Problems we see with medial collateral ligament injuries
Stopping treatment too soon: The pain will return, if the program is not followed until the last week. Patients generally “feel better” after the two weeks of pain management and thus continue on their own with their activities, only to come back after a few weeks with the same problem. The main aim here is not to merely get rid of the pain.
Getting back to sport too soon: Not completing the rehabilitation process can be detrimental to your MCL injury. If you load it too much, too soon, the ligament will not be able to withstand the forces being put on it and you could sustain a re-rupture, starting the whole process right from the beginning, only this time with even more scar tissue to begin with. This can become a recurrent problem and may weaken the ligament to such extent that your knee becomes completely unstable.
Generic braces provide a false sense of security and sometimes athletes will return to sport still using a brace. If the muscles around the knee joint are not strong the brace will not prevent re-injury of the knee.
Waiting too long to come for physiotherapy due to the false sense of support the swelling provides. Swelling makes it more difficult to assess and diagnose the knee completely. (See excerpt on swelling in the knee at general knee ligament injuries)
Not attending to your injury apart from physiotherapy: Your physiotherapist will give you a home program you need to follow. We only see you for an hour maybe twice a week. The rest of the time, it is your responsibility to do what is necessary in order for complete healing to occur.
How long will it take to heal?
Time to recover from a medial collateral ligament injury will depend on the severity of your ligament tear.
A grade 1 MCL injury will take between 2-4 weeks to heal. However, the healed collagen fibers only reach maximal ligament strength after 6 weeks, so to limit the possibility of re-injury it is advisable not to return to sport too soon. If you have to train before 6 weeks it is advisable to use a hinged brace to protect the healing ligament.
If you have a grade 2 MCL injury your recovery time will be between 6 to 8 weeks. With early treatment, we try to get you jogging at 6 weeks, but you should expect return to activity no sooner than 6 weeks.
With grade 3 MCL injuries, your healing time will depend on whether the conservative treatment or surgery option is chosen. Conservative treatment will involve more than 8 weeks of intensive rehabilitation. Initially we will see you twice a week until your pain is under control. Thereafter we will see you once a week to check on the stability and control of your knee. Once you can tolerate everyday activities and control the movement of the knee we will see you once every 10 days or 2 weeks to check on your progress and increase the intensity of your exercises.
Surgery is definitely indicated if a complete rupture of the anterior cruciate ligament is present with medial collateral ligament injury. Full recovery may take 4-6 months and you can only return to sport after 9 months to a year of intensive rehabilitation.