Ep. 6: ACL and MCL Tears
Ep. 6: ACL and MCL Tears
Hey everyone! Welcome back to our NJRI channel! I’m Dr. Jay Bowen and I’m a board-certified physiatrist here at New Jersey Regenerative Institute, or NJRI. Today, we're tackling a topic that’s crucial for athletes and active individuals: ACL and MCL tears. Whether you’re a seasoned pro or just starting your fitness journey, understanding these injuries is key to both prevention and recovery. So, let’s break it down!
First up, let’s talk about what these tears actually are. The knee is a complex joint supported by ligaments that help keep it stable. The critical ligaments are the Anterior and Posterior Cruciate Ligaments (ACL/PCL) and the Medial and Lateral Collateral Ligament (MCL/LCL). The ACL/PCL prevents the movement within the knee from front to back and the collateral ligament from side to side motion. The ACL and MCL are the more common ligaments injured.
The ACL ligament is located in the center of your knee. It helps control rotational movements and prevents the tibia, or shin bone from sliding too far forward relative to the femur or thigh bone. A tear here can be devastating for your stability and function.
On the other side of the knee, the MCL runs along the inner part of the joint. It’s responsible for stabilizing the knee by resisting forces that push it sideways. A tear of the MCL can cause pain on the inside of the knee and have a feeling of instability.
Now, let’s dive into why these tears occur. ACL tears often happen during activities that involve sudden stops, changes in direction, or awkward landings. Think about sports like soccer, basketball, or skiing. It’s usually caused by:
- **Sudden Pivoting:** Quick changes in direction can put immense stress on the ACL.
Hey everyone! Welcome back to our NJRI channel! I’m Dr. Jay Bowen and I’m a board-certified physiatrist here at New Jersey Regenerative Institute, or NJRI. Today, we're tackling a topic that’s crucial for athletes and active individuals: ACL and MCL tears. Whether you’re a seasoned pro or just starting your fitness journey, understanding these injuries is key to both prevention and recovery. So, let’s break it down!
First up, let’s talk about what these tears actually are. The knee is a complex joint supported by ligaments that help keep it stable. The critical ligaments are the Anterior and Posterior Cruciate Ligaments (ACL/PCL) and the Medial and Lateral Collateral Ligament (MCL/LCL). The ACL/PCL prevents the movement within the knee from front to back and the collateral ligament from side to side motion. The ACL and MCL are the more common ligaments injured.
The ACL ligament is located in the center of your knee. It helps control rotational movements and prevents the tibia, or shin bone from sliding too far forward relative to the femur or thigh bone. A tear here can be devastating for your stability and function.
On the other side of the knee, the MCL runs along the inner part of the joint. It’s responsible for stabilizing the knee by resisting forces that push it sideways. A tear of the MCL can cause pain on the inside of the knee and have a feeling of instability.
Now, let’s dive into why these tears occur. ACL tears often happen during activities that involve sudden stops, changes in direction, or awkward landings. Think about sports like soccer, basketball, or skiing. It’s usually caused by:
- **Sudden Pivoting:** Quick changes in direction can put immense stress on the ACL.
- **Direct Impact:** A forceful collision, like a tackle in football, can lead to an ACL tear.
- **Landing Awkwardly:** Misjudging a jump and landing with your knee in a poor position. Especially with knee valgus. Discuss adolescent girls.
On the other hand, MCL tears are often caused by:
- **Direct Blow to the outside of the Knee:** This could be from a collision or a tackle causing the knee to bend sideways and stress the inside of the knee. This ligament resistes the focus, but can become overloaded
On the other hand, MCL tears are often caused by:
- **Direct Blow to the outside of the Knee:** This could be from a collision or a tackle causing the knee to bend sideways and stress the inside of the knee. This ligament resistes the focus, but can become overloaded
- **Overextension:** Excessive bending of the knee outward can stretch the MCL beyond its limits.
- **Twisting Injury:** A forceful twist while the foot is planted can strain the MCL.
So, how do you know if you’ve torn your ACL or MCL? Let’s look at the symptoms:
For an ACL tear you might experience a popping sound at the moment of injury, followed by intense pain and swelling. Often, there’s a feeling of instability, shifting sensation, or weakness in the knee.
For an MCL tear symptoms include pain along the inner part of the knee, swelling, and tenderness. You might also notice that the knee feels unstable, especially when moving side-to-side.
The ACL and MCL injuries often occur together.
Diagnosing these injuries typically involves a physical examination by a healthcare professional, and often imaging tests like an MRI to confirm the extent of the tear. If you feel like you’ve sustained one of these injuries head to our website or give us a call to schedule an appointment.
Once you’ve got a diagnosis, the next step is treatment. The approach varies depending on the severity of the tear.
So, how do you know if you’ve torn your ACL or MCL? Let’s look at the symptoms:
For an ACL tear you might experience a popping sound at the moment of injury, followed by intense pain and swelling. Often, there’s a feeling of instability, shifting sensation, or weakness in the knee.
