MCL Tear: Symptoms, Grades, Treatment & Recovery

Reviewed by the Physiotherapy Team at Waterloo Sports Medicine Centre   

What Is the MCL? 

The medial collateral ligament (MCL) is a strong band of tissue located on the inside of your knee. It connects the thighbone (femur) to the shinbone (tibia) and helps stabilize the knee, particularly against forces that push the knee inward. 

An MCL injury occurs when the ligament is stretched beyond its normal capacity. This can happen from a direct blow to the outside of the knee, a sudden change in direction, or another movement that places excessive stress on the inside of the knee. 

MCL injuries are common in sports such as hockey, soccer, football, basketball, and skiing, but they can occur during everyday activities as well. 

What Are the Grades of an MCL Tear? 

MCL injuries are commonly classified into three grades based on the severity of ligament damage: 

Grade I: A mild injury involving stretching or minor damage to the ligament. The knee is generally stable. 

Grade II: A partial MCL tear with greater ligament damage and some looseness of the knee when stressed. 

Grade III: A complete MCL tear that can cause significant ligament laxity and knee instability. 

What Are the Symptoms of an MCL Tear? 

• Pain or tenderness along the inside of the knee  

• Swelling or bruising  

• Pain when walking or changing direction  

• A feeling of weakness or instability  

• Difficulty bending or straightening the knee  

• Pain when the knee is pushed inward  

What Causes an MCL Tear? 

An MCL tear typically occurs when the knee is forced inward while the foot is planted. Common causes include: 

• A direct blow to the outside of the knee  

• Sudden changes in direction  

• Twisting injuries  

• Falls or awkward landings  

• Contact sports  

• Skiing injuries  

MCL injuries can also occur alongside other knee injuries, including ACL tears. When multiple ligaments are injured, assessment and treatment can become more complex.  

How Can Physiotherapy Help an MCL Tear? 

Most isolated MCL injuries are treated without surgery, and physiotherapy is an important part of the recovery process. A 2024 systematic review found that non-operative treatment is commonly used for isolated MCL injuries, with rehabilitation involving progressive strengthening and functional recovery.  

Exercise Therapy 

Progressive exercises help restore strength and the ability of your knee to tolerate everyday activities and sport. Your program may include: 

• Quadriceps and hamstring strengthening  

• Hip strengthening  

• Squats and lunges  

• Step-ups  

• Single-leg exercises  

• Balance and proprioception exercises  

• Sport-specific strengthening  

Exercises are progressed as your pain, strength, mobility, and knee stability improve. 

Mobility and Movement Training 

After an MCL injury, swelling and pain can temporarily limit knee movement. Physiotherapy can help restore your range of motion while gradually reintroducing normal movement patterns. As you improve, your rehabilitation may progress to running, jumping, cutting, and other movements required for your sport. 

Bracing and Activity Modification 

Some moderate or more severe MCL injuries may benefit from a hinged knee brace to protect the ligament from excessive stress while it heals. The need for a brace and how long it should be worn depends on the individual injury.  

Your physiotherapist can determine which activities are appropriate during each stage of recovery and how to gradually increase your activity level. 

Looking for MCL Tear Physiotherapy in Kitchener- Waterloo? 

The physiotherapists at Waterloo Sports Medicine take an integrated approach to care, with physiotherapists working alongside sports medicine physicians and other healthcare professionals like PASS Bracing!