Steps to Manage MCL Injury

THE MCL SPRAIN, WHAT IS IT AND WHAT DO I DO?

Went in for a challenge, block tackle or you may have fallen awkwardly?  Experiencing pain on the inside of your knee?  Well hopefully you have spoken to a health care professional and following investigation of your symptoms you have had it diagnosed.  If not, here we are going to explore a Medial Collateral Ligament (MCL) sprain.  One of the most common injuries following the previous events listed.  What you’re about to read will help educate you on the process of injury and stages you will go through as well as some basic management strategies to get you back on your feet.

I must advice, if you are in a position where you haven’t already had your symptoms checked out by a health care professional.  I highly recommend you do!

ANATOMY

Your Medial Collateral Ligament (MCL) is found on the inside of your knee. Attaching from the thigh bone inserts on to the shin bone. Its job like all other ligaments is to maintain stability at the knee joint.  The MCL specifically protects the knee from excessively caving inwards (valgus).

INJURY GRADING

When with any ligament sprain you will be given a grade which describes the level of damage…

Grade 1: Here presents a minor tear.  It can often be sensitive to touch in the early onset.  However, individuals usually return to sport/ pain free life in 10 days.

Grade 2:  A larger tear than presented with a grade 1.  You may be experiencing a lack of stability, whilst pain may appear sharp/.  Here you may experience 6-8 weeks on the side-lines.

Grade 3:  Complete rupture, your ligament is no longer intact.   Ouch this one hurts, high levels of pain and a high level of instability. You will need to consult your GP for further investigation and potential surgery.  This can often leave you side-lined for 3-4 months

MECHNAISM OF THE INJURY

WHAT DO I DO?! INITIAL STAGES

For the purpose of this blog I am going to be basing the following example on a Grade 2 mcl Sprain.

Its day, you’re not in the best of moods following waking up and having the reminder your knee is hurting as you swing your legs out of the bed.  First things first, brush your teeth!  I’m pretty sure the others don’t want to hear and smell you complain about your war wounds.  Following this go to the freezer, take out the ice pack, bag of frozen peas or anything frozen and place it over the inside of your knee.  Then whack your feet up and call someone to make you that well-deserved cup of tea!

PRICE Protocol

Protection

Rest

Ice

Compression

Elevation

Its important we adhere to the rice protocol within the first 48-72 hours to ensure we maximise the healing process.  During this process its important you apply compress throughout day. Ensure you remove at night.

I recommend you ice regularly 3 times per day.  for 10mins on – 10 mins off x 3) making sure your leg is elevated when icing. This should only last for 3-5 days dependent on pain levels.

Before I delve into the rehab protocol it is key you are being guided by a health care professional and if you’re a citizen of Bristol let that proffessional be me. Also what I’m going to be baseing the following on is a grade 2 sprain.

Okay so if you’re reading this fresh off the injury then get on that classic RICE protocol to help the healing process do its thing and get a few days off work if you can. Get yourself some compression bandage wearing it throughout day, crutches if possible and icing regularly (3+ times per day, 10mins on – 10 mins off x 6) making sure your leg is elevated when icing (Sofa bound). This should only last for 3-5 days dependent on pain being experienced.

Days 5-14

Time to get moving!

Start off with the simple stuff just basic range of movement exercises against little/no resistance.

So lazy time is over lets get this knee moving again. Start off with the simple stuff just basic range of movement exercises against little/no resistance. The goal of this stage is to increase range of movement, minimize pain and swelling and get you full weight bearing by day 14. To accelerate this stage, I’ll getting to work on your soft tissue to  increase blood/lymphatic flow to your surrounding tissues and also most importantly friction mobilisation on your MCL to break down that scar tissue to recover the ligament quickly and make it as strong as possible for the future.

Okay so I wont go into anymore detail about what your later stage rehab should involve as you will not be able to carry out it on your own. However check out my youtube video (link below) to see what your rehab will look like at the later stages with me at Back2Action.

Like I said before you will NEED to be supervised by a health care proffessional throughout your recovery. Your Sports therapist/physio/chiro will carry out regular assessments so they’re able to make the final decision for when you’re ready to get back playing!

The goal of this stage is to increase range of movement, minimize pain and swelling.  Resulting in pain free full weight bearing within 14 days.  This phase can accelerate by seeing a medical professional who will perform techniques such as; soft tissue massage and friction mobilisation.

As mentioned, previous its important if you are experiencing pain on the inside of the need following incidents such as, a challenge, a block tackle and or if you have fallen awkwardly, you consult a medical professional who will guide you back to full recovery.  I hope these guidelines are useful for you and if you have a family member, friend and or colleague who may find this blog useful please share the love.

Many thanks for taking the time out to read this.

Craig Nurse

Are we losing talent at an early age?

Are we losing talent at an early age?

We all have different memories of school sport – whether good or bad, ask a friend and they will have a strong opinion.

All kids can find something enjoyable in sport and they should be given the chance to try out lots of different activities. But what about those who are gifted at a particular sport and play for teams out of school, are we doing enough for these individuals?

As a performance coach, I see day-to-day how important school sporting activities are. They are where the majority of kids learn about and experience sports and this understanding can have a profound effect on the rest of their lives. In my opinion, everyone should be encouraged to participate in sports for the health and wellbeing benefits they provide, but I also believe that individual excellence should be embraced and nurtured. Would you put an F level maths student with an A* maths student? No. Yet we see this all the time in PE and sports lessons. Talent starts from what we harvest at this core age and I believe that if we suffocate individuals at this early point and don’t give them the chance to shine, it can hinder their opportunities to potentially arrive at an elite level later in life.

On the other hand, is it fair to the individual who is not as talented to be exposed to or suffer the psychological barriers faced with feeling inferior and undervalued in a sporting environment? This can create a heightened sense of fear in this situation and over the years I have seen many individuals become disengaged due to similar experiences to those I have described. This ultimately results in them leading a life where exercise and physical activity is limited due to resentment. I mean, not everyone will be David Goggins (if you don’t know who he is then I recommend that you look him up https://davidgoggins.com/)

Play Fair vs Competition

Over the past decade the approach to sport and exercise has hindered the UK’s ability to continually produce high-level talent. Many schools teach non-competitive traits. There are some schools who do a great job and get all of this right, but often it’s left to the out of school coaches to nurture talented pupils. It’s time we reinstated healthy levels of competition.  I mean… It’s OK to compete – we need to show the future generation it’s OK to lose but also give them the tools they need to learn how to win. There are many life lessons in winning and losing, and the emotional rollercoaster these outcomes present are invaluable in enhancing skills such as decision making and managing pressurised situations. Both traits that as adults we would continually like to improve.

So what’s the answer?

  • Offer a wide range of sport opportunities so that all kids have the chance to find something that they enjoy
  • Teach healthy habits as part of the regular curriculum and link this to PE lessons for all students (not only those studying PE). Many schools do a great job of teaching health and fitness in the classroom but neglect to link it to PE classes.
  • Divide groups by ability rather than age