MCL - time frame to heal

(Georgia)

My 13 year old son tore his MCL playing catcher in a baseball game. He was seen at the emergency room and again by a sports medicine doctor. He has a stage 2 MCL tear. He has been in a leg immobilizer for 4 weeks, as of today.

He wears this immobilizer even when sleeping but takes it off to shower. He pretty well stayed off of the knee for 24 hours and iced it every couple of hours. He then iced it every night for a week during the first week of wearing the immoblizer. He has been on it, while wearing the immobilizer, a good bit after the first week. The plan is for him to move to a hinged brace this week. My questions are as follows.

How long would he typically need to wear the hinged brace and how much activity should he be allowed to do while wearing it?

How long do you think he should wait before resuming normal baseball activities and should he wear the brace for a while when he does resume these activities?

He has played catcher for about 4 years now. Obviously catching puts a lot of stress on the knees. Should he try out for another position or should he presumably heal well enough to continue catching?

Thank you for your advice and opinion.

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MCL - time frame to heal

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Jun 03, 2008
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Protocols are different for every physician
by: Bart - SII

One thing to consider when looking at your son's recovery is your physician's specific protocol for treating MCL sprains. For each physician, there are usually differences in how these injuries are treated. Some are conservative, others are more aggressive...so you may read a ton of stuff online that says lots of different things, but your physician has specific reasons as to why they follow their protocol.

With that said, my answers are based on my own protocol and my opinions based on tissue healing and rehabilitation. So, take that for what it is worth.

For a grade II MCL sprain, my patients usually start off in a hinged knee brace with the hinges set to prevent full extension, and flexion beyond 90 degrees - so usually 30-90 degress of available motion. They are off crutches as soon as they can weight bear without pain.

After 3-4 weeks, we unlock the brace and allow motion to tolerance - rehab is started immediately after injury and focuses on regaining pain free range of motion, maintaining quadriceps function, and working on decreasing pain and swelling.

The decision on when to discontinue the brace is usually one made by the physician and their personal preference. I believe that the sooner you can get out of the brace with daily activities the better. At 4 weeks, the ligament has a good amount of healing taking place and some controlled stress on the joint is actually good for the continued healing. Most of the time, the decision to remove the brace with daily activities is made when there is no tenderness along the MCL with palpation, and when motion is restored to almost normal.

For your son, I would imagine he will be int he hinged brace for another 2-3 weeks and then only need it for activities.

As far as returning to baseball, this decision has to be based on the functional status of his knee. He needs full range of motion, good strength, good control, and to be pain free with all activities. Most of the time after a grade II sprain, this is somewhere around 8-12 weeks after injury, depending on how rehab progresses. It is also important that the ligament be monitored for laxity throughout the rehab process...this is something the physician or clinician can test with a ligament stress test (valgus stress).

Returning to catching should be ok but it may take more than the time mentioned above before he is able to squat regularly. Full motion can take some time to come back. Overall though, as long as he follows the rehab process, he should do well. The MCL has good healing properties and usually does not cause a lot of long term problems if it is treated appropriately in the early stages (which it sounds like you have done so far). Wearing the brace with baseball for the next several months may help but isn't absolutely necessary.

Hope this helps - please comment back if you have other questions.

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Jun 03, 2008
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Submitted by: Bart - SII

