (femur). Whatever it was exactly that happened, it hurt a lot and she’s still limping on it 18 days later. She had an mri 10 days after her injury. Results showed a grade 2 mcl injury, Femoral condyle contusion, grade 1 oblique ligament sprain and a possible meniscus contusion. They couldn’t see a tear in the meniscus but there was a band like signal they said may indicate a contusion. I hope your results were favorable and that you’re doing better.

Steve, I know you mentioned by the third week you were already working on Some strengthening. Did it Hurt to walk during your third week? She’s been doing the leg lifts, crab etc. but the knee extension and heel slides cause some pain. Because of this, she’s stopped the heel slides and leg extensions. It still hurts to walk and she’s limping a bit with her brace. Trying to find the “happy medium” between doing the stretches but being cautious, as to not cause a setback.

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Steven Jackowski
10/1/2020 05:24:49 pm

Hi Jon,

The pain took quite a while to completely disappear. Getting that mobility is critically important. Heel slides and leg extensions will hurt. I think the important thing is to take any stretch just to the point of pain and back off an hold it there - that point of almost pain. You don't push past the pain but at the same time, this recovery isn't going to be completely pain-free. Anything that increases pain is bad - back off. If you can do an exercise with a bit of pain and afterwards it doesn't worsen, then you can very gradually increase what you're doing (a stretch, intensity, resistance, duration, etc.), Double check the videos in the posts. They provide excellent guidance, And certainly, if you have a good physical therapist, that person can provide the best advice for your daughter's particular case.

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Kailey Allen
1/16/2023 09:57:31 am

Hi! I never revisited this post and thought I could still update you years later haha. From that original consult, what we found was that there's actually a combo of multiple more minor injuries that just combine together to create a pretty big problem. What happened was that I had a serious sprain to my MCL (but no actual visible tears! woohoo), a VERY visible and quite large hairline fracture all along my tibial plateau, and my meniscus, while not visibly torn, had been completely "pancaked." In other words, its completely flat, and no longer provides good support. Over the next 8 months, I went through physical therapy while in school and on breaks, and slowly began regaining mobility and flexibility of my knee. After that initial semester, I got a new MRI done of the knee when I came home that winter break to see if anything could have caused my recently slowed progress I was making in PT. That was the orthopedist I saw who made me aware that the one who treated me initially in Boone didn't do the best job at it. The ortho in my home town stated that I should've been immediately put into PT, and should not have had to wait that long for an MRI either; both of these factors made PT exponentially more difficult and less effective overall because of scar tissue buildup (all of which needs to be broken up over time to be replaced by healthy tissue again. Essentially, you have to slowly reinjure yourself to get the body to heal correctly. It's a super cool thing you can do, but it can be a lengthy process). This was also where my flattened meniscus was emphasized, and I was told that my hurt knee will likely develop arthritis and may even need surgery down the line. So, fast forward past the next semester of school, and I complete PT up in my college town. If I remember correctly, I pretty much had full mobility back in my knee, and I still do today. Presently, being on my feet for long periods of time definitely makes me sore, and sometimes certain hits to it will hurt more than it would on my other knee, but overall, it hasn't done badly at all. I've been back in the saddle and showing dressage with the equestrian team at my school even since I was still in PT, so I've come a long way! There's still some posture things I am working out from having a forced limp for so long, but seriously, I never thought my knee would get back to where it is today. There's a definite difference between my right and left knees now, but I'm pretty pleased with how its healed, all difficulties considered. Once you hurt a knee, it's almost certain that it won't ever be 100% again. It can even get back to 98%, but there will still always be slight differences. Overall, my injured knee is probably 80-90%, and since I have full mobility and am able to do most of the things I like to do, I'm pretty pleased with that. Hope everything has gone well for you too!

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Steve
1/16/2023 11:46:40 am

Glad to hear you're doing well. It's been a few years since my original injury and I hadn't had any knee problems until recently. I'm working on recovering from an injury, of all things, bowling! With all the crazy sports I do, who would have thought?! I only mention this because it is the same knee where I had my MCL tear. So your point about not really being 100% hit home. Plus, I have to admit, I'v slacked off on my knee strengthening exercises. Clearly, I need to keep them up no matter how good I feel. I've recommended that to others, but haven't strictly followed my own advice. Thanks for the update!

Kailey Allen
1/16/2023 10:00:30 am

Also, I know it's far past the time you posted this and your daughter should be all done with rehab by now, but yes! Some slight pain is normal and expected! However, having said that, if it's causing *lasting* discomfort that's getting worse every time you do it, definitely stop that exercise. If the discomfort is temporary, isn't significant, and eases once you're done exercising the leg, you should be alright. Always go easy if you're in doubt though!

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Jon
10/1/2020 06:52:39 pm

Thanks Steve,

I’ll have her pick up with those other 2 exercises Soon. I know on summits website it says those exercises Can be started soon after the injury.

I know You were able to paddle out And surf at 5 weeks and It would be great to see her just walk normally at that time frame. Her jr. College softball starts up next semester (early next year) and it would be great for her to be near 💯. 🤞. In the meantime, she’ll be doing what she can to get healthy

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Steven Jackowski
10/1/2020 10:50:31 pm

Hi Jon,

As you read, while I paddled out at 5 weeks with a brace, it didn't go well. Patience is the key. Mobility/range of motion first, then strengthening, then challenges with plyometrics. Good luck!

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Brendan
1/9/2023 06:20:20 pm

I’m 16 weeks into the second grade II in ten years on my back knee. It collapsed on me on a late drop and I have a feeling that it got clipped by the foam ball as I was bottom turning. 16 weeks in and I just surfed for the first time. Super frustrating. No pain, but no strength… like my knee is a boiled piece of pasta. Was shocked by the difficulty of duck diving, paddling, and even sitting on my board. Hoping more time in the water will lead to some better results soon. Can’t seem to mimic the in water activity no matter what I try with weights and bands. Appreciate your post. It’s nice to hear that other people deal with this.

Prashan Thapa
10/8/2020 10:47:40 am

i had this grade 2 Mcl injury..about 4-5 months ago...although i can do all the excercises like jump rope, squats and lunges, running ..there is a slight but constant swelling on my knee...is it a bad sign or is it normal while the injury is healing?

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Steve
10/8/2020 12:24:27 pm

If I recall correctly, it was quite a while before all the swelling was gone - long after my return to full activity. I think this is normal, but do keep an eye on it. RICE is still important and if it worsens, you probably need to back off. Great to hear you're back to full activity. I didn't seen plyometric exercises in your list. Lateral movement is most critical. Hopefully you're working on that and will continue lateral strengthening as part of your regular routine. See my note on reinjury... Good job!

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Andrew
10/21/2020 07:46:17 pm

Thanks for creating this Blog Steve!

I've found it really comforting reading through everyones experiences and challenges with MCL injuries.
I'm at week 7 after a grade 2 MCL tear (soccer) with no other complications. Under load ( running, change of direction, lateral hopping) have no stability issues, I've been diligent with the rehab on the surrounding muscles (VMO, quad, calves, hamstring etc) to create stability.
However, I'm still having some laxity at roughly 20-30deg under no load. The physician thinks the ligament has healed but just in a slightly looser configuration. This laxity is worrying me as its a fuctional movement for soccer players- being able to kick and trap with the inside of the foot under no load. Im really hoping that over the next 4-6 weeks the MCL can begin tightening back up again.

Did you have the same experience where the ligament felt functionally ok ie running, no pain and full ROM etc but that last little bit of laxity taking an age to tighten back up?

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Steve
10/22/2020 08:34:43 am

Hi Andrew,

Absolutely. I had looseness for quite a while. I kept working on strengthening the supporting muscles and kept up the plyometric exercises and stretching (that may sound counterintuitive) and over time it tightened up. Then again, it may depend on how loose it is and it may be worthwhile continuing with a brace while playing (but not exercising. stretching). If you have a good physical therapist, I'd suggest checking in with him/her. In my experience and that of friends, because they usually see rehab all the way through, they may have a better view than the docs. Last and not least, 7 weeks is early for this injury. Mine was 16 weeks before I felt fully able to surf at my most aggressive.

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Brad
5/23/2022 09:15:51 am

Hello, how did your MCL looseness come along mine feels like an open barn door at the moment when relaxing muscles and moving side to side

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Steve
5/23/2022 10:00:28 am

Hi Brad,

No looseness whatsoever. If you're still having issues, I strongly suggest seeing a physical therapist or sports med doc. I have to think that looseness would make it more susceptible to reinjury.

Good luck!

Steve

Ben J
10/26/2020 04:00:43 pm

Great read! I would just like an opinion as to why do MCL’s tear if no actual impact or accidents happen? I’m 41 and I do lunges, squats, plyometrics regularly for years now. I run several times a week and play ice hockey twice per week.
I went to my game and recall when I felt the sharp pain/along side discomfort on the MCL. The troubles I’m having is I was skating in a straight line with no physical contact with anybody. I regret very much continuing to play for 30 mins more with the discomfort to find my leg so swollen the next day that I could not walk. My PT gave me very similar exercises as you offer or recommend on here. I am on week 6 now and still have a lot of pain and ligament catching or binding on something. I will definitely try strengthening twice per week. Anyway im just confused as what other reasons cause MCL’s to tear. Sorry for the long message. Thanks!

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Steve
10/26/2020 04:44:25 pm

Hi Ben,

In my experience and those of friends who've had knee injuries, very often, it's a subtle lateral movement at the wrong time that isn't even noticeable. I've watched the video replay of a friend who travelled 4 days on a boat to a remote surf spot. On his first wave, he blew out his knee without knowing it. When he paddled back out for his next wave, he couldn't even stand up and he ended up waiting 4 days to get to a doctor. He didn't see or feel anything and you can't see anything on the video. For him, it was an ACL tear that required surgery.

I think MCL injuries are even more subtle. I don't think we pay enough attention to the strength required on the inside of the knee. I certainly recognized it when I tried to surf for the first time after my initial injury. BTW, that reinjury was one where I didn't think anything was wrong. At leat until I tried to drive off my back (injured) leg.

In any case, I highly recommend a measured approach to recovery. As athletes, it's too easy to think that the harder we work, the faster we'll recover. Other than range of motion work, that's definitely not true with this injury.

Also, keep in mind that once injured, that knee is forever weakened. You'll recover to 100% but unless you work to continually strengthen, you'll likely reinjure it and that will be even worse.

Good luck in your recovery. And, patience, patience, patience!

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Ben
10/28/2020 02:47:50 pm

Thanks Andrew!
I was not aware that they were subtle injuries as it’s my first knee injury.

Today was my doctors visit and I don’t know how accurate Ultrasound imaging is but they said it was a high grade 2 tear.
I only have one last thing to ask that Forgot to ask in my first message.
Can Graston technique be done on a ligament? Nothing has helped me more in the past, but it was always on muscle.

Steve
10/28/2020 04:48:24 pm

Hi Ben,

Yes, it's surprising how much damage can be done with subtle movements. As for Graston technique, I don't see why it wouldn't help. I've seen it used primarily for tendonitis to reduce the stress on the tendon to allow healing. On the other hand, in this case, it may be difficult to get to the right spot, especially since the ligament must heal itself - effectively rebuild itself.. A high-end grade 2 is what I had and if you think about the structure, it's pretty miraculous that it can heal without surgery. This is not like a tendonitis where the attachment gets inflamed. The middle of the ligament has been torn. But, I unless it aggravates the injury by increasing inflammation or overly limits your range of motion, I can't see that it would be a problem. I'd still check in with a Physical Therapist.

Best of luck!

Steve

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Ben J
11/2/2020 06:25:24 pm

Thanks Steve! Take care.

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Greg w
11/6/2020 02:02:00 am

Nice to find another north coast Surfer’s take on this injury. I did it 3 weeks ago. No barrel section, high tide shore pound. Meager waves too. Never thought a chest hi wave could wreck my autumn surf season. Surfing has put me in a cast before, but that was easy. I knew I couldn’t go til the cast was off. Now I have to judge for myself. I don’t mind surfing through a bit of pain, but this worries me. If I go and re-injure it. Depression will set in. OB has been really good too😭

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Steve
11/6/2020 09:19:44 am

Hey Greg,

Sorry to hear about that. Most of my significant injuries have been on small surf.

