The Medial Collateral Ligament (MCL) runs down the inside of the knee, connecting the thigh bone (femur) to the shin bone (tibia). The MCL protects and supports the knee from being pushed inwards.


Similar to ankle sprains, the ligaments in the knee can be sprained, meaning it has been put under excessive stress and some parts of the ligament are damaged. This could be caused by a big hit to the outside of the knee, commonly from a tackle in sport, or from a large stretch.


A sprain is when there has been damage to the ligament, but it’s not completely torn. You have an MCL tear if the ligament has actually been torn. It is common for MCL sprains to happen at the same time as other injuries to the knee like an ACL (Anterior Cruciate Ligament) tear or a meniscus tear.


However, the MCL has a great blood supply, so it has a greater chance of being able to heal completely. Due to this healing ability, even MCL tears can sometimes be treated without surgery.

Treatment For A MCL Sprain

MCL injuries are diagnosed based on the severity of the damage and are categorised into 3 grades.

  • Grade 1: This is an excessive stretch of the ligament. These sprains only need a relatively short period of rest, with 48-72 hours of walking only, then 1-3 weeks of rehabilitation exercises.
  • Grade 2: This is a more severe stretch of the ligament and requires the same amount of initial rest as a grade 1 sprain. However, the rehab period is likely to take 4-8 weeks.

Treatment of grade 2 MCL sprains will vary, depending on the extent and specifics of the injury. A knee brace may be suggested so your knee movement is restricted, to allow the ligament to heal.

  • Grade 3: This is a tear to the ligament. Treatment often requires surgery, especially if the patient wants to return to playing sport as soon as possible. Again, a brace may be used after surgery with it gradually being unlocked to increase the range of motion in the knee over time.

MCL tears may not require surgery, but it is advised to consult with a sports physiotherapist, sports doctor or a surgeon to discuss all your options and make the wisest choice for safe and effective recovery.

Rehabilitation For a MCL Sprain

There are 4 phases of rehab for these sprains.

Phase 1: Protect the Knee & Regain Normal Knee Movement

This phase is all about allowing the knee to heal but it is not all rest. Your physio will provide expert advice on specific exercises, maybe even from day 1. Note that some MCL sprains require you to prevent the knee from bending fully so always seek medical advice before attempting exercise.


If you have a grade 2 or 3 sprain, you may need crutches initially to give the ligament a chance of healing without putting weight on it.


When you have full flexibility in your knee and little or no pain when walking, then you are ready to move on to the next phase.

Phase 2: Strengthening the Knee

This phase is incredibly important as during the rest period, the muscles around the knee can weaken. Improving the strength of the knee will support the ligaments as well as minimising the chance of injury again.


During MCL rehab, your physio will focus on the hamstrings, quads and glutes. Every week or so, the intensity of the exercises will increase as you get stronger. To maintain your fitness, bike riding, swimming or using a crosstrainer is ideal as it keeps the impact on the knee to a minimum.


Your physio will measure your strength regularly and ensure both legs are equally strong. Melbourne Sports Physiotherapy has specialist equipment to perform these tests, using a dynamometer and/or force plates.

Phase 3: Return to Running

Once you reach this phase work will include jumping and landing on one leg because running is simply a series of hops! Because the body compensates when you are injured, a physio will check that your running technique is even on both sides.


Rehab should also include drills involving change of direction to measure the capacity of your body to perform well moving both left and right while running.


While this phase does have a focus on running, strength training will also continue, both to get your knee ready for running as well as helping prevent a strain in another part of the leg.

Phase 4: Return to Sport

Your physio will make the call on when you are ready to return to playing sport. A plan will be put in place to have you returning gradually, perhaps by short training sessions, working up through non-contact drills and then more open drills with contact. Ideally, working your way slowly up to 2 full training sessions is best, and then actually playing part of a game. Once all is looking good, you will be cleared to play fully.


Recovery can take 4-6 weeks for a grade 1 sprain, and up to 6 months for a grade 3 tear. These timelines can vary considerably, depending on your injury history, whether you had surgery and the consistency of your rehab program.


If you need advice about your MCL injury and rehab process, the experienced team at Melbourne Sports Physiotherapy can assist with a clear and structured plan to have you moving well again as soon as possible. They offer a diverse range of services including post operative physiotherapy, physio for back pain, groin physiotherapy, and much more. Book an appointment online or call the clinic to get started.