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One thing to consider when looking at your son's recovery is your physician's specific protocol for treating MCL sprains. For each physician, there are usually differences in how these injuries are treated. Some are conservative, others are more aggressive...so you may read a ton of stuff online that says lots of different things, but your physician has specific reasons as to why they follow their protocol. With that said, my answers are based on my own protocol and my opinions based on tissue healing and rehabilitation. So, take that for what it is worth. For a grade II MCL sprain, my patients usually start off in a hinged knee brace with the hinges set to prevent full extension, and flexion beyond 90 degrees - so usually 30-90 degress of available motion. They are off crutches as soon as they can weight bear without pain. After 3-4 weeks, we unlock the brace and allow motion to tolerance - rehab is started immediately after injury and focuses on regaining pain free range of motion, maintaining quadriceps function, and working on decreasing pain and swelling. The decision on when to discontinue the brace is usually one made by the physician and their personal preference. I believe that the sooner you can get out of the brace with daily activities the better. At 4 weeks, the ligament has a good amount of healing taking place and some controlled stress on the joint is actually good for the continued healing. Most of the time, the decision to remove the brace with daily activities is made when there is no tenderness along the MCL with palpation, and when motion is restored to almost normal. For your son, I would imagine he will be int he hinged brace for another 2-3 weeks and then only need it for activities. As far as returning to baseball, this decision has to be based on the functional status of his knee. He needs full range of motion, good strength, good control, and to be pain free with all activities. Most of the time after a grade II sprain, this is somewhere around 8-12 weeks after injury, depending on how rehab progresses. It is also important that the ligament be monitored for laxity throughout the rehab process...this is something the physician or clinician can test with a ligament stress test (valgus stress). Returning to catching should be ok but it may take more than the time mentioned above before he is able to squat regularly. Full motion can take some time to come back. Overall though, as long as he follows the rehab process, he should do well. The MCL has good healing properties and usually does not cause a lot of long term problems if it is treated appropriately in the early stages (which it sounds like you have done so far). Wearing the brace with baseball for the next several months may help but isn't absolutely necessary. Hope this helps - please comment back if you have other questions.

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Sep 09, 2008
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MCL
by: Anonymous

I hyper extended my knee and the area of where the MCL is is very sore. I did this 4 days ago and I am debating on going to the doctor. I can hobble around on my leg and the swelling isn't too bad, no bruising, but my knee is stiff and if I try to work my range-of-motion it is more sore. How long should I wait before I try to get my ROM back? Is it really necessary to see a PT or Dr. I really just want to get back to spin class and the gym.

Sep 10, 2008
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I would see a doctor
by: Bart - SII

With an evaluation, the severity of the injury can be determined - that is the key to how quickly you should start your recovery. Mild sprains can usually be treated more aggressively with range of motion and strengthening, while more significant sprains need to have a period of immobilization or restricted motion to allow the tissues to heal. Your doctor can determine how you should progress.

Bart

Dec 14, 2008
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appropriate healing time?
by: pony person

I'm curious and debating what to do and I'm not seeing the answer on the web. I injured my mcl falling through a floor into a 6' deep hole in late april. ( didnt know the floor had a pit under it!) None the less, after er, ortho and an mri about a week later i was dx'd with a grade 1 mcl sprain. Was originally told it was a tear, but mri only found a sprain. im 35 yo very active, and was in a don j brace for 6 weeks. I feel I have a reasonable plus tolerance for pain, only seeing a dr when truley necc.
We are now approaching 8 mos post incident and I am STILL having trouble w/ it. Primarily 'finding' it in certain movements
(usually a plant and twist inadvertently) and I'm also still very stiff in the morning and evening, or whenever I am still for any long period of time. I have about 95% of my squat ability back, the 5% I dont have is not painful to achieve, just takes a little work. THis was a WC case and it's been a nightmare to deal with. but have been very upfront since completing PT in july that it is still giving me some trouble.
- on last call to ortho in july after work hardening to give status, he said I would need to seek a second oppinion if it was still painful and stated the mcl is just a slow healer.. It was agreed to stop the WH tx as it was just aggrevating the mcl and just see what Dr. Time would do for it. It has come along way but i seem to have hit a plateau. My question is, what is a reasonable period of time to expect this to heal, and at what point should I seek a second oppinon. Thank you!