This is the toughest injury I've ever had. It's hard, but be patient. Reinjury is worse as I described. Be rigorous about gaining range of motion, but don't push the strengthening. Go at it slowly. Believe me, it will be worth it. And, after a full recovery, don't stop the exercises, especially the band exercises and the plyometrics. Make them part of your regular stretching routine and you'll avoid reinjury. Good luck, and again (sorry) Patience is the key with this one.

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Victoria Monahan
11/19/2020 07:10:33 am

Hi..I just came across this blog. Thank you! Im 12 weeks into a right lead leg MCL tear. Grade 2 almost 3. I went back to gym a month ago and Mtn biking just shortly after gym. Ended up getting mild plantar fasciitis on left foot because of the favoring going on with the right leg. Arghhh. Im so disgusted with this injury. So debilitating to my lifestyle. Its awful. Its hard to stay down..its deceiving still at times. Feel great...then hurts like heck next. Its the worst injury ive ever had. Thanks for your encouragement. Over it in Arizona.

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steve
11/19/2020 08:22:55 am

Sorry to hear about the injury. For me, I couldn't believe that it would take as long as it did or how much work was required, but not too much. Yes. It was very frustrating.

As you saw, I reinjured a year and a half later because I assumed everything was okay. If you can, add your stretches and exercises to your regular routine. Reinjury is worse so do everything you can to prevent it. It's been two and a half years since that last one and I've had no problems. As I keep saying (probably too often) the hardest part is being patient and accepting that it's going to take time to fully heal. Hang in there!

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K C
11/21/2020 10:58:39 am

Steve,

Thanks for writing this blog and being responsive on the comments section. It’s incredibly helpful during a demoralizing time. I’m currently 2 weeks in walking around the house gingerly (noticeable swelling on both sides of the knee still). Urgent care doctor thought it was maybe a Grade 2 but I’m still scheduling an MRI since my knee cap has locked up with sharp pains during heel slides. Started formal PT a few days ago and they think it might be Grade 2+ so they’re very interested in looking at the resulting images from the MRI in case there’s something with the meniscus.

What upper body exercises could you keep up during your first few weeks of injury? I’m going a little stir crazy not being able to swim, bike, run, windsurf, hike, etc. every day. Trying to stay positive and patient, following your example!

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Steven Jackowski
11/21/2020 03:55:45 pm

K C, Sorry to say I couldn't do much - some bar dips, some weights, but I couldn't even sit in a kayak comfortably (I do whitewater). Maybe a sit-on-top would have worked. Also at some point, I did some swimming with a float between my knees/feet. But I remember that that was too painful the first few weeks - just the body rotation.

Sorry I don't have much more to offer other than to keep the faith and stay patient. Fingers crossed that you don't have a meniscus tear.

Steve

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K C
12/9/2020 03:03:50 pm

After many weeks in the MRI and specialist scheduling maze, the ortho I saw finally read my MRI today and the good news is the meniscus looks great! But because the MCL is a grade 3 (worse than expected), the MPFL is also sprained, and I still have a bunch of tibial plateau bone bruising (amazing what an X-ray misses) - the hinged Mueller brace I thought I weaned off of 2 weeks ago is back in my treatment plan. I’ll need to wear it through weeks 5 & 6 just to help out the MCL. So glad I found this blog though since everything I did right (e.g., heel slides and light cycling) came from this (everything I did that wasn’t clinically recommended was just due to a lack of patience). When in doubt, imaging can help illuminate what’s really going on!

Chris Brosseau
11/29/2020 06:47:39 pm

Hello Steve,
Inspiring story! I had a high grade 2 MCL tear with a a slight stretching of ACL (hit a stump back country snowboarding in Colorado in February 2020) Tried to snowboard Saint Mary's Glacier in May and felt some discomfort. I've been dirt biking, running and skateboarding this summer mostly pain free but still get some weird sensations from time to as of November 2020. Going snowboarding December 3rd and hope to be be pain free!
Thanks!
Chris

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Steve
11/29/2020 10:48:08 pm

Hi Chris,

If you've been doing rehab exercises, I'd keep them up. By now you shouldn't be feeing any discomfort - at least in my experience. If you're not doing the exercises, I'd highly recommend starting/restarting. I guarantee - a reinjury is worse. Plyometric and extension are the most important.

With a La Nina, it's not looking like a great season out here. I'm certainly hoping for more. We had a promising start and then it stopped. Current forecasts have us at least two weeks without any precipitation. Hope it's better where you are!

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Meaghan
1/29/2021 03:40:03 am

Hello all:

This blog is excellent; I'm a full-time ski instructor. I had an MCL/ACL incident two weeks ago; MRI showed a full tear on both. My doctor can't believe the range of motion I have - I blame it on my indomitable spirit. 😉

I’ve rehabbed several race horses 🏇 and got them running when no one thought they would. Here is what I have done so far:
I started the next day w the basic active rest exercises, focusing on squeezing the quad and pushing the knee down. Next, I hit the pool twice a day. It’s been hard with so much powder here in Vermont (we usually don’t get), even harder getting into my car with so much snow. I then went to Tractor Supply and purchased all my medical needs: poultice, vet-wrap, polo wraps, and standing wraps. You can order human poultice online; I just went w what I know. After each pool session, I would walk laps around the pool and use my hands to simulate my ankles. I’m sure you have all seen ski racers do this. My goal was to let each joint flex loosely and comfortably. Goal accomplished!!!

Music is the most important, in my opinion! I would have given up several times without those songs that move me. Hold On by Wilson Phillips has been my go-to song 🎶.

Pool: start by walking, then add small movements (tiny) think of just the ankle to begin. I made little circles in both directions, then added figure 8’s in both directions and w both legs. This is also how I train horses 😉. As you get more comfortable, take longer strides in the pool. By day 4, I was running laps in the pool. Yesterday I swam overhand for the first time, wahoo! Stick w flutter kicks only; my frog legs won’t work yet. I know I can ski when my frog leg is back. Next, those crazy exercises the doctor wants me doing on land I do in the pool first. I use the lane divider as my hurdle, it was hard the first time, but it gets easier each time. I focus w all my mental strength, and I remember to squeeze all those muscles. Mental strength is so vital while getting through physical strength.

I'm very holistic. I go to the slopes every day between pool sessions and practice what I did in the pool on the snow. I made sure I went when it wasn't icy or busy. I needed some uneven ground to train on. LISTEN to your BODY, don't push it too far. I found a small hill to start and walked some figure-8’s, then moved to on the snow, the same process. Each day gets more comfortable, follow the prescribed exercises, and keep your mental strength healthy. I have kidney disease, which means no pills at all for me; I don't even use Tylenol; this is a mental challenge you are going through; the physical recovery is a product of Your mental focus. Yesterday I put my ski boots on and walked around w my skis and poles; I couldn't clock in w my bad leg yet, I stopped and didn't push anymore. This is where ill be guiding my strength now that I have a benchmark.

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Steven Jackowski
1/29/2021 08:00:31 am

Excellent! You're on your way and with out a doubt, you'll be skiing soon. I was lucky. The timing on mine was such that I was back in the water a couple of month before ski season. The good news was that skiing puts a lot less lateral stress on the MCL than surfing, so I knew I was good to go. I love the idea of the pool exercises in the snow. This is great! Let us know how you progress towards full recovery. And, as I noted, don't stop the exercises (particularly the stabilization exercises) after you're 100%. They will help prevent future injuries, which have a longer recovery time).

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Joe link
1/8/2022 11:33:53 pm

Had a grade 3 3 and a half months ago didn’t hurt at all when I got cleared not even to bend it outward and now it hurts after I go run playing football but it didn’t hurt after I did that 2 weeks ago and I never felt it pull to the point that it would be reinjured which is weird to me because 3 weeks ago I was totally normal now it’s sore all the time and there was never a time where I hurt it again.

Steve
1/9/2022 10:28:23 am

Joe,

For me, I had to keep up the exercises for months afterwards. In fact, I have added most to my daily stretching/strengthening routine. As I said in my update at the bottom, I reinjured it just dancing because I had assumed it was okay and I didn't need to keep up on the exercises. I strongly recommend restarting if you stopped and keep them up.

Steve

Mary
3/20/2021 08:08:29 pm

Did you get a surgery?

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Steve
3/20/2021 09:33:27 pm

Hi Mary,

Not sure if you're asking me or Meaghan, but no. I didn't have surgery. In general with an MCL tear, even a grade 3 (complete tear), they can be healed with proper rehabilitation per my blog and the comments of others. I note that this is unique for the MCL, ACL, Meniscus, and PCL tears often require surgery.

Celia
2/25/2021 03:34:30 pm

Hi Steve,
Thanks for all your great advice and candid feedback! I have a somewhat crazy question to ask... I just damaged my MCL (MRI tomorrow) and I have been completely off my feet for 7 days. After reading your blog and comments, I realize I need to start (slowly) with stretching and exercises. My question is, what advice to you have for someone who hates repetition and gym workouts?? I don’t keep up (no matter how hard I try) with them and I hate doing the same thing every day. I am very active with my kids (biking, walking/hiking) and we LOVE to alpine ski - and my goal is to be back 100% for next season. Is there an alternative rehab that you might suggest? Told you it was a crazy question but had to ask.... :)

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Steven
2/25/2021 10:23:12 pm

Hmm. Difficult question. I've been lucky. I've always been able to do whatever workouts were required for rehab and conditioning without a coach. My wife is the opposite. She needs structured classes for yoga (I can do it on my own), and consistent physical therapy for rehab. Recently, she asked if I could be her personal trainer and so far that's working well. If you're married, perhaps you could arrange to have your spouse walk you through the exercises every day. Without daily work, your recovery will be long.

If that doesn't work and you have the financial capabilities, perhaps you could hire a personal trainer for an hour a day. Otherwise, I think physical therapy would be best. It would likely be only a couple of times a week, but hopefully you can motivate yourself on at least some of the off-days.

But again, you don't need a gym workout. Really, if you can just dedicate 15-20 minutes a day to those exercises, you'll succeed. 15-20 minutes? I'm sure you can do it. Set aside a particular time every day. Maybe your kids could help - hey Mom, show me your exercises... Good luck! Sorry I didn't have more suggestions.

Steve

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Meaghan
2/26/2021 03:50:51 am

Hi Celia,

I'm a full-time ski Instructor in Vermont; I had two grade 3 tears in January, both my ACL & MCL. My doctor gave me a return to snow three weeks after, and I've been skiing for the past three weeks. I went to the pool twice a day. There is magic in the water. Active rest is very important, keep it moving. I would wake up and just start dancing. Make a fun playlist and dance through the storm.

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Rebecca
8/3/2021 06:43:01 pm

Meaghan,

Did you have a full grade 3 MCL and an ACL? And you were back skiing in 3 weeks? My daughter has a full MCL tear; she’s at 5 weeks and feels good but is working on stability to make sure she’s ready to play soccer again.

Steve
8/3/2021 06:50:17 pm

Hi Rebecca,

I'll jump in just in case Meaghan doesn't respond. First, 3 weeks is remarkable, even for a grade 1 injury. Second, for me, I could ski long before I could surf. There isn't as much lateral stress on the knee skiing as surfing, and certainly not as much as kicking a soccer ball or making lateral defensive moves. I strongly suggest that she go slow and work on stability and strengthening and if it hurts, back off. Good luck!

Steve

Kim link
3/8/2021 12:04:09 am

Thanks for sharing such a detailed article. I'm nearly 4 weeks into my MCL injury and getting annoyed that it's not healing quicker! I want to get back out and start hiking again - which is likely where the injury occurred. But I know it's a long healing process; my GP advised the RICE method, gave me a course of anti inflammatory medication, and referred me to physio. I've been doing very light stretches so far but it just feels like it's pulling all the time. Painful too. I tried driving yesterday for the first time and it hurt - especially using the clutch - but was doable. It swelled up by the time I got home though.

