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Best MCL Tear Treatment in Delhi

McL Tear treatment and cure
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What is MCL Tear ?

An MCL (Medial Collateral Ligament) tear is a common knee injury that affects the ligament on the inside of your knee. This ligament runs from your thigh bone (femur) to your shin bone (tibia) and is crucial for stabilizing the knee joint and preventing it from bending too far inward.

Causes of MCL Tears

MCL tears typically occur when a force pushes the knee sideways, particularly from the outside of the knee, causing the ligament to stretch or tear. Common causes include:

  • Direct Blow to the Outside of the Knee: This is a very common mechanism, especially in contact sports like football, rugby, or soccer, where a player might be tackled on the outside of their knee. This force pushes the knee inward, stressing the MCL.
  • Twisting or Pivoting Movements: Sudden, forceful twisting of the knee, especially when the foot is planted, can also cause an MCL injury. This is often seen in sports like skiing (when the ski does not release) or basketball.
  • Awkward Landings: Landing incorrectly from a jump, causing the knee to buckle inward.
  • Hyperextension of the Knee: Overstretching the knee beyond its normal range of motion.
  • Repetitive Stress: While less common for acute tears, repeated stress on the MCL over time (e.g., from certain swimming strokes like breaststroke, or heavy lifting) can cause the ligament to lose its elasticity and become more prone to injury.
  • Falls: Simply slipping and falling, especially if the lower leg splays out, can injure the MCL.
Grades of MCL Tears:-

MCL tears are classified into three grades based on severity:

  • Grade 1 (Mild Sprain): The ligament is stretched, but not torn, and the knee remains stable. There’s usually some tenderness and mild pain.
  • Grade 2 (Partial Tear): The ligament is partially torn, leading to some looseness or instability in the knee when tested. Pain and tenderness are more significant.
  • Grade 3 (Complete Tear): The ligament is completely torn, resulting in marked instability of the knee joint. This is the most severe form and often involves intense pain and significant swelling. Grade 3 tears can also occur in conjunction with other knee injuries, such as an ACL (Anterior Cruciate Ligament) tear.
Symptoms of MCL Tears

The symptoms of an MCL tear can vary depending on the grade of the injury:

  • Pain on the Inside of the Knee: This is the most common symptom, ranging from mild soreness (Grade 1) to severe, sharp pain (Grade 3). The area will often be tender to the touch.
  • Swelling: Swelling and inflammation usually develop on the inside of the knee, often quickly after the injury.
  • Tenderness: The inside of the knee will feel tender when pressed.
  • Popping Sensation: Many people report hearing or feeling a “pop” at the time of the injury.
  • Stiffness: The knee may feel stiff, and it can be difficult to fully straighten or bend it.
  • Instability or “Giving Way”: A feeling that the knee is unstable, loose, or may “give out” or buckle, especially when trying to put weight on it or make pivoting movements. This is more pronounced in Grade 2 and 3 tears.
  • Difficulty Walking: Pain and instability can make walking difficult or cause a limp.
  • Bruising: While not always present, some bruising can occur around the inside of the knee.
Advanced Physiotherapy for MCL Tears

Most MCL tears (especially Grade 1 and 2) heal well with non-surgical treatment, and physiotherapy plays a crucial role in rehabilitation. Advanced physiotherapy focuses on a structured, progressive approach to restore full function, strength, and stability, and prevent re-injury.

Phases of Rehabilitation and Advanced Techniques:-

Phase 1: Acute/Protection Phase (Immediately Post-Injury – typically 0-2 weeks)

  • Goals: Reduce pain and swelling, protect the injured ligament, and maintain some range of motion.
  • Interventions:-
    • RICE Protocol: Rest, Ice (cryotherapy to reduce inflammation, apply for 20 mins multiple times a day), Compression (elastic bandage or compression sleeve), Elevation.
    • Bracing/Immobilization: A hinged knee brace may be used to protect the MCL from valgus (inward) stress, especially for Grade 2 or 3 tears. Weight-bearing may be restricted initially, often with crutches.
    • Electrotherapy: Modalities like TENS (Transcutaneous Electrical Nerve Stimulation) or high-intensity laser therapy to help with pain modulation and tissue healing.
    • Gentle Range of Motion (ROM) Exercises: Passive or active-assisted knee flexion and extension within pain-free limits (e.g., heel slides, prone hangs).
    • Isometric Exercises: Gentle muscle contractions without moving the joint (e.g., quadriceps sets, hamstring sets) to prevent muscle atrophy.

Phase 2: Subacute/Early Strengthening Phase (2-6 weeks)

  • Goals: Restore full range of motion, improve muscular activation and strength, and begin proprioception training.
  • Interventions
    • Progressive ROM Exercises: Increasing knee flexion and extension, including exercises like wall slides, heel slides with towel assist.
    • Stretching: Gentle stretches for quadriceps, hamstrings, and calves to maintain flexibility.
    • Closed Kinetic Chain Exercises: These are exercises where the foot remains in contact with a surface, which are generally safer for the knee joint.
      • Mini Squats/Wall Squats: Gradually increasing depth as tolerated, focusing on proper knee alignment.
      • Leg Presses (double leg, then single leg): With appropriate resistance.
      • Step-Ups/Step-Downs: Starting with low steps and progressing.
      • Bridge Exercises: To strengthen glutes and hamstrings.
    • Proprioception Training: Exercises to improve balance and body awareness, which is crucial for stability.
      • Single-Leg Balance: Starting on a stable surface, then progressing to unstable surfaces (foam pad, wobble board, BOSU ball).
      • Balance Squats: Performing squats while maintaining balance.
    • Manual Therapy: Patellar mobilizations to ensure the kneecap moves freely, soft tissue release techniques for surrounding muscles.

Phase 3: Rehabilitation/Dynamic Stability Phase (6-12 weeks)

  • Goals: Develop dynamic knee stability, enhance strength, and improve endurance for functional activities.
  • Interventions:
    • Advanced Strengthening:
      • Lunges (forward, reverse, lateral): Essential for building strength and stability in different planes of movement.
      • Single-Leg Deadlifts: To strengthen hamstrings and glutes while improving balance.
      • Calf Raises: For ankle and lower leg strength.
      • Resistance Band Exercises: For targeted strengthening of hip abductors and adductors (e.g., crab walks with a band).
    • Neuromuscular Drills: Exercises that challenge coordination and reaction time.
      • Lateral Shuffles: To improve side-to-side stability.
      • Agility Ladder Drills: For quick footwork and changes of direction.
      • Controlled Pivoting Drills: Gradually reintroducing rotational movements with caution.
    • Cardiovascular Conditioning: Stationary cycling, elliptical training, or swimming (avoiding breaststroke kick initially) to maintain fitness without stressing the knee.
    • Plyometrics (controlled): For power and explosiveness, introduced cautiously for athletes (e.g., jump squats, lateral hops, box jumps with soft landings).

Phase 4: Advanced Functional Training/Return to Sport (12+ weeks, variable)

  • Goals: Restore full sport-specific or activity-specific function, prevent re-injury, and ensure readiness for high-impact activities.
  • Interventions
    • Sport-Specific Drills: Mimicking movements and actions required in the patient’s sport or activity.
      • Cutting Drills: Gradually increasing speed and intensity of changes in direction.
      • Deceleration Drills: Training the muscles to absorb impact effectively.
      • Jumping and Landing Mechanics: Refining technique to reduce stress on the knee.
    • Progressive Load Management: Gradually increasing the volume, intensity, and complexity of training.
    • Strength and Conditioning: Continued focus on overall lower body strength, core stability, and endurance.

 

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