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Dec 14, 2008
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Submitted by: pony person

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I'm curious and debating what to do and I'm not seeing the answer on the web. I injured my mcl falling through a floor into a 6' deep hole in late april. ( didnt know the floor had a pit under it!) None the less, after er, ortho and an mri about a week later i was dx'd with a grade 1 mcl sprain. Was originally told it was a tear, but mri only found a sprain. im 35 yo very active, and was in a don j brace for 6 weeks. I feel I have a reasonable plus tolerance for pain, only seeing a dr when truley necc. We are now approaching 8 mos post incident and I am STILL having trouble w/ it. Primarily 'finding' it in certain movements (usually a plant and twist inadvertently) and I'm also still very stiff in the morning and evening, or whenever I am still for any long period of time. I have about 95% of my squat ability back, the 5% I dont have is not painful to achieve, just takes a little work. THis was a WC case and it's been a nightmare to deal with. but have been very upfront since completing PT in july that it is still giving me some trouble. - on last call to ortho in july after work hardening to give status, he said I would need to seek a second oppinion if it was still painful and stated the mcl is just a slow healer.. It was agreed to stop the WH tx as it was just aggrevating the mcl and just see what Dr. Time would do for it. It has come along way but i seem to have hit a plateau. My question is, what is a reasonable period of time to expect this to heal, and at what point should I seek a second oppinon. Thank you!

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Jan 16, 2009
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4 weeks??!!
by: Anonymous

I hurt my knee skiing new years day. I went to an orthepedic surgeon a few days later and found out I partially tore my MCL (grade II)and fully tore my ACL. it has now been two weeks since my injury and I have been rehabing for about a week. I was never in an imobilizing brace. My leg feels great. I think imobilxing your sons leg will only make it harder to recover. I was told it would take 6 weeks to fully heal my MCL but that I should start riding a stationary bike at 1 week if I could tolerate it. I am confused as to why your son was put in an imobilizing brace in the first place.

Feb 10, 2009
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mcl sprain
by: Anonymous

I fell about 8 to 9 weeks ago on the ice. After seeing and ortho and having a mri i was told i sprained my mcl. i was given a knee brace to wear. i am still having issues with pain that is worse at night to the point i can't sleep. i tried wearing the knee brace at night but it makes my knee hurt even worse. i have found that prolonged standing also makes the pain worse. i have noticed that i don't fully extend my leg when standing. how long will it take my knee to heal and can an mri be wrong? because my knee cap itself will ache.

Feb 15, 2009
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My MCL injury
by: Anonymous

I don't know how I injured my knee. A few days before Thanksgiving, I noticed my knee was hurting. As the days went by, my knee hurt more and more, especially when I would sit for a while and then get up. After 45 days of this, I spent one weekend going out and about and had to sit on the back seat of my sister's car. My knee was so swollen the next day, I couldn't walk. That's when I went to the doctor. After doing a few things to my knee (pressing here and there) he told me I had MLS. X-rays were normal. He gave me a brace that I have worn for 3 whole weeks. My knee is finally getting better and I can now bend it more and more. Before the doctor, I put ice on it. while wearing the brace, I would take it off and rub it. Its tons better and I can now walk a little normal now.

Feb 16, 2009
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For Anonymous MCL injury
by: Anonymous

I don't think that an MRI would be wrong. I didn't have one. One thing I've learned in past health issues, is that sometimes I had to be my own doctor and figure out things. Don't get me wrong, Doctors are THE ones to go to. Like when I was taking zoloft, I was told I can stop taking it without a problem. It was a problem and I did it my way. When I felt lightheaded everyday. I was told I was fine. I realized it was the soda I was drinking. I had a bad shoulder for 5 years. Doctor gave me pills and it didn't go away. I fixed it on my own by simply changing the way I slept. So maybe your leg hurts at night because of the way it is positioned. Try sleeping on a couch with a pillow under your knee for a few nights. I did that and it helped a whole lot. Ice it for 20 minutes every day and wait a couple hours and ice it again and don't bend your knee at all for anything until it's better.

Apr 03, 2009
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MCL tear
by: Anonymous

I tore my MCL playing rugby and the doctor said to keep it in a hinged brace for 3 weeks. After that time period she said that I could return to sports. Did she mean I could return to rugby or is that too soon?

Apr 10, 2009
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tore MCL, can I try to bend after a week?
by: Anonymous

Hi,

I slid while hiking and twisted my knee. Strangest thing is it did NOT hurt so much right away but after 1 hr it started to become stiff and i couldnt sleep all night.
Went to an Ortho next day.. he said give it 1 week, and then slowly try to increase the motion.
I have a knee cap on. Very stiff knee... can bend very little. it hurts to stand long or walk around. My next appt is after 3 weeks.