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Steve
3/8/2021 06:43:35 am

Hi Kim,

I strongly recommend the exercises in the my post. They do work but it will take time and patience. The heel slides and associated stretches will be difficult, but range of motion is essential. Don't give up!

Steve

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Milk
3/18/2021 01:09:34 pm

Hello Steve and Everyone,

Thank you very much for sharing the experience.
I wish I saw this blog on the first day I got injured.

I did my MCL on 10th Feb, by simply slip on the surface while landing from not so high jump (tennis practice).
Confirm with the doctor 3 weeks later. He didn't mention the grade, but said it would heal on it own ... Would take 2-6 weeks... So I think it is probably somewhere between Grade 2. Now, I am on the end of 5th week. Nowhere from healing, but it is getting better.

This post has helped conforting me and allow me to adjust my time-frame with the rehab schedule.
I have overdid a few times with light exercises or rehap due to
>> [3rd day] Underestimating the severity as I feel a lot better after talking the medicine (anti-inflame + muscle relaxant)
>> [8th day] feel good with no pain, even without the medicine and thought it was only Grade 1.
>> [15th day] feel a lot better, hence did too much of the rehab.
After these these mistakes, I have been more careful with whatever new activities I would put into my routine and try not to over do it.

Steve (or anyone), if you still see this post, I have a few questions.
1.) Is muscle stiffness/tightness (near the MCL) in the morning is common thing even on the later week (5th week)? Do you have the explaination why it is happening and how do you cope with it?
2.) Even in the 5th week, if I overdid the rehap/exercise, I would be a bit in pain the next day. So, I usually ICE it just after the rehab to avoid inflammation. Not sure whether this is a good idea, or better off do less with the rehab without any ICE?

Lastly, I would like to share a few trick I used to overcome the stiffness/tightness in the morning or anytime during the day. As I mention that I used ICE to avoid inflammation after the rehab, on the contrary, I also use HOT-PACK to looseni up the muscle near the MCL. So since the 4th week, I have been switching between HOT-PACK and ICE-PACK though out the day. I heard that HOT-PACK would encourage blood flow; hence heal faster. Not really sure it would, but at least it is my current remedy on the tightness/stiffness in the morning.

P.S. Would be interesting to see how long this blog would go... At some points, I think Steve could be more knowledgeable than some doctors that haven't experienced the MCL sprain themselves. At least, at this point in time, it is the most informative than most website/youtube I read/watched.

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Steve
3/18/2021 04:19:28 pm

Hi Milk,

To answer your questions:

1) Yes. There us definitely stiffness/tightness and it will last well beyond your recovery. Continuing your stretches will make it slowly go away. It takes time for the fibers to reestablish themselves. When they do, it's important to prevent them from getting too tight which seems to be their tendency. Thus, keep up gentle stretching with regular movement to help them grow in the right way.

2) Ice is important each time you reinjure. That said, I'd back off. You have to be patient. For stretching, take it to the point of pain then back off. For exercises, if it starts to hurt, it's time to back off. If you're having increased pain the next day, you did too much. Note that in general, in the morning, you will have stiffness/pain for a while. Warm up gently, then do the stretches, then the strengthening.

As for the heat, it's a great idea. Hot-packs, hot tubs, massages, etc. are all good for increasing the blood flow after the initial swelling has been reduced through ice/RICE.. Ligaments and tendons don't get as much blood as muscles, though to my understanding the MCL has a bit more access to blood. Hence the reason it can usually heal itself without surgery.

Bottom line is to be patient. That's the hardest part of rehabbing the MCL. I guarantee that if you take it slowly but are rigorous about the stretching and gentle strengthening, you'll get to full recovery faster.
If you overdo it, you steadily lose ground.

Good luck!.

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Milk
3/18/2021 09:17:02 pm

Hello Steve,

Thank you very much for a very informative reply.
Now, I knew how to handle the stiffness/pain in the morning properly.

I will try to be more patient!

Really appreciate the work you are doing here!
This probably helps a lot of people, including me.

Cheers!

Sarah Aviles
3/22/2021 05:49:30 pm

I agree just reading this info on here, is so helpful during my mcl recovery.

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Milk
5/12/2021 06:33:54 am

It has been 3 months since my injury. I would like to put the record here for my own references and for others.

After 2 months, the injury has got a lot better. There were usually a small pain and some tightness in the morning, esp. when I walked down the stair. They went away once you started stretching or doing anything that will warm the joint up. The MCL didn't cause the problem in the everyday life anymore. Can walk around without pain... Just need to be careful not to catch the edge while walking. Regarding the exercise (tennis), shadow swings with weight transfer on both legs were totally fine. I would avoid excessive exercises, like landing the serve on your MCL knee, though. If you put too much weight/work on it on the day before, you would feel the pain the next day. As Steve mentioned many times... Need to be patient.

After 3 months, pain and tightness does not bother me in the morning anymore. Today was the first day after a while that I went to play tennis with the rebounder wall. Things totally fine, but I was very careful though. I have been jumping on both of my legs for around a week already and it seems to be okay too. Having said all of that, sometimes I still felt some stiffness in the knee in some particular angles/movement, esp. after the exercise. But they will subside after one night rest.

I guess I am very close to fully recovered now. Maybe one more months similar to what Steve has experienced. Will try to update this thread again once I am fully back on my knees in the court.

Milk
6/24/2022 12:12:42 pm

Hello Steve (not sure you still monitoring this comment) or any one that have similar experience,

A bit of update and questions.

- A year and 2 months after the injury : been playing tennis by avoiding a lot of stress on the knee (less moving to the side). Sometimes, the day after the exercise, I still felt pain in the knee due to the inflammation. If I iced it on the day before going to bed, it is usually fine the next day.

- Then I found 'Asian squat/Resting squat', after starting doing this daily, that inflammation after exercise went away. I has also helped with my ankle pain on the side. So it has becames my daily ritual since.

- A year and 4 months after the injury (now) : Been doing the asian squat (maybe in a bit wrong pose; too wide knee), and went out to play tennis with a bit high intensity, then come back with an inflammation on the MCL again. I tried to rest, now felt pain on piriformis muscle instead. But If I perform some stretch for the piriformis muscle, it went away, but then I would felt something on the knee, right away.

My questions are
- Is it common to still felt some inflammation on the MCL after some exercise?

- I learnt that the muscle/ligament of the whole legs are actually connected and work together to support us in some ways. Have you ever experience by avoiding putting too much stress on the MCL, it actually put more stress on other parts of the legs (piriformis muscle, or ankle) and cause some kinds of chain injuries? If so, apart from strenghtening exercise on the MCL itself, do you do other streghtening in other parts of the leg/body to avoid this chain injuries?

Please excuse me for a bit complicated question.
I understand that it might be better for me consult some orthopedic doctor instead, but usually, it does not really solve my injuries.

Thank you.

ref: asian squat : https://youtu.be/l7MROWaaY1o

Reply
Steve
6/24/2022 01:29:33 pm

Hi Milk,

Yes, for quite a while, it was common for me (and others I've talked to) to have some inflammation after exercise. You might consider using a brace when lateral movements are involved (like tennis).

And yes again, inflammation of the knee can cause pain elsewhere and vice versa. For me, most of the time, it was a problem elsewhere (e.g. piriformis) which put more stress on the knee and brought that pain back.

It's now been several years since my last MCL (re) injury. I attribute this to the fact that I continue stretching every day to maintain range of motion and I've added knee stabilization exercises to my daily workouts. I think these are critical to maintain after an injury, it doesn't take much for surrounding/supporting muscles to weaken and make you more susceptible to reinjury. I note that I also regularly do plyometric exercises (e.g. hopping on one foot from side to side).

Unfortunately, after these types of injuries, we have to work harder on maintenance to be able to continue our sports.

In any case, it's probably not a bad idea to consult a doctor or perhaps better, a physical therapist. Often we're inadvertently doing something that causes a misalignment, sometimes over developing one set of muscles at the expense of others causing an imbalance. A physical therapist who specializes in sports can probably best spot anything you might be doing wrong which would aggravate your injury.

Good luck!

Steve

Milk
7/4/2022 09:20:15 am

Thank you very much for a reply, Steve.

I felt relieved after knowing it is common for others to have inflammation after exercise (cause they said otherwise on Youtube etc.). Also, information that other parts would be affected by the MCL also.

I think I will have to incorporate the stretching/strengthening exercise to my daily routine. I am starting to learn why people stop doing sports when getting older... but I will do my best to continue it.

I also plan to consult some physical therapist in a near future.

Information on this blog and you have been a great help on my injury. Thank you again.

Milk

Sarah Aviles
3/22/2021 05:42:17 pm

MCL tear skiing Aspen Feb 9th. What a crazy injury to heal. I work on my feet so that doesn't help. Given a hinged brace at ER and once home seen orthopedic. Doing PT and still doing very modified yoga 🧡
But yeah one day feels strong,yet another feels like never gonna heal.
Had some glitchy knee stuff recently that would give severe pain just moments. Like knee catches with ow. Scheduled now for MRI,the glitchy stuff stopped so that is good. Might still get MRI just to know how knee looking I think. So almost six weeks out. 🙈

Reply
Steve
3/22/2021 05:50:31 pm

Hi Sarah,

In general a good PT or Osteopath can determine the degree of the injury and whether meniscus or other ligaments are involved. If it's just the MCL, you can rehab even a grade 3 (complete rupture) without surgery. You should be seeing steady progress if you have a good rehab plan. There's no reason to push, it will just take longer to fully recover. Definitely look at the rehab exercises/programs I recommended. They worked for me and now, for countless others.

Good luck!

Steve

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Sarah Aviles
3/23/2021 04:58:59 pm

Thanks Steve, yep been doing PT and the stretches you suggested whole time now. 😉
MRI tomorrow, hoping to just find it is only mcl. I believe they diagnosed correct...but want MRI since so much pain yet, just if anything peace of mind that only mcl. My work makes this tough as on feet job. (Drs didn't have me restricted from work at all, which did surprise me) but trying to listen to body.

Sarah Aviles
3/24/2021 09:47:26 pm

Oh boy MRI finally of this injury...yep mcl sprain listed but along with some other concerning things.
From report: Moderate marrow edema in the anterior and posterior aspects of the medial tibial plateau with findings suggestive of a subtle subchondral fracture in the posterior aspect of the medial tibial plateau. Significant marrow edema in the posterior aspect of the lateral tibial plateau. Mild apparent downsloping of the posterior most aspect of the lateral tibial plateau may represent a developmental finding. A subtle subchondral fracture in this region is difficult to exclude.

Steve
3/24/2021 10:37:12 pm

Yikes! I don't know much about this possible fracture, but from what I understand, if it's not displaced, and it seems like displacement would have been clear in the MRI, non-surgical treatment over 3-4 months can resolve it. Since that is what's required for a bad MCL tear, conservative rehab may do the job. Hopefully you can avoid surgery. I'd suggest getting a second opinion from a sports-med doc (MD or DO (osteopath)) and hopefully they can recommend a good physical therapist who has experience with these specific injuries.

Above all, be patient. From the case studies I've read you can get there if you work consistently, but gradually.

Again, good luck!

Steve

K C
3/23/2021 03:01:45 pm

I’m back again since I originally read through comments trying to understand how long everyone need to get to full recovery! With the Grade 3 MCL and grade 2 MPFL, it took me about 4 months to feel really good about jogging, swimming at 95% sprint speed (tried out a 100IM), and doing plyometrics/agility drills on an empty gridiron at lunchtime hours. Felt really confident!!! Then a 5-mile hike with too many hills and uneven terrain threw some swelling back my way and I’m back to feeling like month 3; nagging pains and minor swelling throughout the knee. As you’ve said, patience is key! During the whole day after the hike I felt great and had no idea I overdid it. It was the next AM where I woke up with swelling (oops!) Trying to tell everyone out there that this might take some time, but the stabilization exercises will bring me back.

