Non-surgical Rehabilitation
When you begin your therapy at Collective Health, our initial treatments for a collateral ligament injury will focus on decreasing pain and swelling in the knee. Rest and anti-inflammatory medications, such as aspirin, can help decrease these symptoms. You may need to use crutches until you can walk without a limp.
Most patients receive therapy treatments for collateral ligament injuries. Our therapists may treat the swelling and pain with ice, electrical stimulation, and rest periods with your leg supported in elevation.
We will use exercises to help you regain normal knee movement. Range-of-motion exercises are normally started right away with the goal of helping you swiftly regain full knee movement. This includes the use of a stationary bike, gentle stretching, and careful pressure applied to the joint by our therapist.
Exercises are also used to improve the strength of the quadriceps muscle on the front of the thigh. As your symptoms ease and strength improves, your therapist at Collective Health will guide you through advancing stages of exercise.
When you get full knee movement, your strength is improving, and your knee isn't giving way, you'll be able to gradually get back to your work and sport activities. We may prescribe the use of a functional brace for athletes who intend to return quickly to their sport. These braces support the knee and protect the collateral ligaments.
Although recovery time varies, minor sprains of either the MCL or LCL often get better within four to six weeks. Moderate tears should rehabilitate within two months. Severe MCL tears require up to three months. Patients who are still having problems after three months may need surgery. Severe tears or ruptures of the LCL are the trickiest, because they tend to leave the knee joint the most unstable, and patients with this condition typically don't do well with non-surgical care. Patients who continue having periods of swelling or instability in the knee may also need surgery to correct their problem.
Post-surgical Rehabilitation
Rehabilitation proceeds cautiously after surgery of the collateral ligaments, and the treatments our patients receive vary depending on the type of surgical procedure that was used. Some surgeons have their patients use a continuous passive motion (CPM) machine after surgery to help the knee begin to move and to alleviate joint stiffness.
Most patients are prescribed a hinged knee brace to wear when they are up and about. Surgeons occasionally cast the leg after reconstruction surgery of the LCL.
Patients are strongly advised to follow the recommendations about how much weight to place on the leg while standing or walking. After a ligament repair, you should put little or no weight on your foot when standing or walking for up to six weeks. Weight bearing may be restricted for up to 12 weeks after a ligament reconstruction.
When you begin your post-surgical therapy program at Collective Health, the first few treatments are designed to help control the pain and swelling from surgery. Our goal is to help you regain full knee motion as soon as possible.
Our therapist will also work with you to make sure you are using the crutches safely and only bearing the recommended amount of weight while standing or walking. As the rehabilitation program evolves, we will choose progressively more challenging exercises to safely advance your knee's strength and function.
Ideally, you will be able to resume their previous lifestyle activities. However, some patients may be encouraged to modify their activity choices, especially if an allograft procedure was used.
At Collective Health, our goal is to help you keep your pain under control, ensure safe weight bearing, and improve your strength and range of motion. When your recovery is well under way, regular visits to our office will end. We will continue to be a resource, but you will be in charge of doing your exercises as part of an ongoing home program.
Physician Review
X-rays may be required to rule out the possibility that any bones have been damaged. Stress X-rays may be useful to confirm that one of the collateral ligaments has been torn. Stress X-rays are plain X-rays taken with someone attempting to open the side of the joint that is suspected of being unstable. The X-rays will show a widening of the joint space on that side if instability is present.
Magnetic resonance imaging (MRI) may be ordered if there is evidence that multiple injuries have occurred, including injury to the ACL or meniscus (a special type of cartilage in the knee joint). The MRI machine uses magnetic waves rather than X-rays to create pictures that look like slices of the knee.
This test does not require any needles or special dye and is painless. If there is uncertainty in the diagnosis following the history and physical examination, or if other injuries in addition to the collateral ligament tear are suspected, an MRI scan will probably be suggested.
An isolated injury to the LCL or MCL rarely requires surgical repair or reconstruction. Partial tears to the LCL, such as Grade 1 or Grade II injury, are usually treated by reduced activity and allow the ligament healed with or without a brace for several weeks. Most doctors opt not to immobilize the knee in a cast when the MCL is torn. Some doctors prefer to issue their patients a knee brace after the injury if there is significant pain and instability.