I still can't beleive it has become this serious.

I wonder how soon I can return to normal dancing and hiking.

What can I DO to make better it????

Exercise or NOT?

Is it okay to walk in the first week?

Please help!!
Anita

Apr 18, 2009
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MCL - Grade II with avulsion fracture of femur
by: Anonymous

I feel everyone's pain on this page! I am at 7.5 weeks of recovery from a grade II MCL sprain that came with a small avulsion fracture (tearing away of the bone) of the femur where the MCL attaches. I'm walking great, but twisting when the leg is planted is out of the question. Leg still gets tired, sometimes aches, and there is still pain on palpatation directly over the avulsion site. My self-directed PT has been swimming, walking and doing weights -- as pain allows (forget the "no pain, no gain" mantra, in this case, if there's pain, I either slow down, stop, or reduce the weight). I am optimistic that I will be able to hike again by the 10 week point. Question -- is there any reason to NOT use a hinged knee brace while hiking this summer as a little extra protection?

Apr 18, 2009
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i would totally wear the brace
by: pony person

i wrestle w/ horses ( im an equine vet technician.. so my job is to keep the vet from getting hurt by a silly 1200 # animal who gets needle shy for vaccines, etc.) on the april 26th i will be 12 months post injury. from my grade 1 i spoke of earlier..

I kid you not when i tell you that even now, occasionally if i plant my foot and twist/turn a certain way, to the max of my ROM i can still feel it.. it isnt painful, but It lets me know its there. Almost like a reminder not to push it any further.. ( as if i needed one!) ..

It wasnt until i would say 10 months post injury that i stopped 'hitting' it.( finding the tear accidentally) doing activitieds of daily living ( I would find it mostly getting out of the drivers side of the car( right leg).. oddly.)

I wore my brace for work and other aggresive activities taht I felt were risky( hiking, riding horses and working) for about 4 months post injury -- consistently then backed it off as i felt more confient.

Ive been w/o the brace on for risky stuff since about 6 months post injury. Riding was uncomfortable for a while but not unbearable.

Best of luck to you!!! Sounds like you've got the right idea! dont do anymore than your knee allows!

Apr 27, 2009
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MCL
by: Anonymous

Wow this site is just what I was looking for! I'm in week 7 of a Grade 1 sprain, after four weeks I was allowed off the hinged brace, and cleared to run (just no cutting or contact until pain free). I'm a bit worried though that running will just prolong the recovery. Bicycling goes really well though so I think I'll eventually heal.

Since my doc did NOT recommend any PT, are there any stretching and twisting regimens out there I can use?

May 07, 2009
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MCL SPRAIN!!! NEED HELP!!!!
by: Anonymous

Hey, i play college football and sprained my MCL 4 weeks ago. My trainer said it was a grade 1 but here were my symptoms. The day after I wasn't able to walk well at all. Had to limp badly. It happend on a weds and by sat i could walk normally. In about a week i was able to feel no pain while walking around. I was able to ride a stationary bike with no pain at all that monday. I received rehab with ice and stim machine for the first week and a half, two weeks. Then had heat and ultra-sound done on it for two weeks. It has now been 4 weeks and i feel no pain while running. No pain when shuffling. The only time i feel pain is when i'm using the leg curl machine and still it isn't severe. The main concern i have now is i need to start training for the fall and no doctor can seem to give me a straight answer on whether or not i'm ready to start squating on this knee hard. They keep telling me to take it easy but i feel no pain when doing it and at some point i gotta stop taking it easy and take it up a notch go 100% with squats, hang cleans and deadlifts. What my real question is i guess is if i feel no pain while performing the excersise and it has been 4 weeks is that a sign that i'm healed and ready to go? Also they did the movement test on my knee and my injured knee showed only a 1 mm difference in movement then my uninjured knee. My school trainer said anything over 2 1/2 mm would be consider abnormal. So do you think i'm ready to start using this thing full blast??