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Steve
3/23/2021 04:55:50 pm

Hi K C,

Glad to hear you mostly recovered. I think the most frustrating thing with this injury is that even when you think you're back to 100% (or 95%), you need to ramp up slowly on every activity, even those you used to do without thinking. I certainly made the mistake(s) of thinking I could do what I did before.

Hopefully, it's not a reinjury, which as I experienced, took even longer to recover from than the original.

And, keep up those stabilization exercises even after you're fully recovered. They will help prevent future injuries. I have the same thing with some major back injuries - now I have those and the knee exercises added to my daily routine too.

Good luck!

Steve

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Sarah Aviles
3/23/2021 05:01:03 pm

Good info, helps to not feel alone in how long these take to recover. Ortho had mentioned when six week out I will be able to not use brace at work anymore. And here we are ...pain and 🙃
Patience and stabilize/relaxation yoga 🧡

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K C
3/25/2021 10:20:37 pm

Sarah - glad your yoga practice is going well! Definitely not alone: I saw the same interpretation in my MRI findings (I had a grade 3, yikes!) and my orthopedic specialist said to not worry too much about it because it’s essentially bone bruising that should take ~6 weeks total to “resolve.” My PT read through the MRI findings too and she said A. sitting more (I was still avidly standing while cooking nightly, trying to ignore the aches), B. avoiding stairs/jumping and C. using the hinged brace except sleeping and while doing daily PT exercises was helpful for the tibial plateau bone bruising issue at least in that first round of healing. Started plyometrics around week 12...it was a slower process than I expected in spite of all the infrared light I was using on my knee.

Jill
4/2/2021 06:29:02 pm

Hi Steve! I'm so glad I stumbled upon this blog! I am having a very hard time being seen in person right now and have been forced to wait due to a backup from people putting off in-person appointments (pandemic). I'm desperate for some answers though I know you can't tell much from a description - any advice from a fellow athlete is greatly appreciated!! Sorry for the long-windedness of this but I care deeply about having a solid, quick as possible recovery and I can't seem to get a lot of help!

I'm an always-active 38 year old. I won't say that I am some disciplined, hardcore athlete but I'm just a generally always active person, never sitting down for longer than a few minutes at a time. I grew up playing very competitive soccer and figure skated from about 5-18, right up until I decided I'd had enough of it and quit right before college. Anyways, I've always hiked, biked, run, played any sport I can, and I'm literally always on my feet all day long at work. I'm not in ridiculous shape but I am really healthy and active and don't have much by way of aches and pains ever. I feel very blessed.

Well last Wednesday night in a soccer game I jumped up to trap a ball and came down funny on my right leg, and felt that quirky feeling that I guess may be described as a "pop" though I felt more like everything went out and then came back in again all in one split second, and I went down. This is the same knee that 21 years ago I tore my MCL on, and opted not to have surgery. I've since been very active on it with zero problems. I'm afraid now my luck has changed.

After laying there for a moment I was able to limp off the field and limp around the house that night and the next day at work by utilizing the ball of my foot to bear weight. Weight bearing was never really all that painful. My biggest issue has been range of motion and joint stiffness. If I very slowly and very carefully go about it, I can get my leg now to straighten when seated on the floor with my legs outstretched. Not really at the leg lifts point just yet, I've tried to do them but I can't get my leg to go up much more than an inch off the floor. But when standing up, I can only really get it to fully straighten when I take the weight off of that leg and onto the other, otherwise it always wants to stay a little bit bent. I can also fully straighten it pretty easily if I bend over to touch my toes, but not so much if I'm standing upright. I don't really know because I'm totally afraid to push it where I haven't been seen yet. Maybe it could straighten if I pushed it. I can't imagine doing squats right now, but I can imagine lightly jogging. It's weird. Pain doing regular activities isn't really an issue anymore, it's really more of a crazy stiffness especially in the morning, and a feeling of my leg being really tired after walking around on it for a bit. Almost like my injured leg feels like it's been walking around in sand for a long time while my other leg's been on a flat surface. I can't explain it but it makes my whole leg tired, especially my quad and calf, probably from compensating for the knee a little bit. Due to lots of people now feeling comfortable going in to orthopedists and doctors as they get vaccinated, I was unable to get in to be seen by a doctor until next Thursday (that's 14 days from my injury). I'm really afraid I'm setting myself back not being seen by someone earlier but I literally can't get in for an appointment. I'd go to the ER but my insurance is awful. The only thing my doctor's office could do for me in the meantime is send me in for an x-ray, which noted "no acute fracture or subluxation," "mild narrowing of the medial joint compartment," a "small suprapatellar joint effusion" and said on there "no abnormality of the visualized soft tissues" but I know that an x-ray won't tell me anything about my ligaments really.

I do believe in keeping moving, not overly "resting" it though many people say to keep off of it. In the last 7 days I've done less, movement-wise than I have in many years and it's killing me, and I know it's only just the beginning. I've been doing light walking around my neighborhood, just about a mile or so at a very slow pace. I do have stairs in my house, they're a bit inevitable and to be honest don't cause me pain, especially going upstairs. Going downstairs is a little scary but I've yet to have an issue on them, I just take them very slowly. It's more of the idea that if it is something like my ACL, I'll feel that instability so I try to avoid it.

I've definitely improved in some ways since day 2-3 (I'm on day 8 right now), I can sleep comfortably at night, I'm able to walk a bit more normally, pain only really happens when pushing the ROM, but in terms of stiffness it's worst in the morning and takes a bit of tiptoeing around to get myself moving before I can start walking heel to toe again. It's improving but at a snails pace. I kind of feel like I'm plateauing in terms of improvement

Reply
Steve
4/2/2021 08:49:07 pm

Hi Jill,

The standard test for an MCL tear is the Valgus test. Basically a doctor, physical therapist, etc., moves your foot outward to see if there is looseness on the inside of the knee or pain with that movement. In my case, after my injury, my foot moved outward more than 45 degrees. That is a grade 2 MCL tear meaning the ligament is torn but not completely.

From what you describe, your injury is likely an MCL tear. To my understanding, soccer players injure the MCL more than most, and it's injured exactly as you describe.

Assuming you didn't tear anything else (e.g. the meniscus), you can rehab this yourself. Even a grade 3 MCL tear can be healed without surgery. But, it's definitely worth consulting an orthopedist or neuromuscular medicine specialist to ensure only the MCL is affected.

In the meantime, I strongly suggest following the links to the rehab programs I described. You need to be conservative and go slowly. You should do heel slides twice a day and work on extension and range of motion before you do anything strenuous or attempt any kind of strengthening. It would also be worthwhile investing in a hinged brace to take the load off as much as possible when walking or standing.

Again, check out those links and be conservative. Fingers crossed that your doc confirms it's just the MCL.

Good luck!

Steve

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Steven Jackowski
4/2/2021 08:52:44 pm

Jill,

One more thing. Plateauing - This injury takes time. Lots more time than you want it to. Be patient. Keep working on ROM and once you can achieve the goals indicated in those posts, advance to gentle strengthening. But, the key here is patience. And, being an active person, it's incredibly hard not to try to push through the rehab. This one definitely doesn't work that way. If you aggravate it, it will set you back and your overall recovery time will be longer.

Steve

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Jill
4/3/2021 11:29:45 am

Thanks so much for the advice, Steve, are you talking about the sportsinjuryclinic.net link? If not could you post the specific link(s) you're referencing? Very much appreciated.

Also, I have an old brace from my previous MCL tear - it's a bit tight esp in the calf as I was 17 when fitted for it, but I remember my parents paying a fortune for it and telling me to wear it every time I play - that was 21 years ago now and my mom is no longer with us. I still have it and it's in great shape because my soccer career coincided with the injury so I never really felt a need to wear it much again. Now I'm back playing again as an adult after almost 20 year hiatus and grateful to have it if I need it. It's a "Bauerfeind SofTec Genu" according to the inner tag. It's pretty restrictive and I can't really tell at this point whether I feel better or worse when I put it on and walk around. I'm wondering if I'm doing more harm wearing it now prior to having someone look over my knee, or whether I should wear it as much as possible when walking around - just trying not to set myself back further guessing on something like this. Anyway, thanks again!!!

Steve
4/3/2021 02:18:01 pm

Hi Jill,

The main site I used was the Sports Injury Clinic: http://www.sportsinjuryclinic.net/sport-injuries/knee-pain/mcl-sprain

I'm not sure if the brace will work, You need to try it out. If it makes things worse, don't use it. Also, don't be tempted to think the brace will let you resume activities. I'd suggest focusing on ROM and easy strengthening until you see the doc.

Steve

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Sarah Aviles
4/2/2021 07:14:35 pm

Hi KC,
Yeah no Dr limited my work except for few days. So I've been on feel working at fast food restaurant I manage. I can sit and do lots of business but also have to help team. So when see orthopedic about MRI results finally on the 6th. If he suggests more rest, brace and PT, gonna have to ask limit to work. It's hurting a lot worse. So we will see. Thx for your info

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Sarah Aviles
4/8/2021 05:58:20 am

Update on my MCL, orthopedic checked out MRI and has me off work. Very limited weight bearing. So only PT stuff pedaling, and movement exercises for whole leg strengthening on floor. No stairs, no walks, no weight bearing. See him again 23rd. For evaluation. Also given a steroid injection, due to cyst and inflammation in knee abundance yet. MCL could see the tear spot, and thickening. Square one, but better than saying surgery, so reboot, rest, and recovery.

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Steve
4/8/2021 07:28:32 am

Great news. Now comes that hard part: patience.

Hang in there!

Steve

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Sarah Aviles
4/10/2021 06:28:10 am

Hanging! Restorative, restful, meditation yoga 🧡 the leg strengthening exercises on floor only, while no weight bearing. I'll get there. Very helpful not to be working on feet, but from home when can support work on laptop. 🧡

Deb Jones
4/14/2021 06:17:28 pm

Okay, Steve. After 19 months, yes, over 1.5 years after taking a very hard fall onto pavement where I missed a curb, I was never properly seen by a competent doctor or orthopedic professional soooooo still in much knee joint pain when trying to squat, bend down, sweep, mop, lift 15 pounds, or do much walking or exercise.. I have tried to self heal, but may have damaged the knee permanently! I finally got an MRI which confirmed 3 problems including the MCL one you describe (1) with patellafemoral pain syndrome, chondral and subchondral fluid thickening, possible cysts, etc. I now will take physical therapy, but the orthopedic doc wants me to have custom shoe inserts.??? WHAT? I am 63 and was the epitome of health before the nasty fall. I think I'll get a second opinion. Thank you for this recap and the caution to keep strengthening the joint with PT. I SO WISH I HAD READ THIS LAST YEAR and had a better ER doc. I was I was afraid it was broken. I had 2 jobs that I so needed, so pushed through the pain. Again, blessings for future sports. I would be happy to sleep, walk, clean, and work without pain. I will start PT next week!!! Wish me luck!! Deb

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Steve
4/14/2021 07:10:23 pm

Hi Deb,

All my experience and that of most of the people who've commented on my original blog post were dealing with the immediate aftermath of acute injuries. I have no idea how this works after 19 months. Hopefully it's similar though I suspect the buildup of fluid and associated effects may make it a bit harder. Hang in there. From what you've said of the MRI results, at least there are no other ligaments involved so hopefully the recovery will go well. Good luck!

Steve

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Sarah Aviles
5/9/2021 07:07:54 pm

Deb your stuff like mine MCL, and patella osteoarthritis and damage to plateau. Three months out from injury. Yikes sorry you didn't get good Dr info to start. My MRI wasn't right away and I work lots on feet which is hard. Good luck and hugs. I am supposed to PT but doing PT stuff at home. Can't afford PT. But learn a lot on what is good etc thru sites and orthopedic

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Mike Lumi
4/17/2021 06:44:38 am

Yesterday I re-injured my mcl tear that I just finished rehabbing, I had a grade 2 year while surfing in December that luckily didn’t require surgery but was close and downright painful. I’ve always been really flexible, now in my mid 40s and I refuse to give up riding a fish, I found myself tearing my mcl on an uneventful wave where my frontside foot stuck to the board (winter boots) on a awkward kick out where my board slipped outward to the side and brought my leg with it while my upper body was rotating the opposite direction- at the time it hurt and I knew I had done something wrong but decided to see if I could surf through it, the 45 degree water and 5-4-3 compression probably gave me some false confidence that initial injury. That was a mistake.

