Knee Sprains (ACL, PCL, MCL, LCL)

A knee sprain occurs when a ligament in the knee is stretched and torn. There are 4 main ligaments in the knee that can be sprained, they are:

• Anterior Cruciate Ligament (ACL)
• Posterior Cruciate Ligament (PCL)
• Medial Collateral Ligament (MCL)
• Lateral Collateral Ligament (LCL)

Grade 1

Mild sprain/micro tearing of the ligaments. There is tenderness over the ligament (MCL/LCL can be directly palpated) and no significant swelling

Grade 2

Moderate sprain/incomplete tearing of the ligaments. There is moderate swelling and tenderness over the ligament and usually some bruising occurs. The knee may feel unstable to the patient.

Grade 3

Complete tear of the ligaments in the knee. There is profuse swelling in the knee immediately. Severe laxity without a distinct end point is felt when testing the ligament and the joint is very unstable.

Associated with an acute traumatic incident, often with the leg planted on the ground.

ACL

• Landing from a jump, pivoting, or decelerating suddenly
• Unable to "touch" the pain
• Usually a "pop" is felt or heard

PCL

• Hyperextension of knee
• Not as common as tears of ACL
• Direct blow to the tibia (shin) with the knee in a flexed position

MCL

• Valgus stress to the partially flexed knee
• Pain felt on the inside (medial) aspect of the knee
• Able to "touch" the pain

LCL

• Direct varus stress on the knee
• Much less common than MCL tears
• Pain felt on the outside ( lateral) aspect of the knee
• Usually associated with other injuries

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RICE

Rest: The patient should rest the knee, crutches or a cane may be required.

Ice: Apply a cold compress, wrapped in a towel or in a Trainers Choice compression wrap, to the knee for 15 minutes per hour, a minimum of 3 times/day.

Compression: Apply compression to the knee by wrapping with an elastic wrap, or applying a compression knee sleeve support.

Elevate: The knee should be placed in an elevated position to reduce swelling.

Athletic Therapist or Physiotherapist to aid healing and correct any muscle imbalances through stretching and strengthening

ACL

• Strengthen surrounding muscles, specifically the hamstrings and quadriceps
• Surgery may be required to reconstruct the ligament
• Custom knee brace often required to protect the ligament from re-injury

PCL

• Strengthen surrounding muscles, specifically the hamstrings and quadriceps
• Surgery is not typically required to repair this ligament
• Custom knee brace may be required to protect against re-injury

MCL

• Strengthen surrounding muscles
• Surgery not usually indicated and therapy with conservative rehabilitation
• Hinged knee brace to support and protect from further injury

LCL

• Strengthen surrounding muscles
• Acute surgery may be required to repair the ligament and associated injuries
• Hinged knee brace to support and protect from further injury