For an MCL tear symptoms include pain along the inner part of the knee, swelling, and tenderness. You might also notice that the knee feels unstable, especially when moving side-to-side.
The ACL and MCL injuries often occur together.
Diagnosing these injuries typically involves a physical examination by a healthcare professional, and often imaging tests like an MRI to confirm the extent of the tear. If you feel like you’ve sustained one of these injuries head to our website or give us a call to schedule an appointment.
Once you’ve got a diagnosis, the next step is treatment. The approach varies depending on the severity of the tear.
For a complete ACL tear, surgery is often recommended to reconstruct the ligament, but this is not always necessary despite the current hype and frequency that it is performed. There is the “rule” of thirds.
Everyone should have a trial of physical therapy as one third can compensate with re-training the muscles to oppose the translation forces. Another third can avoid surgery if activity modification is an option. However, there is a third of injuries where the knee shifts or gives way with little stress. This would be an indication for surgery. Most recommendations are to wait around 6 weeks after injury to reduce the bleeding that often occurs within the joint to minimize the risk of developing scar tissue within the joint. Post-surgery, a rigorous rehabilitation program is crucial for regaining strength, motion, and functional tasks. Physical therapy will focus on rebuilding muscle strength and stability. If the ACL injury is a partial tear, we can place one’s concentrated bone marrow in the ACL tear under x-ray guidance in the office.
Treatment for MCL tears usually depends on the grade of the injury. Grade 1 and 2 tears can often be managed with the classic RICE protocol. That is - rest, ice, compression, and elevation , along with physical therapy. We may recommend a hinged knee brace to protect the ligament from overload or re-injury and speed recovery.
Grade 3 tears which are more severe, may require surgery, but many can heal with conservative care. For a grade 3 tear, we advocate for a non-surgical approach unless there is a significant feeling of instability, which would likely mean there were additional structures involved. If you came into my office and I diagnosed a MCL tear, options would include conservative care, bracing, or platelet rich plasma (PRP).
Prevention is always better than cure! To reduce the risk of these injuries:
Everyone should have a trial of physical therapy as one third can compensate with re-training the muscles to oppose the translation forces. Another third can avoid surgery if activity modification is an option. However, there is a third of injuries where the knee shifts or gives way with little stress. This would be an indication for surgery. Most recommendations are to wait around 6 weeks after injury to reduce the bleeding that often occurs within the joint to minimize the risk of developing scar tissue within the joint. Post-surgery, a rigorous rehabilitation program is crucial for regaining strength, motion, and functional tasks. Physical therapy will focus on rebuilding muscle strength and stability. If the ACL injury is a partial tear, we can place one’s concentrated bone marrow in the ACL tear under x-ray guidance in the office.
Treatment for MCL tears usually depends on the grade of the injury. Grade 1 and 2 tears can often be managed with the classic RICE protocol. That is - rest, ice, compression, and elevation , along with physical therapy. We may recommend a hinged knee brace to protect the ligament from overload or re-injury and speed recovery.
Grade 3 tears which are more severe, may require surgery, but many can heal with conservative care. For a grade 3 tear, we advocate for a non-surgical approach unless there is a significant feeling of instability, which would likely mean there were additional structures involved. If you came into my office and I diagnosed a MCL tear, options would include conservative care, bracing, or platelet rich plasma (PRP).
Prevention is always better than cure! To reduce the risk of these injuries:
- **Warm-Up Properly:** Always do a thorough warm-up before engaging in physical activities.
- **Strengthen Your Muscles:** Focus on strengthening the muscles around the knee to provide better support.
- **Flexibility: ** Stretching the muscles for balanced movement and reduced stress across the joint.
- **Practice Good Technique:** Whether you're jumping, running, or tackling, using proper technique can help prevent injury. TECHNIQUE and APPROPRIATE BIOMECHANICS are KEY!
- **Wear Proper Gear:** Good quality footwear and protective gear can also make a difference.
PART 8: And there you have it—a comprehensive look at ACL and MCL tears. Understanding these injuries, their causes, and how to treat and prevent them can keep you in the game and on your feet. If you found this video helpful, make sure to hit that LIKE button and SUBSCRIBE for more knee health videos - it does not cost you anything and really helps us. Also, people have told me they missed prior videos so hit the BELL to be notified of future content. And if you have any questions or personal experiences to share, drop a comment below. Thanks for watching, and we’ll see you next time!
PART 8: And there you have it—a comprehensive look at ACL and MCL tears. Understanding these injuries, their causes, and how to treat and prevent them can keep you in the game and on your feet. If you found this video helpful, make sure to hit that LIKE button and SUBSCRIBE for more knee health videos - it does not cost you anything and really helps us. Also, people have told me they missed prior videos so hit the BELL to be notified of future content. And if you have any questions or personal experiences to share, drop a comment below. Thanks for watching, and we’ll see you next time!