Until that moment I’ve never sustained an injury that kept me from surfing or doing what I wanted to do, it’s a depressing feeling at first but felt confident in my road to recovery and ability to bounce back. Fast forward to yesterday, 3.5 months later and feeling 99%, after rehab and exercise I buggared the drop on a wave and the exact same movement happened again and my leg went off to the side with my board resulting in the exact same painful pull. I found your story while laying on the couch in rice mode this morning- feeling a bit depressed at starting back from square one, especially now that summer is coming. While it appears this current re-injury isn’t as bad as the initial one, it’s super painful to touch the inside of my knee but I can put weight on it just fine, it’s the bending that hurts and I can’t straighten it fully. My question is, is there anything different you did in rehabbing the 2nd injury and do you surf with a brace today?

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Steve
4/17/2021 10:20:07 pm

Hi Mike,

Sorry to hear about the reinjury. Unfortunately, for me, my reinjury was less severe than the original, but it took almost as long to rehab it. I used the same procedure with a bit more wisdom, so I didn't have the setbacks that I had the first time. You might be luckier, but I'd suggest proceeding conservatively and maybe things will progress faster.

I don't wear a brace and have been back to full surfing since rehabbing my second injury. No limitations. But, I regularly do strengthening and stretching to maintain my range of motion and to avoid another injury caused by thinking that once it's better, I don't have to continue working it.

Yeah, I take a bit longer to get in the water as I go through a 5-10 minutes series before paddling out, but I've been years without a subsequent knee injury so it's worth missing a few waves. Plus, I think it's helped me avoid other injuries.

So, patience, patience, patience, and be diligent about the stretching and strengthening even when you feel you're at 100%.

Good luck!


Steve

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Mike
4/18/2021 08:01:46 am

Thank Steve! This was the website I needed at the time of my first injury, I feel like there should be a link to this on Surfline or should be featured in the surfers journal. Day 2 of second recovery, I found that during my first rehab adventure prone paddle boarding was a good way to get my cardio back while getting into mother ocean and being able to stabilize my leg- spear fishing and oyster diving came after that where I could manage my knee movements- Also acupuncture helped too-thx again!🤙

Alison
4/19/2021 10:31:29 am

I wish I came across this earlier!!
49 year old female with grade 3 MCL tear on Right knee from skiing 7 weeks ago. I have been was told to start using it more, but get nervous that it hasn't healed well enough!
If the complete tear hasn't had enough time to "join back together" won't the motion from walking and stationary bike set me back? Is walking in moderation ok (with brace)? Should I get another MRI? I was told 6-8 weeks for healing, but not sure if that's truly accurate for grade 3.
My answer and concerns are probably somewhere in this thread of prior posts, but if anyone has feedback please lmk.

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Steve
4/19/2021 02:21:38 pm

Hi Alison,

First, if it was a grade three tear, I've never heard of anyone healing in 6-8 weeks. Mine was a bad grade 2. The Valgus test had my lower leg moving more than 45 degrees outward. It was easily 12 weeks before I could resume full activity that put lateral stress on my knee.

However, even a grade 3, assuming there is no other damage, can heal itself.

If you can walk and do the stationary bike without pain, you should continue. The objective is to work on range of motion, then strengthening. Walking and biking are great ways to strengthen. But, if it causes pain, back off - either in intensity or duration, or both.

I strongly suggest looking at the exercises in the original blog and continuing to work on the range of motion and strengthening. Using bands on the opposite leg to really work on knee stabilization is critical. Ultimately, you should be able to do the plyometric exercises.

And, as I've suggested to many others, once you think you're at 100%, keep up the exercises regularly to prevent reinjury. I didn't do that the first time an really suffered with the reinjury. The good news is that I've now gone several years at full activity (surfing, skiing, etc) without a problem.

Be patient, go slowly, and get strong.

Good luck!


Steve

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Matt
4/30/2021 04:30:08 pm

Hi Steve, great read, i feel like a lot of us posting in the comment section are here due to injuring our MCLs.

So I injured my MCL grade I at the skatepark (dont ask me why a 38 year old would go to the skatepark). Right away after falling in an awkward position I knew something was not right. I had a bit of pain but nothing crazy. As soon as I got home the pain started. I couldnt twist my knee at all and at night just even turning in bed was so painful it woke me up. I did ice and elevate for 2-3 days and was able to see my doctor after a couple weeks. He said I had a grade I with Pes andersine bursitis and said I would be fully recovered in 3 months and that I could start surfing again after a month but only at 50% adding 3% daily (whatever that means in surfing lol)....

I did all the stretches and strenghtening exercises that the doctor told me too and began to see slow imporovement. I was out of the water for 8 weeks and then decided to give it a try and as you said in your post back side is where the pain was for sure. I started surfing conservatively and some days I would have pain other I wouldnt.

But yesterday I was surfing and had a late takeoff in the white water which pushed me forward making my knee bend really fast causing a lot of pain. The pain subsided after a couple minutes of me moving it in the water and kept surfing. But today my knee is in a lot of pain, hadn't had this type of pain since the beginning of the injury, the pain is when I slightly bend the knee, its tight again (hadn't had tightness in a long time), i just feel like i regressed about a month of good recovery.

Im just worried that I might have re-injured my MCL which makes me really really bummed as I was getting close to doing my normal activities, now i have too much pain to even do my stretches or physical therapy exercises.

Did you have some days were you thought you re-injured your knee again but it was fine? do you think I started doing too much activity too soon? Thanks for any input!

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Steve
4/30/2021 07:21:38 pm

Hey Matt,

I had a few days where I did too much and had pain for a day or two, but if it went longer than that, I probably re-injured the MCL.

If yours has gone longer, it's very possible you reinjured your MCL. The only way to know for sure is to have a good physical therapist, sports med doc, or osteopath doc take a look. The real test is that valgus test. Straighten your leg and have someone try to move your foot to the outside. If you feel pain on the inside of the knee or if your lower leg moves outward, most likely it's the MCL.

The big problem is that once you're injured, the surrounding muscles get weaker and provide less support. This means that not only is it easier to reinjure the MCL, but you can injure surrounding ligaments and muscles. Only a doc and possibly an MRI can tell the whole story.

Even with pain, I'd keep up the range of motion exercise, particularly the heel slides and straightening. I note that when I reinjured my MCL sometime later, even though it was a grade 1, it took just as long to heal as the original. Work on range of motion then strengthening. You don't want to lose range of motion.

Maybe you'll be lucky and you didn't reinjure it. But either way, go slow. Make sure you're close to 100% before you get back in the water. You should be able to do the plyometric exercises without pain (jump from one foot to the other laterally, do one foot hops forward, back and to the side). You should be able to bike, run, and probably skate.

As I discovered, because we're used to being tossed around in the surf, we don't realize just how much force is acting on us, particularly on any injuries. So, hold off as long as you can. Don't risk reinjury.

Good luck!


Steve

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Matt
5/12/2021 06:29:23 am

Thanks Steve,

I dont think I re-injured the MCL, i feel like I probably just tweaked it as it got better in the next days. Its just frustrating because ill feel around 100% with no pain squatting , only slight pain when I deep squat and shift my weight towards the affected knee but overall no pain, and then ill tweak it in a weird way surfing and im back to just icing and going through the whole 4 days of getting better. This time even if i feel 100% i wont be trying to go back to surfing for at least 3 more weeks. My Doctor actually told me I could go back to surfing 50% after 8 weeks of the injury, which I did and all this happened, so i guess i have to take it even slower. Just frustrating watching all our friends surf and specially when I have two new boards I want to ride!!! ugh!!!!

Also my doctor gave me just a sheet with a couple exercises which I feel like they are not really enough. I downloaded the app from the website your recommended "sports injury clinic" and did the phase two. Just a quick question do you do those everyday? I feel like my butt has had a serious workout after yesterdays rehab, dont know if i can do it everyday lol! Also a friend who had a grade 2 mcl tear from doing airs told me yesterday that his physio would make him kick a ball towards a wall for a bit to "activate" the ligament, stupidly i did that myself yesterday at the park and had automatic pain that lasted all yesterday. I really should just stick to the physio app now. Also dont think I want to see my doctor again yet, ill wait and see, my copay is super high (Thank you for-profit American healthcare!)

Appreciate your comment section and the time you take to reply to each one of us. Thank you

Matt

Steve
5/12/2021 04:33:06 pm

Matt,

Hang in there. Be patient. I know the exercises are tough, but once a day is a minimum with range of motion stretches twice a day. And yeah, kicking a ball is about the worse thing you could do. It really stresses the MCL. Do the plyometrics and when you can confidently do forward and back and side to side 20 times with no pain, then maybe try a few gentle kicks.

Stick with it and I'm sure you'll be comfortably back in the water in a few weeks!

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Lori Murphy
5/16/2021 07:23:23 pm

Hi Steve, I found your blog desperately looking for help. I tore my rt mcl about 9 years ago,I had to have surgery and it’s been great. I did aquafit which really helped me so I could do other exercise. Covid closed aquafit in March 2020😞
In April 2020, I was walking down the hallway and “ping!” It tore! Probably grade 2... and I’ve been struggling for a year now. I finally went for a cortisone shot a week ago, but there’s been no improvement

I’ve elevated, iced, rested, ibuprofen and stretches. Nothing helps

I can’t believe this will be the rest of my life, it’s painful

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Lori Murphy
5/16/2021 07:23:49 pm

Hi Steve, I found your blog desperately looking for help. I tore my rt mcl about 9 years ago,I had to have surgery and it’s been great. I did aquafit which really helped me so I could do other exercise. Covid closed aquafit in March 2020😞
In April 2020, I was walking down the hallway and “ping!” It tore! Probably grade 2... and I’ve been struggling for a year now. I finally went for a cortisone shot a week ago, but there’s been no improvement

I’ve elevated, iced, rested, ibuprofen and stretches. Nothing helps

I can’t believe this will be the rest of my life, it’s painful

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Steve
5/20/2021 05:16:07 pm

Hi Lori,

Sorry for the delayed response. I was travelling with intermittent internet.

What's worked for most people is to work on range of motion, then slowly add strengthening exercises. For me and others, the temptation to do too much too soon generally sets us back.

The main thing is to work on range of motion with things like the heel slides as described in the blog. I'd avoid anti-inflammatories and cortisone unless the pain is way too much. To my understanding, ligaments need a bit of inflammation to heal properly.

I have a feeling you need to start seeing a good physical therapist. Most are familiar with this type of injury and can do a reassessment and prescribe good exercise routines.

Then again, if you've been doing the work as described (range of motion, then strengthening), and it's not improving, You should probably get an MRI to ensure it's not something else.

Good luck!

Steve

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Jill
5/20/2021 12:08:12 pm

Hi again Steve! Well, it's been 7 weeks now since my injury. To reiterate, I injured my right knee playing soccer, I was suspicious I had re-injured my MCL which I tore when I was 17 (I'm now 38). Last time I'd written on this blog I hadn't been properly seen by a doctor and had been limping around on it for 15 days. Long story short the ortho ruled out my ACL, MCL, LCL and I was diagnosed with chondromalacia patella. No MRI but he used a sonogram (?) machine to take a look at the tissue. He said there is about a 5% likelihood an MRI would change his mind on what's going on with me, and it would be $1600 out of pocket with my piss-poor Kaiser insurance. So we've held off on the MRI.

Recovery has been extremely slow going. Even my doctor seems surprised that at the 4-5 week mark, I wasn't farther along. I injured it on March 24th and had planned to be back to soccer by June 1.

As it stands now I'm doing my PT regiment given to me by my doctor and PT. It consists of clamshells, heel slides, leg lifts, squats with resistance bands, side step squats with resistance bands. Cycling about 30 minutes a day, zero pain doing that. I do the PT regiment religiously, like 3 times a day. I always feel better after doing the regiment than not doing it, movement feels much better than stagnation.

