Grade 2 MCL tear

by Dan
(New Jersey )

5 days ago my 12 yr old son slid into 3rd base and his knee went one way and his foot the other. He said he heard a pop. Took him to the ER and they took x-rays which came back negative.

Took him to the Orthopedic Surgeon and he ruled out ACL and Meniscus tears, but ordered an MRI. He got the MRI and the results came back as a grade 2 MCL tear.

He has pretty good range of motion in the knee and can put full weight on it. He says it doesnt hurt to bend the knee, but hurts when he tries to lock it out. He is a little sore, but each day there seems to be slight improvement.

He walks with a slight limp, but when he first puts weight on the knee it buckles a bit. He is now wearing a hinged brace which he says gives him much more support.

My question is 2 part.

1) should he be off the leg or should he be walking on it ? I have read so many different things. some say stay off it, but the majority says start rehabbing right away.

2) how long will he be out of sports (specifically baseball now)?

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Grade 2 MCL tear

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May 15, 2008
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Early controlled rehab is a good idea
by: Bart - SII

Most of the actual literature on treating MCL sprains focuses on early controlled rehabilitation. What is meant by this is the use of a brace that helps to provide support and protect the healing ligament, and then rehabilitation that works on improving pain free range of motion, strength, and balance.

The MCL becomes tight at full extension, so this explains why he has pain in this range. Often, my physicians will set the brace to not allow full extension for the first few weeks, which will allow the ligament to heal.

Rehab should be focused on being fairly pain free, and not pushing the knee too fast. Soft tissue heals on a specific timeline, so you can't really speed it up. By 2-3 weeks after injury, there is a good scar formation, and you can then start placing stress on the ligament in a controlled manner.

If this was my patient, I would probably be hesitant to allow return to play before 6-8 weeks after injury - and this would be very dependent upon how his knee healed, how quickly his strength, balance, and endurance returned.

Grade II sprains are the hardest to treat because they require a lot of close supervision in order to heal well.

Sorry for the delay in answering - I hope this helps - feel free to comment back with other questions.