MCL Sprain: Grades, Symptoms, Treatment & Recovery Time

The Medial Collateral Ligament (MCL) is one of the four major ligaments in the knee.

It is located at the inner aspect of the knee joint. It attaches the tibia bone (found in your leg) to the femur (thigh bone) and prevents the knee from going inwards. An MCL sprain is an injury to the ligament and can vary depending on the severity of the injury. Usually, an injury to the MCL may also affect other ligaments in the knee and lead to instability.

Structure Of The Knee Joint

knee structure

The knee joint is a hinge joint found in our legs between the thigh and leg. It is made up of 3 bones

  • Femur or thighbone
  • Tibia or shinbone
  • Patella or kneecap

Ligaments hold these bones together and also help to stabilize the knee. These ligaments are:

  • Anterior Cruciate Ligament (ACL)
  • Posterior Cruciate Ligament (PCL)
  • Medial Collateral Ligament (MCL)
  • Lateral Collateral Ligament (LCL)

What Can Cause An MCL Sprain?

1. Trauma

One of the major causes of MCL sprain is usually due to trauma to the outer side of the knee joint. An external trauma can overstretch or tear the ligaments on the inner aspect of the knee.

2. Knee Deformities

Deformities such as knock-knees put a lot of stretching pressure on the MCL which may eventually lead to a sprain.

3. Muscle Weakness

Weak muscles around the knee joint can cause ligament sprain. The muscles and ligaments work together to stabilize the joint. However, if the muscles are weak, there will be a lot of pressure on the ligaments which can lead to an injury in the MCL.

What Are The Different Grades Of MCL Sprain

Grade 1 MCL Sprain

In this grade of injury, the ligaments are not torn but have been stretched above the ligaments limit. It’s like stretching a rubber band just before it cuts. The rubber band cuts when it has exceeded its elastic limit.

Grade 2 MCL Sprain

Some of the ligaments are torn in this grade of injury.

Grade 2 MCL Sprain

This is the most severe grade of ligament injury. The ligaments are completely torn and there is also joint instability.

MCL Sprain Symptoms

Look out for the following signs:

Pain And Tenderness

Pain may be felt at the medial aspect of the knee. If there is no pain at the medial aspect, then it may not be an MCL sprain. Touching the medial part of the knee will cause pain.


Swelling will be seen on the medial aspect of the knee.

Pop – Like Sound

A pop-like sound or tear sound is usually heard when a ligament snaps.

Unstable knee

The MCL stabilizes the inner part of the joint. So when there is an injury to the MCL, there is a tendency for the knee to “give way” when bearing weight on the affected knee. The knee may also lock while walking or standing.

How Is It Treated?

Medications (NSAID)

Medications such as ibuprofen or diclofenac can reduce swelling and also relieve pain.

Use The PRICE method

The PRICE method is an acronym used to treat an acute injury. The acronym stands for:

P – Protect

Protect the joint from further injury. This can be done using a knee brace or a POP cast. This prevents the joint from any form of movement, stabilizes the knee and aids healing of the MCL.

R – Rest

The knee joint is a weight-bearing joint in the body. The knee is necessary for us to move and stand. When injured, the knee needs to be relieved of its duties. The use of crutches or any other walking aid can be used to avoid weight bearing on the affected knee.

I – Ice

ice for pain

Ice has a lot of benefits. It reduces swelling and also relieves pain by making the painful site feel numb. Ice is usually used in forms of ice packs or crushing ice in a damp towel and placing it on the medial side of the knee for 15 minutes every 3 hours for the first 3 days.

C – Compression

Due to the swelling associated with an MCL sprain, compressing the knee with a crepe or compression bandage can help reduce the swelling at the affected joint and provide a bit of support.

E – Elevation

The affected knee joint needs to be elevated to reduce swelling. The knee has to be elevated in such a way that it is raised above the chest level. This enables the heart to pump up the swelling from the knee is a gravity-free plane.


Exercises are done with caution depending on the stage at which the healing process is.

At the initial stage, you may want to avoid any exercise that will involve the movement of the knee. As the ligament heals, strengthening exercises will be recommended as the muscles around the knee joint need to be strong enough to support the affected MCL. Equipment such as sandbags and resistance bands may be used to strengthen the surrounding muscles. Some of the exercises that can be done are:

Static Quadriceps Contractions

This is done by contracting the quadriceps without moving the knee joint. It is usually recommended at the initial stage of the injury.

Ankle Pump Exercises

An ankle pump exercise helps to strengthen the calf muscles and also aid in reducing the swelling at the knee. This is done by moving your ankle up and down 10 times in sets of 3.

Hip Abduction Exercises

This is done by lying on the affected side. If the left MCL is sprained, lie on your right side. Raise your affected leg towards the ceiling and bring it down. Repeat this 10 times in sets of 3.


Surgery is usually the last option. It is usually done for a grade 3 injury. The surgery is called a knee ligament repair and it involves stitching the torn ligament with a healthy tendon.

Recovery Time

The recovery time of an MCL sprain depends on the severity of the injury.

  • For a grade I injury, it may take a few weeks to heal
  • for a grade II injury, it may take six weeks to heal
  • For a grade III injury, it may take 3 – 4 months to heal.

How To Prevent An MCL Sprain

  • Wear appropriate shoes.
  • Listen to your body. After the sprain has healed, ensure you do not overwork the affected leg. The language the body uses when it can take it anymore is a pain. A previous sprain can lead to more injuries that may get worse.
  • Warm up properly before doing any sporting activity. Effective warming up before any sporting activity can prepare the muscles to act as extra support to the knee joint.
  • Always remember to stretch.

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Adekanmi Lipede, M.Sc, MPH

Adekanmi Lipede is a licensed physiotherapist with a Master's degree in physical activity and public health from Loughborough University. She joined 25 Doctors in 2018 and is passionate about educating people about the best steps to take when trying to be physically fit or when recovering from a mobility-related condition. For fun, she loves to exercise and read.
Adekanmi Lipede, M.Sc, MPH