Overall I've definitely improved since the injury. I'm not in as much pain regularly, and I'm able to move around more easily than I had been. However, in some ways it feels like I've really not progressed much. I feel like I hit a plateau about 2 weeks ago and not much has differed. Two weeks ago I was feeling much better in certain aspects, walking without a limp, and was even able to jog a mile without stopping and walking, without pain. But then it seemed to flare up again. I guess I pushed it too soon. it's cranky. One hour I'll be able to move around and it feels good, the next hour it's stiff and sore. I still have sharp pain if I try and do any deep squats (more than 45 degree angle). I've tried (gently) jogging around with a soccer ball under foot, just to get the feel of dribbling back, and it's so awkward it's almost like I've never played before, or I'm playing with a peg leg or something, I can't explain it. Not necessarily painful, just feeling really odd. The knee is super awkward at times, almost like I'm trying to straighten it under water or something. I can't really explain the feeling. I notice it the most obviously when I do a squat and come back up to a straight leg position, the standing up straight part it feels jelly-like almost and slow to straighten the joint from bent to straight. Straightening the leg has been an issue from day 1, that has to improve where I can fully straighten it, but it feels awkward. No one seems to understand where I'm coming from with this specific symptom, my PT especially - he said he's "never heard it described that way." The doctor and PT mostly seem concerned about pain which I don't really ever have unless I make a sharp movement or spend too much time keeping it bent in one position.

Due to the fact that it hasn't improved much, I've cut out the light jogging and am mostly just sticking to my little PT regiment and cycling. Like you've said above, maybe started doing too much too soon although it feels worse when I do less movement so it feels like I'm damned if I do and damned if I don't.

Is there anyone else who has had these specific symptoms in the knee? Any further advice? I know this is an MCL blog but it seems like there are some people on here with other knee issues.

As a note, things like the heel slides really did save my life in terms of increasing my ROM. That is the one thing that I can say has improved. Otherwise I'm feeling stuck. I'm beginning to wonder if I will ever actually get back to normal - could this be something I never fully recover from, no matter how much time elapses?

Sorry for the ramble. Thanks!

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Steve
5/20/2021 05:06:32 pm

Hi Jill,

Sorry to hear about the slow going. While it's supposedly not an MCL problem, your issues sound similar to those I have had. I think the issue is scar tissue that builds up in the joint. It takes time for that to 'dissolve' or get properly aligned. I'd keep up the physical therapy exercises especially knee stability (use a band on the non-injured leg and go forward, backward, and to the side). I'd suggest trying the plyomentric exercises including jumping side-to-side and forward and back on one foot. If that hurts, back off. I also suspect that you just need more time. Even with just the MCL, you're looking at 12-16 weeks. So at this point, I'd suggest patience. When it takes longer than we expect, we get frustrated and often overdo it. Good luck!

Steve

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Hayley
5/22/2021 03:48:44 pm

Hi
I injured my mcl (grade2) 1 week ago playing soccer which was one week after my 42nd birthday. This injury is on my right knee which had an acl repair 15 years ago...
I’m Happy to read that rehab is getting people back to activity but ally of these comments say that people are reinjurying their mcl, this freaks me out. At my age I guess recovery is longer and harder so having to do it more than once isn’t something I want to do but the thought of giving up my soccer breaks my heart. I’ve played forever and still love it more now than ever.

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Steve
5/22/2021 07:20:17 pm

Hi Hayley,

Yes. I reinjured my MCL and others have too. However, since my second one, I haven't had additional problems. I attribute this to the hard lesson that I needed to keep doing the stretching and strengthening exercises, particularly the knee stabilization exercises. Since I've added these to my daily warmup routine, I haven't had any more issues.

Unfortunately, most of us have a tendency to believe that once we're better, we're done with the physical therapy exercises. With this and other injuries, I've learned that each results in a weakness that needs to be continually addressed. Plus, as we get older, we have to work harder to maintain muscle strength and flexibility.

So, bottom line: once you're better, be sure to continue strengthening and stretching to assure stability. You'll be much less likely to see a reinjury.

Steve

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Jill
5/24/2021 12:32:55 pm

Can totally relate, Hayley! Adult soccer player here myself who just injured a knee that had a previously torn MCL.19 years later and I'm supposedly suffering from chondromalacia after a quirky landing on the turf and instant pain. It's been going on two months now and I'm not much better off than I was after it happened! Progress seems to come and go intermittently and plateau. Trying not to get frustrated and keep on my PT daily. One thing I note is that my knee feels better after the PT versus keeping off of it or inactive. I just do what I can day to day and hope that some day I'll be able to get back out there again. It feels cruel for everything to be opening back up after a year and everyone's out there playing, to be sidelined by an injury at this point. I feel your pain! Best of luck to you!!

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Abby
6/1/2021 01:25:53 pm

Hello all, thank you for sharing your experiences. I am 26 years old and a very active person. I tore my MCL (grade 2), 5 months ago cliff jumping and landed wrong in the water. Due to insurance issues, misinformation, and the hoops I had to jump through to get approval, I didn’t get into PT until month 2-3. It felt locked (unable to straighten) from day one of injury. Because of this, I was just resting my knee and not stretching. It became very stiff and my best measurement was 20 degrees lack of extension at month 3. Adhesions had grown and I could not fully extend. I had a manipulation under anesthesia at month 4. The doctor got my extension to 5 degrees lacking and full bend 140 degrees under anesthesia and had to break up the adhesions. He said it was truly blocked due to the adhesions and very difficult for him to get it to 5 degrees. Following the MUA, I stretched all day every day for 1-1.5 weeks. This was so painful and hard. For the last month, I have worked aggressively to stretch and straighten my knee. At month 5 (now), I am maintaining a 5 degree lack of extension and 120 degrees flexion. I was just approved to walk without a crutch. This has been the hardest thing I have ever been through. I want to go back to my hobbies and not have pain anymore. Many days I feel hopeless that I will ever by 100% again and achieve full extension. I can walk up to 3 miles now with a limp and do this every other day. I am exhausted easily when standing for periods of time and feel weak. My muscles in my left quad are atrophied. My physical therapist is positive about my progress but I am concerned I will never get back full extension. Reading all your posts, it seems that you all healed much quicker and were able to get back to activities I can’t imagine being able to attempt. Do you all think it is too late for me to achieve full extension? My physical therapist thinks I have hit a plateau on extension but cannot give me an estimate for full recovery. My flexion is increasing steadily but my extension is stuck. I am stretching in extension 1-2 hours daily with weight on it, and doing bending exercises. I am swimming in the pool and ocean 1-2 times per week. If you all have any advice, I would appreciate it. This has been incredibly hard on me mentally though I have approached it with positivity. I cannot sleep without a pillow under my knee at night. Thank you!

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Steve
6/1/2021 02:20:38 pm

Hi Abby,

Don't give up hope. I suspect that largely because you didn't work on range of motion, you have much further to go than the rest of us. On a different kind of injury, I too had extension problems several months after the original injury but I've been faithful with my stretching twice a day and am now almost back to 100%,

With that particular injury, my doc also recommended therapeutic acupuncture to hit trigger points that kept spasming. It worked wonders. With other injuries, I've seen Rolfing work well, and there are some newer osteopathic techniques that can help increase range of motion. You might also consider a second opinion from another PT. In my experience, they have widely different specialties. Or, find a good Osteopath that specializes in neuromuscular medicine. They are full doctors with additional training in muscular medicine.

Bottom line, though, is to keep up the stretching. Don't push too hard or you'll set yourself back, but hang in there!

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Abby
6/1/2021 04:33:17 pm

Thank you Steve for providing this thread and your response! The encouragement and suggestions were very helpful and I will keep up the stretching and exercises. I know people come back from way worse injuries than mine and will continue to hold onto hope! I will look into acupuncture, Rolfing, or an osteopath. Thanks again!

Sarah
6/5/2021 11:15:19 pm

Hey there! I googled “MCL injury still hurts after 15 weeks” and found this post. I fell down the concrete stairs at my apartments, broke my ankle and injured my knee. I had surgery on my ankle and was non weight bearing for 8 weeks. I wasn’t able to see the knee doctor for 5 weeks because I was recovering from surgery. By the time I got an MRI, I was 8 weeks into this injury. Doctor said I tore my MCL (grade 2) damaged cartridge and had a lot of bruising. I can’t remember what else but he said I had 8-12 more weeks of healing. I saw him again 4 weeks later. They said 8 more weeks again! It still hurts just as bad as before, still can’t straighten or bend it without pain and it hurts to walk. Many exercises in physical therapy hurt. My doctor said I need to strengthen my leg muscles to help with the pain. I feel that I have and it still hurts the same. I’m hoping for better answers at my appointment Wednesday, but I’m just worried there is something else wrong because of how bad it hurts.

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Steve
6/6/2021 07:36:17 am

Hi Sarah,

This is an injury that will heal, but it will take time. The fact that you didn't get to start working on it right away means that it will likely take longer. In general for most people, success comes from working on range of motion, then strengthening. I strongly suggest you follow the links in the blog post, though if you have a good physical therapist, s/he likely has experience with this injury and and provide good guidance.

On that range of motion, heel slides, leg straightening, and leg lifts were critical for me. Once I could straighten my leg, I started with easy strengthening exercises. The knee stabilization exercises were hard but had the most imparct. At the point that I could walk reasonably well and bike (on a stationary bike), I started the plyometric exercises.

This all takes time - a lot more than you'd expect, so patience and persistence is the key. It's important not to reinjure it, so go slowly but do the stretches at least twice a day and when you can do the strengthening, do those twice a day if possible, rotating which ones you do.

I Hope this is helpful, but quite frankly, I think 8 weeks is very optimistic. If you read others' comments, you'll see that for most, it was longer, but ultimately, pretty much everyone was successful.

Hang in there!


Steve

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P
7/22/2021 11:34:53 pm

Hi Steve,

I injured my MCL 6 weeks ago by working out. I was told the ligament was sprained but not torn. It has been 6 weeks and although my full range of motion has returned, I am not able to walk without pain. Strengthening exercises have been limited to body weight only as my knee swells up even with the addition of very low weight. I feel as if my other knee is also injured, although to a less degree, as I feel the same pain in both knees.

I am feeling devastated. Before my injury I was an avid gym-goer and an active dancer. I am afraid that this bilateral knee pain will linger and I will no longer be able to do the things I enjoy. I have been going to physiotherapy and doing bodyweight strengthening exercises but I feel as if I am getting nowhere. Is there any hope of returning to life as it once was?

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Steve
7/22/2021 11:44:32 pm

Sorry to hear about the injury. In my experience, you will get back to 100% but it may take time - this is assuming there is no other damage - just MCL issues. For me, what made the biggest difference once I got range of motion back was knee-stabilization exercises. There should be some videos on the links in the blog post. Basically, use an elastic band on the good leg and do side, back, front and other side reps pulling the band towards/across. I worked up to 3 sets of 20 in each direction, then moved on to the plyometric exercises (jumping forward, sideways and back on one foot). At the point that was comfortable, I was back in the surf. Good luck!

Steve

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P
7/23/2021 08:23:47 am

Thank you so much. Will a resistance band work for the knee stabilization exercises?

The biggest problem right now is pain. On days where you had even minor pain, did you do the knee stabilization exercises or rest?

Steve
7/23/2021 10:43:00 am

This reply may show up out of order since another comment seems to have jumped in the middle. Yes, a resistance band is perfect. As for the pain, there were certainly stretches and exercises that were painful.

Heel slides were very painful at first as were knee extensions. In general, for stretches, I would reach the point of pain, then back off a bit an hold - just below the point of pain.

For strengthening, in general, pain is not good. Certainly if what you're doing causes pain to increase, you should back off.

However, the problem with resting or taking many days off is that loss of range of motion. I'd suggest keeping up the stretching on the more difficult days, but again, not past the point of pain.

