MCL Exercises for Injury Recovery

The medial collateral ligament, or MCL, of the knee provides stability to the inner knee with weight bearing activities. It is most vulnerable to injury with high impact activities, sports, falls, and even tissue changes caused by aging. An MCL tear, also known as an MCL sprain, can leave your knee feeling stiff, sore, and out of commission. MCL exercises are one of the best treatment options for restoring knee function. Keep reading to learn more about exercise for an MCL tear.

Recovery MCL Exercises

Start gently with stretching and targeted non-weight bearing muscle strengthening. From there, work in more dynamic movements that challenge your knee and prepare it for getting back 100% to your normal activities. The following exercises are listed from easiest to hardest so that you can move your way down the list over time. 

An acute knee injury will most likely require a formal period of rest, ranging from a few days to weeks to allow tissues to heal. One of the biggest concerns during this period of immobility is to maintain knee range of motion to prevent unnecessary stiffness. Outside of keeping up with pain free knee bending and straightening (knee flexion and extension), moving the patella, or kneecap, is an effective way to reduce inflammation and minimize the effects of decreased knee mobility by preventing adhesions.

• Sit in long sitting on the floor or a bed with the knee you want to address out straight
• If the knee is very stiff, you may need to place a small towel roll under the knee (ensure it’s not too cumbersome)
• Otherwise, let the knee relax as straight as possible to allow passive movement of the kneecap
• Place your hands on each side of the knee cap
• Gently use your fingers to push the kneecap from side to side, keeping it relatively pain free
• As you become more comfortable with this movement, you can also move the kneecap up and down as well
• Repeat for 1-2 minutes as needed throughout the day

This is a great technique to combine with other massage techniques for sore local muscles (see more below under the foam roller section). 

When the knee is injured, the local muscles tend to tense up to prevent how much you can move the knee and provide some protection. The hamstrings often get very tight with knee pain and can aggravate your symptoms. Thus, some gentle stretching can feel great.

• Lie on your back with a stretch strap (you can use a towel if you don’t have a strap)
• Wrap the end of your strap around the bottom of your foot and hold each end with your hands
• Staying relaxed, straighten your knee and then gently lift your entire thigh up toward the ceiling
• Stop when you feel a strong but comfortable stretch in the back of the leg
• Hold for 30+seconds for 2-3 sets
• Note: exercise extreme caution with this stretch if you have also torn your ACL
• Alternatively, you can stretch your hamstrings sitting on the edge of a chair or both hamstrings at once with a forward fold in standing

Additionally, other notoriously tight muscles include the calves and glutes. You can use your stretch strap or other stretching techniques to address these areas as well.

The glute muscles, located on the outside and back of the hips, play a pivotal role in providing knee stability; particularly to the medial knee where the MCL is located. Weakness or poor coordination of the glutes can lead to excessive strain on the inner knee. This exercise can help.

• Lie on your side with the hip you want to work facing up toward the ceiling
• Stack your hips directly on top of each other and bend the knee of your bottom knee for stability
• Tighten your abs to prevent movement of the trunk and lift the side of your leg straight up toward the ceiling
• Make sure that your kneecap and toes point straight forward and not up toward the ceiling as you lift
• Go as high as you can before returning to the starting position
• Repeat 10-15 times for 2-3 sets on each leg
• To progress this exercise, you can add weight or progress to doing this movement in standing with bands or weights to further challenge your knee stability and strength

We just talked about how important glute strength and stability is for knee health and return to sport. The exercise we just reviewed above addresses the side glutes, while this one will address your largest glute muscle, the gluteus maximus. This muscle is built for providing power with daily moves and sports. Get started in restoring this power here.

• Lie on your back with both the knees bent and feet flat on the floor hip width apart- the closer your heels are to your butt the better (if knee pain allows)
• Tighten your abs and butt as you lift your hips off the ground as high as you can tolerate
• Hold for 1-3 seconds before slowly returning your butt to the ground to repeat
• Continue for 10-15 repetitions for 2-3 sets
• To progress, try a single leg bridge or stand up and try hip extension with a band or weights

Swelling and pain of the knee most often impacts the strength and coordination of the quadriceps muscles on the front of the thigh (anterior). Restoring proper quad strength and activation is important for the return of proper knee function with a significantly lower risk of knee injury. This exercise helps restore your confidence in the quad and the ability to properly activate it with activity.

• Grab a loop resistance band or other band with a knot tied in it
• Wrap the band around a sturdy surface or shut it in the door at about knee height
• Place the leg you want to strengthen in the loop while facing the secured end
• Set up the loop so that it resting against the back of your knee
• Stand far enough away from the anchor to give your knee adequate resistance
• Now, with your foot on the ground and toes pointing forward, let your knee bend and heel rise off the ground (keeping it controlled- don’t let the band do the work)
• Then, reserve directions straightening the knee as you place your heel back on the ground by tightening the front of the thigh
• Hold for 5 seconds for up to 10 repetitions and 2-3 sets total on each knee
• Focus on keeping an upright posture and do not let the hips shift forward and back as you move the knee
• Increase the resistance of your band as tolerated

Being able to stand on one leg without knee pain and good stability is an important step in finally returning to daily activities like walking and running. Plus, it helps in preparing the joint for higher level sports activities too.

