TREATMENT - Knee Collateral Ligament Tear
Collateral Ligament Tear: Treatment
Most orthopedic surgeons agree that tears of the MCL or LCL should first be treated conservatively. This means without surgery. However, each person is different and your doctor may feel you need surgical treatment immediately. If you are told that you will require conservative care you can remember the plan easily by remembering the words: Control, Avoid, and Rehabilitate.
Control: Get your pain under control
Cryotherapy (ice, cold therapy) is an excellent way to control your pain. Do not apply ice directly to your skin for more than 5 minutes as it can cause burns. A device specially designed to cool your joint (see our PolarCare Cub and AirCast Cryo/Cuff IC Cooler) can be used for longer periods, as long as you carefully follow the directions and discontinue its use if you have pain or a burning sensation.
Over-the-counter pain medications can be of use. These include anti-inflammatories such as MotrinTM (ibuprofen) and AleveTM (naproxen), and pain medications, such as TylenolTM (acetaminophen).
Occassionally heat can be of benefit after the initial pain has resolved. Heat is sometimes useful to combat stiffness.
Bracing. In addition to providing stability, braces provides pain relief by stimulating some of your nerve fibers which make you feel that your joint is more stable and secure. These are the same nerve fibers you compress when you grab your finger after you hit it with a hammer. Even though your finger was just smashed, you squeeze it with your other hand as hard as you can and it makes it feel better. Our DonJoy Drytex Hinged Knee Brace is specially designed for providing side to side stability which is critical for the healing of a collateral ligament tear. For more significant tears, the DonJoy Playmaker Knee Brace provides the best stability, especially for return to sports. Some doctors will prescribe the DonJoy IROM Knee Brace or DonJoy Telescoping TROM for specific conditions where controlling return of motion is necessary.
Avoid activities that cause your pain
Just like the old bad joke about the patient that told the doctor: "Doc, everytime I do this, my knee hurts" and the doctor replies: "Well, don't do that!" Although this may seem humorous, there is some truth to the joke. Your body has developed a very complex mechanism to inform you that something is wrong. Humans that ignored these warning signs are no longer living with us today. When our great, great ancestors did not listen to this mechanism, they were killed off by disease or by predators. Thus, pain acts as a warning signal to stop, rest and do something else. Avoid such activities as squatting, kneeling, heavy lifting, climbing, and even running. Listen to your body and make a list of activities or movements that increase your pain and DON'T DO THESE THINGS. Also, make a list of activities and movements that reduce your pain and DO THESE THINGS.
Rehabilitate your knee
The key to this step is to remember controlled motions. This means you have complete control of these motions through a structured rehabilitation program. Most rehabilitation programs can be done in the convenience and privacy of your own home. In specific cases, your doctor may prescribe formalized physical therapy, with a therapist or trainer. Rehabilitation involves first getting your motion back after allowing your ligament to heal, then improving your strength.
The keys to rehabilitation include
- Motivation to actually do the exercises. See our page on motivational strategies to improve your success.
- Correct exercises for your problem. See your doctor or physical therapist if you need advice in this regard.
- Proper equipment. This equipment can either be at your therapists office, at your health club, or items that you purchase for use at home. We have found that people who do their exercises at home are much more likely to benefit from the program as they more frequently perform the exercises.