P
8/3/2021 04:28:47 pm

Thank you so much for your advice. I am definitely feeling better and although I can’t hit the gym or dance yet, I am able to walk limited distances and go swimming now.

I have worked up to 3 sets of 20 for the resistance band exercises. I want to start plyometrics as my uninjured leg is stronger and there is a definite imbalance. For the jumping exercises, how many sets/reps did you do?

Steve
8/3/2021 04:36:19 pm

Hi P,

I started with side to side - jumping from one leg to the other and back - initially just a few, the gradually building up to multiple sets of 20. I then did the same thing with the single-leg hops (forward, back, and side to side). If it started to hurt, I stopped and tried to go a bit further the next day. For strengthening, I believe the general rule is that if it hurts, back off. Hope that's helpful.

Steve

Sarah
7/23/2021 08:56:09 am

Hi Steve, I left a comment a while back about my MCL injury from falling down the stairs. I rehabbed it for 17 weeks and saw no improvement at all. I ended up getting a second opinion because my first doctor said there was nothing else he could do for me. My new doctor is amazing! He ended up reconstructing my MCL with donor grafts and I had an arthroscopy to clean up damaged cartilage In my knee. My doctor said the tear in my MCL was a grade 3 still after 17 weeks of trying to heal it. I am almost 4 weeks post surgery now and the pain is way better and I’m more stable. Almost ready to walk without crutches. Just wanted to share because sometimes surgery is necessary in cases where the tear isn’t healing on its own. There are doctors that actually help!

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Steve
7/23/2021 10:38:50 am

Hi Sarah,

Glad to hear things are working out. Sorry that surgery was required. All my reading and reports from others indicate that most MCL tears can be healed without surgery, but clearly, the keyword is 'most'. Thanks for this update. I'm sure that for those who are struggling to do their own rehab, this fallback will be reassuring.

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Jason
7/24/2021 03:22:22 pm

Thanks for posting your article Steve. There's a mixed bag of medical information on the internet about MCL injuries, but none of them provide good insight into a good recovery plan and what to expect.

I'm 45 and not nearly as active as I used to be in my youth, but I had been working out daily for the past few months, and feeling/looking pretty good.. 6 days ago, I was playing Ultimate Frisbee with a couple of my kids and a group from church, I went down going for a disc and buckled my right knee inward as my body contorted on the way down. I felt the inside of my knee get tight and hot, and then POP! just before I tumbled onto the ground. I knew that I'd injured myself, but I didn't know to what degree. My knee felt loose and damaged after that, but I didn't know what I'd done. I hobbled around for the remainder of the game, slowly.

I researched it online when I got home and determined with the incident, location and audible POP!, it was probably a grade 2 or 3 MCL tear.

Pain set in while I was sleeping and it was almost unbearable. I could barely make it to the bathroom on Monday and Tuesday. Thank goodness for Amazon Prime speedy delivery for my leg brace. My unloader knee brace truly makes a world of difference. I don't sleep with it on, but anytime I'm up and about, I'm wearing it.

Not a ton of swelling or bruising, but around day 4, my MCL started itching like crazy and my mobility increased. I believe those are good signs that I'm on the mend. It still aches like a really bad tooth ache 24/7, but I imagine that will subside in time.

My plan is to see how I feel at the end of 3 weeks and begin performing some light squats and deadlifts with my brace on. I miss my vertical climber, so I'll give that a go too. Until then, I'm just working out my upper body to try to keep somewhat in shape, but man does that get boring.

Oh, I'm one of those people who only goes to the Dr. if I absolutely have to, or to get my annual physical, so I'm doing this all on my own. I've had too many unnecessary pill and surgery pushing encounters with local doctors, that this is a path that I've chosen to go and it has treated me well so far.

Reply
Steve
7/24/2021 05:19:24 pm

Hi Jason,

Sounds like you're on the right track. I'd strongly suggest working on range of motion exercises daily, if not more. I'm not sure you need to wait three weeks to begin strengthening exercises, particularly the knee stabilization exercises with elastic bands. . Check out some of the links in the article. Ultimately, the most beneficial and the best test to see if you're ready to jump back into Ultimate, is to build up the plyometric exercises (jumps, side to side, front and back, and one-legged).

Good luck!


Steve

Reply
Garrett
8/10/2021 10:42:36 am

Steve, thank you for sharing. As a 22 year old athlete this injury has been devastating. As a recent college graduate and incoming MBA student I was hopeful of playing my final year of water polo (since covid gave another year of eligibility) which starts in a week and a half. I can swim fine but I haven't scrimmaged at all. it's my left knee that's injured and when I eggbeater and my left leg moves inward I feel pain. It's pretty tough to eggbeater with my hands out of the water or ball in hand like I'm getting ready to shoot. I didn't get and MRI, just an xray and regret not getting the MRI. I injured it initially June 19th, 2021 so 8 weeks ago from this upcoming Saturday. The funny thing is that the next day it hurt and felt stiff and thought nothing of it. It didn't swell much at all, maybe a small small amount but that's it. 2 days after injuring it I was still able to run 3 miles, swim, and workout and didn't think much of it. I'm not quite sure what to do, I've been stretching some and doing band work but the last few weeks hasn't gotten much better. Dad thinks I need to test and push it with training camp being in a week in a half but im nervous to try. Doctor originally said it was a sprain but all he had to go off of was an xray and a few weeks ago said it felt strong and like it was healing well and was good to start egg beatering. Not quite sure what to do so any advice will help, my coach isn't very understanding so if I'm not able to play and do camp on the 19th of this month he's more likely to kick me off the team.

Reply
Steve Jackowski
8/10/2021 06:09:31 pm

Hi Garrett, The gold-standard test for MCL issues is the Valgus test. Basically, a doc or physical therapist supports your leg, slightly bent and pushes your foot outward while holding the knee steady. If the foot goes over 45 degrees, it's a grade 3 tear. If it moves but is less than 45 degrees, it's a grade 2. If it doesn't move, but hurts on the inside across the MCL, it's a grade 1. Generally a grade 1 will heal in a few weeks (2-3) and a grade 3 can take 4-5 months. From what you've described, it sounds like a grade 1 - as your doc said, a sprain. It probably wasn't a great idea to run right after the injury, but ultimately, it's the lateral motion that causes the damage and can slow healing. If you have full range of motion, the band work should help. At the point that doesn't hurt, I'd start plyometric exercises. First hop side to side from one foot to the other and back. When you can do a bunch of those without pain, try hopping on one foot - forwards, back, and sideways. Keep up the band work and increase the reps for everything - gradually. Having played water polo myself I'm understand the issue with the eggbeater. The good news is that you're just offering resistance against water, not a soccer ball, a surfboard, etc. I'd suggest that you start with a short session - maybe 30 seconds or less. Get out of the water and take a break. If you have no pain and it doesn't hurt, start extending the time. Keep building up giving yourself day to rest between and maybe two if you take it too far and it starts to hurt. And if it hurts, take it back a level and stay there for a few workouts. Keep swimming and working on your upper body strength (take practice shots while standing) to keep in shape. If you don't push it too much, you may make it to camp. As for pushing through the pain, if this Is an MCL problem, it's not an injury to try to push through. In my experience, it just gets worse if you push it too hard. Hope that's helpful. If you have a chance, get a professional opinion from a physical therapist that works with athletes. They can verify the injury and prescribe a solid rehab program that will get you back in the game ASAP.. My suggestions are just my ideas based on my personal experience and that of quite a few people who have shared this injury.

Good luck!


Steve

Reply
Jake May
8/27/2021 09:29:16 am

Hey Steve,

I'm trying to figure out if the time it's taking me to heal is normal or not. Here's the timeline of my injuries:

March 2020: PCL Tear - Grade I. Soccer injury, twisted knee when running

July 2020: Kicked soccer ball at full power and had to take it easy for some time. Tenderness on medial side of knee

September 2020: Hiking injury. Foot got caught in root and twisted knee while falling. MRI Results - Mild sprain of MCL without tear.

February 2021: Walking one step at a time. Knee still bothered me from hiking accident. MRI results - mild sprain of MCL

August 2021: I can do anything that is not dynamically-demanding (e.g. hiking, farm work, subtle footwork with soccer ball, hiking). I can't kick a soccer ball at full power or swing my leg violently for a high kick without irritating it. Tenderness on the medial side of my knee at the location of what seems to be my MCL.

Does the timeline of my injuries and lack of full recovery seem normal or cause for concern? I saw you said re-injuries can take longer. One full year seems like a long time relative to everything I've read. Thank you in advance for any responses.

Jake

Reply
Steve
8/27/2021 02:28:06 pm

Hi Jake,

One of the things that happens with these injuries is that supporting muscles get weaker after each one. You didn't mention whether you'd done the rehab exercises. I've found that to prevent reinjury, you need to add them to your regular workout routine. Otherwise, you risk reinjury. If there are no other injuries (e.g. meniscus tear), I suspect you may need to work more on strengthening. I strongly suggest the bands followed by the plyometric exercises. I'd make sure I can do lateral hops and lunges as well as single foot hops forward, back and to the side, all without pain, before moving on to my preferred sports that will put lateral stress on the knee. Also, you might consider a brace as you begin those sports to help with lateral stress. And then, take it slowly. Do a light workout with a ball then see how you feel the next day. If pain is worse, back off and continue working on stretching and strengthening.

You might also want to consult a good physical therapist that specializes in sports injuries. S/he can probably help you with a program.

Good luck!

Steve

Reply
Michael McDougall
8/30/2021 12:10:10 am

Hi Steve,

I really enjoyed reading the post and wanted to ask a few questions and get your input.

About a week ago (Friday 20th August) I sprained my MCL in a division 1 ncaa soccer game. My athletic trainer said I had suffered a grade 1 mcl tear cause there was no loss of stability. I injured it in a tackle with an opponent and felt the pop inside my mcl. I proceeded the next weeks with rehabilitation, ice, compression and strengthening exercises. We had a game on the Thursday (26th of august) which I did not play and we had a game today (30th of august) which I warmed up in but didn’t play. I experience moments of sharp pain when I pass or strike the ball with my right foot which is the knee I injured.

I wanted to ask you what sort of rehabilitation exercises did you do with a band that helped you? I want to develop a program that I stick to to increase the strength in my knee. I can sprint and run but passing a ball gives me pain. Besides band work what other stretching exercises did you do that really helped as well?

Thanks!

Michael

Reply
Steve
8/30/2021 10:39:16 am

Hi Michael,

The links in the blog post have the best exercises and stretches. For the bands, I attach one end to a low object and the other to the ankle of my good foot. I then face the attachment point and pull my leg back with the injured one slightly bent. I turn 90 degrees and pull to the side, then 90 degrees and to the front, then 90 degrees and pull to the other side. This really works on stabilizing the bad knee. It make sense to do both knees.

Once I solid on those along with knee bends, etc., I move to the plyometric exercises, hopping from one foot to the other side-to-side and when that is painless, moving to hopping forward, back, and to each side using only the bad leg.

As for stretching, heel slides are great at the beginning then putting your heel on a raised cushion and working to straighten your leg.

In general if it hurts, particularly if pain increases, back off and increase resistance/reps more slowly. Again, check out the videos and if you have a good physical therapist, they can provide the best rehab program.


Steve

Reply
liz
8/31/2021 09:11:27 pm

hi Steve,

can't explain how helpful this site is! mostly on helping me to adjust my expectation on the heeling time... was really frustrated at first knowing it takes like 6 weeks before can walk pain-free again.

my case is: grade 2 mcl tear during wake-boarding 7 days ago. and my questions are:

1. I'm on a adjustable leg brace now and walking stick all the time(only takes off during sleeping). Im doing it coz I was scared to hurt it again by putting weight on it...but is this method correct? is it really not possible to put weight on my injured leg? will it tear more if I put weight?

2. I can straighten my leg, but cannot bend it much. may I know the reason why? is it common for a grade 2 tear mcl? will it be able to bend again by itself, or is it a must to do stretching exercises or else it won't be able to bend again?