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May 07, 2009
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Submitted by: Anonymous

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Hey, i play college football and sprained my MCL 4 weeks ago. My trainer said it was a grade 1 but here were my symptoms. The day after I wasn't able to walk well at all. Had to limp badly. It happend on a weds and by sat i could walk normally. In about a week i was able to feel no pain while walking around. I was able to ride a stationary bike with no pain at all that monday. I received rehab with ice and stim machine for the first week and a half, two weeks. Then had heat and ultra-sound done on it for two weeks. It has now been 4 weeks and i feel no pain while running. No pain when shuffling. The only time i feel pain is when i'm using the leg curl machine and still it isn't severe. The main concern i have now is i need to start training for the fall and no doctor can seem to give me a straight answer on whether or not i'm ready to start squating on this knee hard. They keep telling me to take it easy but i feel no pain when doing it and at some point i gotta stop taking it easy and take it up a notch go 100% with squats, hang cleans and deadlifts. What my real question is i guess is if i feel no pain while performing the excersise and it has been 4 weeks is that a sign that i'm healed and ready to go? Also they did the movement test on my knee and my injured knee showed only a 1 mm difference in movement then my uninjured knee. My school trainer said anything over 2 1/2 mm would be consider abnormal. So do you think i'm ready to start using this thing full blast??

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May 14, 2009
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true it can take a long time.
by: james f uk

I had a snowboarding compression crash in jan 09. On relection the pain and symptoms were exactly the same as my recent mcl tear. had 3 mouth recovery with no medical help from the first injury above. Kashmir was a liitle short of nhs.

In june 09 I had a wakebord crash with exactly the same type of fall and forces on my right knee. (the same one)

I really started to kill in the evening of the second crash and got progressivly worse over the next 24hrs. walking up hill could not happen for 4 weeks, stairs i did on my butt for 2 weeks.

Had an MRI that showed grade II tear and high signal where the MCL joins the bone (Fantastic).

Currently it is 11.5 months since 2nd strike. I have seen 8 doctors in the uk over 10 months! its always 4/6 week to wait for the appointment. Also 3 of the docs recently recommended a hinged brace to try to give my unstable knees support during work and play, I went to get messured for one and the doc told me there are no braces for mcl injuries! I know incredble.

It is the twisting, walking, cycling,sleeping and amazingly doing nothing that makes it sore. alway worse after a rest. and the sore spot over the mcl, oh my word that was the killer for sleeping and has not gone away. My wifes bum was perfect however for resting my knee on while sleeping! thanks honey.

this is 12 months since the injry! I am getting a second opinion in a week or two.

Look after your knees take your time but remember u only live one so go for it.

If anyone has some advice iwould be very greatful

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May 14, 2009
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Submitted by: james f uk

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I had a snowboarding compression crash in jan 09. On relection the pain and symptoms were exactly the same as my recent mcl tear. had 3 mouth recovery with no medical help from the first injury above. Kashmir was a liitle short of nhs. In june 09 I had a wakebord crash with exactly the same type of fall and forces on my right knee. (the same one) I really started to kill in the evening of the second crash and got progressivly worse over the next 24hrs. walking up hill could not happen for 4 weeks, stairs i did on my butt for 2 weeks. Had an MRI that showed grade II tear and high signal where the MCL joins the bone (Fantastic). Currently it is 11.5 months since 2nd strike. I have seen 8 doctors in the uk over 10 months! its always 4/6 week to wait for the appointment. Also 3 of the docs recently recommended a hinged brace to try to give my unstable knees support during work and play, I went to get messured for one and the doc told me there are no braces for mcl injuries! I know incredble. It is the twisting, walking, cycling,sleeping and amazingly doing nothing that makes it sore. alway worse after a rest. and the sore spot over the mcl, oh my word that was the killer for sleeping and has not gone away. My wifes bum was perfect however for resting my knee on while sleeping! thanks honey. this is 12 months since the injry! I am getting a second opinion in a week or two. Look after your knees take your time but remember u only live one so go for it. If anyone has some advice iwould be very greatful

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May 23, 2009
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Grade III MCL tear
by: Anonymous

I completely tore my mcl @ the end of April. My doctor said he has only seen 1 mcl in 20 years that need surgery. While I can appreciate not having knee surgery since my other knee had acl and meniscus surgery 1and1/2 years ago. I need to return to work and am out until healed because of the nature of my work. I do not have any pain to speak of and really only had pain when I tore it while grappling. My leg feels strong just unstable. I want to speed my ability to get to running or have surgery and get to healing from that. Anyone else experience similar problem?