• Stand near a wall or chair as needed for safety and balance assistance
• Shift your weight into the leg you want to balance on while lifting the opposite leg
• Hold your balance for 30-60 seconds for 2-3 sets on each leg
• Challenge your balance further by adding a variety of progressions-
• Stand on a foam pad, balance disc, or balance board (if it doesn’t cause pain)
• Try neck, arm, or leg movement 
• Close your eyes
• Add in additional movements, such as throwing a ball, squatting, etc. 

At this point in your exercise program, there are a ton of other functional moves that require lateral knee stability that you should try as you’re comfortable. These include moves like squats, step ups, lunges, calf raises, cutting, changing directions, and other moves specific to your everyday life, sport, or hobby. 

Helpful Exercise Tools & Equipment

Having a few good tools at home can help keep you motivated and consistent with your exercise program. Consider adding the following equipment to your arsenal for knee recovery.

Stretch Strap

Don’t let poor flexibility affect your ability to stretch. Having a designated stretch strap can help you stretch your legs, such as the hamstrings, quads, and calves, without feeling like you’re going to strain your neck or back in the process of reaching your leg with your arms. There is a reason that stretch straps are so popular among yogis, because of the ease and comfort they can provide with your stretching routine- no matter what your level of flexibility is.

Exercise Ball

An exercise ball is such a versatile tool, and a must have specifically for athletes. The innate instability of a ball makes it a great option for returning to sports by preparing the knee and lower body for unpredictable moves. You can add an exercise ball to some of the exercises listed above as an additional challenge, such as bridges, squats, lunges, and more. Your physical therapist can also help you get creative in preparation for returning to sport. 

Resistance Bands

It’s so easy to keep a resistance band around for your knee exercise program. You can throw it in your purse or even a pocket on the go, or bring it with you to a competition to warm up the legs. A resistance band is a great way to target specific muscle groups and add a new dimension of challenge with many different movements, such as squats, leg raises, and more. Plus, they’re low cost and a popular exercise tool of choice among physical therapists.

How to Choose the Right Set of Resistance Bands

Balance Pads

As discussed above with the single leg balance exercise, having the ability to safely balance through your injured leg is one of the important final steps in the recovery process. If you can’t balance without good knee stability, your risk of knee injury rises exponentially. Use of balance tools can help you prepare your knee for the unexpected.

Learn About Different Balance Trainers Here

Foam Roller

Whether you’re using a traditional foam roller or vibrating foam roller, these tools can be a great way to keep sore and stiff muscles looser and more flexible. A roller can be used to apply pressure to larger muscle groups, which is ideal for the legs with the hamstrings, calves, quads, and glutes. Additionally, you can use it to promote better posture (lying on it vertically) or even utilize it as a way to challenge your balance.

Knee Ice Wrap

When completing your exercise program, there is a chance that you will experience a mild increase in swelling, stiffness and pain temporarily. Try utilizing ice and other pain relieving techniques to improve your recovery time. Bonus points for adding compression and elevation to your knee while you ice for 20 minutes as needed after your exercise routine.

Other Ways to Treat MCL Tear Symptoms

Knee Braces

The use of a knee brace can help boost your recovery process when utilized correctly. Soft neoprene braces can be used to increase your sensation to the knee while you work on better knee coordination. Plus, as you return to higher level activities you may find you need a little extra lateral support of the knee with a sturdier brace. Talk to your doctor or physical therapist to discuss what options might be best for you.

Choosing the Right Knee Brace

Exercises to Avoid

What you can and can’t do following an MCL tear will largely depend on your symptoms and the severity of the injury. Plus, what you can do will change as your tissue improves and your tolerance for activity slowly returns. You should avoid any movement that elicits an increase in knee pain or swelling. Here are some specific things to avoid:

• High impact sports
• Cutting
• Jumping
• Pivoting
• Twisting 
• Running

If other ligaments or the meniscus are involved, like the ACL, there may be other higher level moves you want to avoid at first too.

MCL vs ACL

Tips for Effective Exercises

With the right mindset in place, your knee program will yield great benefits. As you get started with your exercise program, keep these basic tips in mind to maximize your efforts.

• Allow adequate initial rest time before jumping into exercise- start with stretching and massage
• Start by targeting specific muscle groups in the legs before progressing to more functional weight bearing strengthening exercises
• Use your symptoms, particularly pain and swelling, as gauge for when to modify or progress your exercises
• Pair your exercise routine with other treatment methods and pain relieving modalities to expedite your tolerance and overall recovery.
• Have patience in the recovery process to reduce the risk of reinjury. Avoid higher level activities before your knee is truly ready
• Consider a round of physical therapy for the best possible results and a full return to your favorite activities
• Consider use of a knee brace when you return to your sport or any other higher level activities
• Be consistent with your program and you will make gradual progress toward recovery

Why Exercises Aid MCL Recovery

Deciding to forgo an exercise routine puts your knee at a significantly higher risk of knee reinjury and future problems down the road like arthritis. A well designed exercise program is essential for getting your knee joint back to its previous level of function following an MCL tear. MCL exercises aim at two things.

• Building Strength
• Increasing Range of Motion

Voice any concerns to your doctor when necessary so they can help guide you in your program. Of course, get in touch with your physical therapist or orthopedic doctor for medical advice as soon as possible if your symptoms get suddenly worse or are affecting your quality of life.

Sources:

https://www.raynersmale.com/blog/2014/7/3/mcl-rehabilitation-from-ruin-to-return-to-play

https://www.sportsinjuryclinic.net/sport-injuries/knee-pain/acute-knee-injuries/medial-knee-ligament-injury-exercises

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