Medial Collateral Ligament Sprain
Description/Cause:
References:
- Injury to the MCL is most often caused by an acute valgus stress or hyperextension, dislocation, or chronic overload in athletes and laborers.
- MCL injuries are most common in throwing athletes.
- More common than LCL injuries
- Throwing athletes
- Traumatic injury
- Chronic MCL injury usually presents with medial elbow pain that progressively worsens over time.
- If it continues to worsen, the patient may develop secondary symptoms of the common flexor origins, ulnar nerve symptoms, and lateral compartment chondromalacia.
- Patients with acute MCL injuries complain of medial elbow pain following a valgus stress.
- They may have bruising on the medial side of the elbow, ulnar nerve symptoms, and may describe a popping sensation during an overhead throw as many MCL injuries occur in throwing athletes.
- Valgus stress test
- Imaging
- NSAID
- With acute injuries resulting in dislocation some may use immobilization for 1 week followed by mobilization with or without a hinged brace. If the elbow remains unstable after reduction, surgical stabilization will be necessary.
- For chronic overload lesions, a period of rest (1-3 months) from the valgus activity is necessary. Conservative management includes specific exercises for flexor and pronator muscle strengthening.
- Should surgical intervention be necessary, physical therapist should supervise the return to sport or work. Most patients are able to regain full ROM while in a dynamic elbow brace.
- Active motion and supination
- PRE to improve elbow stability - progress gradually with more extensive injuries
References:
- Alobi B, Gray A, Ferreira L, Johnson J, Athwal G, King G. Rehabilitation of the Medial-and Lateral Collateral Ligament-deficit Elbow: An In Vitro Biomechanical Study. Journal of Hand Therapy. 2012;25:363–73.
Acknowledgements:
David Funk, Student Physical Therapist at A.T. Still University
Ethan Hunke, Student Physical Therapist at A.T. Still University
Morgan Johnson, Student Physical Therapist at A.T. Still University
Ed Nheiu, Student Physical Therapist at A.T. Still University
Lindsay Walczak, Student Physical Therapist at A.T. Still University
Last edited: July 13, 2015