May 31, 2009
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knee injury
by: Anonymous

five weeks ago i hurt my knee skiing. I did not hear a pop or feel a sudden tear and was able to ski down the moutain immediatley after the injury but i did feel pain in my knee. The next day my knee got worse and i could hardly walk. I want to my student health center and the doctor felt my knee and tested it's mobility and without taking any mri's or X-rays she thoguht that it was a simple mcl sprain. She gave me a packet on mcl tear that had excercises for me to do to restrengthen the ligaments. I have been doing those exercises ever since my injury and it has slowly been getting better. My main concern is that after 5 weeks the inside of my knee where the MCL is located is still a little swollen and tender. I have no trouble walking and can ride a bike. the only thing that gives me a little bit of pain is bending my knee so that my heel touches my butt. Is this something that i should be concerned about? should i go and see a doctor and possibly get an MRI?

Jun 07, 2009
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i injured my mcl and probably my lcl and patella has some discomfort..
by: wonderboy18

its been 86 days since i was injured while playing basketball..i hear a pop sound at the time of my injury and after landing through jump i saw my knee is dislocated sideway.then i take it back that time and hearing another pop sound it was hurt like hell..since that i didnt visit any doctor yet and not taking x rays..just resting,exersice and icing on it..my knee is feeling well now but not the same again..how long does it take to heal my mcl?..should i visit a doctor?..pls help me..thanks

Sep 22, 2009
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what should i do
by: Anonymous

i was playing football when one of the players grabed me by the neck and pulled me back i put all my weight on my right knee and heard a popping sound. i got up fine just with a little limp but my knee felt loose like it wanted to buckle. Its the second day and i cant put any weight on it, i can move it up and down with little pain but when i move it left and right the pain is.....the worst pain i felt... i went to the emergency room and got x-rays, there is no bone fractures. Should i go to a ortho. or should i use the RICE method? (rest,ice,compression,elevation) i need advice fast are there any exercises i could do to help it get back to normal????

Sep 22, 2009
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RICE it man!
by: james f

I would defo rice it! ASAP It has been 15 months since i strained/torn MCL. I had to push the docs in the uk because they kept saying it will heal on its own. I got a new referal and have had an operation where thry removed the problem with the inserstion of the MCL scaring.

When I first did it and for 8 months it was so sore. In US and CA they brace it for the first few weeks with some restiction. RICE it and massage the painful area.

Good luck.

Oct 13, 2009
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mcl rehab
by: Dev

Dear readers obviously management varies from case to case i'm seeing many similar injuries at the mo on my othopaedics rotation.rest of the effected limb is essential. one should wear a fixed hinge brace allowing movement from 30-90 deg for a while - 4 weeks. mcl is least stretched at 30 degs flexion so allows for a reliable healing process. if leg is in a leg brace allowing full extension u can get a mcl which is stretched and prone to further injury. at the same time do stretch to limits of pain a few times a day to avoid stiffness hope all works out with rehab

regards
Dev

Nov 13, 2009
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Sprained or torn MCL ?
by: Anonymous

I'm a 32 yr old karate practicionner. I got hit on my leg during kumite and i heard my knee pop and fell immediately to the ground.
Went to the hospital and now i've been referred to an orthopedist. I dont know if it's a sprain, the level of the sprain or if it's torn. It's not too painful but my leg is immobilized in a brace. There's no swelling but i feel my knee is 'loose'

I'm in pretty good shape and have never suffered a serious injury before. How long do you think i can resume my practice of karate ?