The human knee is an absolute marvel of a joint that rivals that of the most effective hydraulic hinges in machines. Not only are the knees the main weight bearing joints of the body, but they are also responsible for allowing us to stay mobile.
Just like a hydraulic arm requires oil for lubrication, the knee utilizes synovial fluid available in two forms. Free flowing synovial fluid nourishes and lubricates surround bones to prevent damaging bone on bone friction. It can also exist with tiny little pillows called bursa sacs that act as shock absorbers within the knee.
The Mighty Menisci
Another key piece of hardware that allows the knees to rotate while minimizing friction is the meniscus. Each knee comes complete with two menisci. These beneficial structures can be thought of as functional washers or o-rings that exist to provide separation between key structures. These o-rings within each knee look different depending on which one you are taking about.
The medial meniscus is located on the side of the knee closest to the midline of your body and is C-shaped. The lateral meniscus exists on the side of the knee further away from the body and is a closed and complete circle.
An easy way to remember both the location and shape of these important friction reducing structures is that the medial meniscus is closer to the midline and the shape of the ring is a C or MC. The lateral meniscus lies outside of the midline and the shape of the ring is an O or LO.
While bursitis, an inflammation of the cushiony bursa sacs can cause pain and lead to further friction problems. A meniscus tear can make the knees more prone to further injury by increasing bone in bone situations, the devastating effects of losing a ligament can lead to total failure of the knee machine.
Within each knee, you have the 4 ligaments which work as the 4 main pillars of knee stability. They are the weight-bearing structures that also make motion including extension, flexion possible, and provide general stability to prevent the joint from buckling in any direction.
The anterior cruciate ligament or ACL, prevents the knee from hyper-extending. When you stretch your leg out, it it the structure responsible for preventing your tibia and fibula from extending past your femur. The posterior cruciate ligament is located behind the ACL and is is responsible for keeping the femur from sliding over the knee.
Events or incidents that could cause the femur to go over the form of the knee are much less likely to occur and is the reason why PCL injuries are the least common of the ligament injuries.
The lateral collateral ligament or LCL is located on the same side of the knee as the lateral meniscus and works in concert with MCL to give stability to the knee. A force exerted on the inside or medial side of the knee will lead to damage to the outside LCL.
The MCL is the LCL partner in keeping things stable and stands for medial collateral ligament. You know that medial means midline, so the MCL can be found on the same side of the knee that the medial meniscus is on.
The easiest way to cause damage to the MCL is by direct force to the outside of the knee where the LCL is. Being struck on the outside of the knee causes the inside of the knee to buckle into the midline of the body. Depending on the severity of the blow, the MCL can suffer three different grades of sprains.
What is a Sprain Exactly?
A sprain is the stretching or tearing of a ligament that can be classified using a 3-grade system. A grade 1 MCL sprain is the least serious of the three and is a slight over-stretching or tear of the ligament that can cause some slight discomfort but can usually heal on its own when given time.
Stability will not be an issue with this lowest severity sprain. A grade 2 sprain falls in place between the slightest of tears (grade 1) and a complete tear (grade 3). A grade 2 sprain is a much more significant tear that will not only cause pain but will also decrease stability. A grade 3 strain is a complete tear of the ligament that usually brings a ton of swelling with it.
Walking is usually made impossible as stability of the knee will be extremely compromised and with a loss of a single ligament, more work is then put on the remaining ligaments, which can make a full sprain sufferer more prone to injury of the others.
RICE and Other MCL Sprain Relief
Depending on the severity of the MCL injury, different routes of treatment will be advised. In order to properly diagnose the severity and grade of the MCL sprain, you should be examined by a trained medical physician licensed in orthopedics or sports related injuries.
If the MCL sprain is either a grade 1 or 2, and the tear is not complete, varying degrees of RICE can be used. No, please do not put rice on your knee. There is no far out all-natural remedy here. RICE is actually an acronym for the four steps of self-treatment that will help heal the ligament. RICE stands for rest, ice, compression, and elevation. Rest means exactly what it sounds like.
After an MCL sprain, make sure you take weight off of the affected knee and only walk when you absolutely have to. The more you have time to rest, the less likely you stress out the already damaged ligament and prevent a grade 1 from becoming a grade 2, or even worse, a grade 2 fully snapping to a grade 3. Sticking to a 48-hour period of rest after a sprain should be sufficient time to allow exacerbation of a grade 1 or 2.
The I of RICE is ice. Regularly implement icing sessions will reduce swelling and inflammation and allow for the natural healing factors of your body to work at an optimal rate once the panic mode of swelling has worn off. Ice can also greatly reduce pain, as it will dull your body’s pain receptors.
Compression is the C of RICE and by using a snug but not too tight sock, bandage, or other mode of body wrapping, will ensure inflammation reduction by increasing blood flow. The tightness of the compression apparatus should be tight enough to push blood into and out of the area, but not too tight that it could cut off circulation to the area and create an entirely new array of complications.
The final letter of RICE is E and it stands for elevation. For a successful elevation, the the affected knee must be place above the level of the heart to ensure optimal blood flow to the area. This increase in circulation to the damages MCL will allow for the highest amount of natural anti inflammatories to travel with the blood to the ligament.
Beyond RICE for MCL Sprains
While the RICE method does wonders for grade 1 and 2 sprains, it cannot repair a fully torn grade 3 MCL sprain. Ligaments by nature already have an incredibly weak blood supply. If the stabilizing unit is fully torn, ligament circulation drops even further, making full repair of a torn ligament virtually impossible without the use of surgical means.
During surgery, the orthopedic surgeon will base his or her approach on exactly where the tear has occurred. If it is in the middle of the ligament, the two halves will be sewn back together. If the tear is above the center of the ligament, it will be sewn back into the thigh one. If it is below the midline, it will be sewn back into the shinbone.
Surgery is not always the case, however, as medicine is never an exact science. Certain complete tears can heal on their own with the use of physical therapy. Through PT, the other parts of the knee machine will be strengthened in order to strengthen the other ligaments of the joint and reduce the workload of the healing MCL.
Key Takeaways from MCL Sprains
The knee is a truly amazing locomotive machine. Unfortunately, like any other machine, it can begin to function less optimally when one of its parts are damaged.
The most important knee parts for stability are the four ligaments surrounding and traversing through the hinge joint. A blow to the outside of your knee can cause damage to the inner MCL.
In all three varying grades of MCL sprains, RICE can lead to healing or at least a decrease of swelling and pain. Sometimes surgery is required to repair the MCL when the ligament is too far damaged to heal on its own.