I was already seeing a doc,but he was not able to tell me more about the injury, only asked me to put ice on it few times a day....lol so I will wait patiently for your reply, thank you so much!

Reply
Steve
8/31/2021 10:49:13 pm

Hi Liz,

First and most important step is range of motion. You need to stretch by doing heel slides and leg extensions. I strongly suggest following the links on the post. Next, you need to work on strengthening - band work then plyometrics. Again, check out the links on the original post. It will take time. If you have a good physical therapist, you can get a customized rehab program. But agian, working on range of motion is the most critical part. Then strenthen.

Good luck!


Steve

Reply
Duria D link
9/10/2021 09:25:40 pm

I injured my MCL grade 2 while hiking. It was very painful in the first week and I was able to get the X-ray and MRI scheduled within a week. It’s been over two weeks and I am resting and able to walk with a sleeve on my knee. I use the brace too.

My question is about what food or nutrition will help the mcl tissue heal faster.

Also, does heat or massage therapy help? I read all of the comments above and would like to know if ice or heat works. I am in my fifties. I can walk but climbing stairs and bending the knee is painful.

Reply
Steve
9/11/2021 07:42:14 am

Hi Duria,

I'm glad to hear you're recovering. Hopefully you're doing the range of motion exercises and the strengthening exercises. With this particular injury, the supporting muscles get weak if not worked, and the tendon will heal badly and you will lose range of motion if it's not stretched.

As for massage, that's an excellent idea. Again, it helps with flexibility and range of motion. It also stimulates blood flow to the area. Tendons and ligaments often heal very slowly because of the lack of blood supply to them,

For foods that help, there's a lot of debate. There are a number of supplements that some think help like glucosamine. However, most of the doctors and therapists I've talked to about this injury are more consistent in what not to consume. Most recommend against using much ibuprofen. They say that with ligament and tendon injuries, inflammation helps healing and ibuprofen reduces inflammation. The also tend to suggest a reduction in alcohol consumption.

Hope that's helpful. Perhaps some others will have some suggestions on nutrition.

Steve

Reply
Jools
10/3/2021 05:28:47 pm

Hi Steve Your post and all the comments are very inspiring and I too would like some advice please.
I am 56 and 4 weeks ago I was dancing with my grown up kids, and my feet have slid out, knees bent in towards floor and heard and felt cracks in both at the same time. Didn’t hit floor with knees as I through myself backwards landing in my right side bracing with my right arm. Immense pain, couldn’t walk, iced on and off for 36 hrs before I could get into dr. Continued to ice on and off for a week taking lots of pain killers trying to keep both legs elevated. 5 days later mri and ultrasound results grade 2 mcl tear in both knees put me in heavy hinged braces to wear 24/7 which lasted one night as they were too heavy and produced immense pain to sleep in so I walked very slowly to physio as I am unable to drive and they ordered me softer hinged braces which arrived the following week. depending on the exercises I do it seems to aggravate one or both. They taped my left knee last week but I had to cut it off after 3 days as it was constantly aching and I couldn’t straighten my knee even when I took it off it took a couple of days before I could straighten. They have got me only walking around my unit without braces if I go outside I have to wear them and it’s uncomfortable and quite inhibiting so I haven’t really ventured out with them except for physio or dr appts. I have been doing quad tightening, heel slides, lifting from knee upward whilst laying down and sitting on bed, lying forward and bending knees up towards backside and calf raises. I do these every hr, every day. I feel some days I don’t seem to be getting better as some days my knees really ache and they are still sore too touch. If I stand too long I have to have them bent.. And obviously certain movements really hurt. I am wondering if I am doing the wrong exercises or if I am doing too much of the ones I do. It is also putting referred pain on other areas of my knees and my ankles. I had decided from tomorrow I would take the braces off as I feel they are hindering me and do some small walks carefully outside and thought I would google how to repair when I found yr post. I used to do Muay Thai and stopped about 7 years ago due to tears in ligaments in both shoulders snd both ankles and have lost a lot of strength because the only exercise I do now is walking. Even where my previous injuries are they are not strong and I am scared if my knees don’t heal properly that I will end up broken and on a walking frame long before my time and fir my mental health I do not want this as I need to be active. I will go onto the links you have suggested for exercises.
Thanks and sorry for the long post
Jools

Reply
Steve
10/3/2021 06:34:51 pm

Hi Jools,

Both knees! Of the countless comments and questions regarding this post, this is the first time I've heard of someone who injured both knees at the same time. I suspect that will make recovery much more difficult.

Keep in mind that I'm not a medical expert. I've recounted my personal experience and the experience of others.

In general, the process is to work on range of motion, then easy strengthening, then much more challenging strengthening.

Heel slides and leg extensions seem to be the best at getting initial range of motion. Most people take it just to the point of pain and then back off and hold the stretch.

For me, the overall pain continued for several weeks, then slowly abated unless I did something stupid - pushing too hard, too fast, or making lateral movements before I was ready.

As for the brace, in my experience, it's best to go without them when you can, but to use them any time there is risk of reinjury, especially if there's a risk of lateral motion. Lateral movement should wait until you can walk reasonable distances without pain.

As for the walking, I'd walk a short distance and if I don't have increased pain, increase the distance slowly. You might also consider a stationary bike as this can strengthen supporting muscles with less impact than walking.

Do check out those links and above all, be patient. It will take time, but as you can see from almost everyone who has commented, if they stick with the program and go slowly, they do fully recover.

If you're really struggling, find a good physical therapist who has experience with this injury (and recommendations from other patients) to help customize your rehabilitation program.

Good luck and hang in there!

Steve

Reply
Bill
11/16/2021 10:08:34 am

Thank you so much for this blog!! I played football and LX through collage, jumped out of airplanes in the army for 24 years and ski raced til a few years ago. I just turned 65. On Thursday I stepped (jumped?) into a ditch of water I thought was a foot deep but it was three feet deep like a knife edge. Trapped my lower leg and my whole body weight twisted over my knee. Worst pain I can recall. I had to walk a mile back to the truck and the knee felt funky wobbly. Iced it for a day (I now see that should have been more), saw my GP and he poked and prodded. Could be ….??? (Didn’t seem like the ACL tho). The nurse put on a hinged brace and home I went. I was looking for the hinge release on the brace, got out the instructions and discovered they sent me home with the brace on backwards. Easy fix and it works much better the “right way”. VA health care so gotta get an X-ray (to show nothing) before you can get get an MRI and I couldnt get an Xray til Monday. (Ordered on Friday but the fax machine jammed). When they call with the Xray non results I’m going to push to have an MRI so I can know exactly what I’m dealing with AND maybe some professional PT to at least get me started on the right track. Right now 5 days after the injury I can walk straight ok, even up and down stairs but the inside of the knee is very tender and can’t take any pressure. It’s still really swollen which I think keeps it from bending full range. My doc’s theory that it might be better in a week is not looking good LOL. Thanks for all the info on this blog. My general takeaway is it WILL get better! The stories about the setbacks are almost the best because when I hit them I’ll know they’re normal!!! Ive bookmarked this and it’s going to reall help me out. Thank you!

Reply
Steve
11/16/2021 02:20:59 pm

Hi Bill,

Hang in there. Most important is maintaining/gaining range of motion. You really don't want it to seize up. Check out the stretches in the links, and if possible, do at least the heel slides and leg extensions until you get a good diagnosis.

Good luck!


Steve

Reply
Abby
12/14/2021 03:43:07 pm

Hi all,
I just wanted to give an update from my post back in July. This blog really helped me to have hope during the last year. I am about 95% back to normal. I still have pain after strenuous activities but very little. I am able to fully straighten my knee and can ease it into fully bent after 20 minutes of stretching (this is painful). At this point, I am just lacking an easy full bend and squatting comfortably. I just avoid this motion altogether out of habit of not being able to do it. It is painful when I sit on my knees on a hard surface. I believe my hips have lost some mobility. Sitting cross legged is possible but uncomfortable. I have gotten into cycling, running, and going to the gym because of this injury. I am currently training for a 10k. After this weeks runs, I am taking a day off do to pain in my knee. All in all, I am almost fully healed.

Reply
Steve
12/15/2021 09:07:09 am

Hi Abby,

Sounds like good news! After rehabbing my knee, I had a serious back injury in a surfing accident. I recovered after several months, but noticed my pop-ups were difficult. Ultimately, I discovered that it was my hip flexors. I've been working on that daily and am now back to 100%. I suspect hips get to be a problem after most injuries. You might consider adding hip flexor stretches to your warm-ups and cool-downs (and definitely do them on off days). Have a great holiday!

Steve

Reply
Dana
12/25/2021 12:57:27 am

Hi Steve,

I'm an avid hiker who just reinjured my MCL. First tear was in July 2021...i wish I had read your story during my initial injury rehab. I did not allow my knee to heal completely from a Grade 2 and just reinjured yesterday, hiking on difficult terrain, in the snow, tripped, twisted same knee and back to square one, since I'm pretty positive that it's a Grade 2 or possibly Grade 3.

I did not continue exercises to strengthen knee, did not wear the Brace I was given by ortho and did not complete PT because I was feeling better. Lesson learned.

I'm looking for links to exercises you referenced, but don't see them. I'll just research the heel slides and other exercises. That being said, tripping on rocks and roots while hiking is commonplace - is there anything you can think of that help avoid injury when this happens? Perhaps balance exercises? Thoughts?

Thank you so much for such a helpful article!

Reply
Steve
12/25/2021 12:53:03 pm

Hi Dana,

I wrote this blog a few years ago and it appears the links to exercises no longer work - the Sports Injury Clinic now offers an app that you can download (for a fee), and the other seems to have dis/misplaced theirs. When I get a chance, I'll do some more research on sites and will update links in the blog. In the meantime, I did a search on 'MCL tear rehabilitation exercises' and came up with some good links, so you might try that.

As for stability to prevent hiking injuries, for me, it required the regular and consistent exercises which i continue as part of my (mostly) daily warm-up exercises/stretches. In particular, the knee stabilization exercises seem to help the most (attach a band to your good leg and then pull it forward, sideways (both sides) and back forcing your bad leg to work hard and strengthen). I actually do this for both legs for consistency and to avoid injuring the other one. I've also become addicted to a balance board which I use frequently when watching TV or waiting on my wife.

Hope that helps!


Steve

Reply
Brittany
11/19/2022 10:00:47 pm

Hi Steve,
I had a grade 2 MCL sprain while surfing San Diego exactly 4 weeks ago today. I am just now seeing your post/blog and wish I had 4 weeks ago because it’s the most accurate and helpful that I’ve seen this entire time! You’re 100% right on the bend and extend range of motion exercises as well as patience patience patience. I was frantic and depressed my first few weeks and just wanted to say everything on here is so accurate and relatable. I’m only probability about 65% back to normal but I understand now it just takes a lot more time than I was expecting. Hope you’re doing well and injury free!

Reply
Steve
11/20/2022 10:33:14 pm

Hi Brittany,

Thanks for the comments. I'm luckily injury free, though as I mentioned in a follow up, Once weakened, this injury requires ongoing work, even when you're back to 100%: keep up a subset of the range of motion and strengthening exercises to avoid reinjury.

Hope you have a solid recovery!


Steve

Reply
Jarek
1/11/2023 09:15:23 am

Hi Steve, what a fantastic blog, I wish I had found it right at the beginning of my diagnosis which was just over 2 months ago! I have been following my rehab quite to the letter and practising daily, however, I found that setbacks, even in the most innocent situations, are part of the recovery. My MCL got sprained-torn during a basketball games (or games as it was happening over time now when I look back). Just like you, I have been trying to force myself back in to the game too soon, as soon as there was no pain. And it's definitely not a good thing. But looking at recovery times of yours and others, I now know there is no lead time on it. It's all very individual.

I would add to all the advise, worth checking your feet and look after ankles and most definitely feet arches. My orthopaedist told me that my biggest issue is flat foot from another ankle sprain that happened 6 months before MCL and most likely led to the leg instability and MCL issue.

Good luck to everyone who suffers with injured MCL! Let's trust our blood supplies and be careful :)

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