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MCL
Medial Collateral Ligament
Question | Answer |
---|---|
What is the most common ligament injury involving MCL at the knee caused by? | Driect external force-valgus(pushing you into)force directed to the lateral aspect of the knee Football |
What is another common lig injury at the the knee involving the MCL? | Non-contct abduction or rotational stress SKIing |
What is the "unhappy triad" | ACL & Medial meniscus are injured |
Test that are performed for MCL is what? | Valgus Stress Test |
What position is the pt in for the Valgus stress test? | Supine with knee in 30 degrees of flex |
The PTA is in what position for Valgus stress test? | PTA stand to the side of affected limb at the level of distal tibia. Firmly grasp the medial aspect of the distal tibia with one hand,other hand at lateral aspect of the joint line |
When doing the Valgus stress test what is the direction of force? | The medial joint line will gap or open and will be + for MCL tear |
What is the mechanism of injury if Valgus stress test is performed to pt with knee in ext? | The knee still gaps or opens medially this signifies a serious injury to MCL,ACL,PCL and posterior joint capsule |
When the Valgus stress test is performed in full ext and there is no gap what does this signify? | PCL and anterior capsule are ok |
What are the critcal factors for healing of the MCL? | 1.Maintences of torn fibers in close continuity 2.Intact & stable ACL & other supporting lig 3.Immediate controlled motion and stress to the healing ligament 4.Protection of the MCL from unwanted stresses such as valgus stresses and ER |
Rehab for the MCL can be treated how? | Can be tx sug. or non surg. depends if it is isolated or not |
What do most surgeons tx for non surg. ? | Grade I, II, and III |
The MAX phase of protection for MCL rehab the motion in limited? | Range limiting hinge brace is used initially to control unwanted valgus & rot. stresses |
What is key in MAX phase? | Early protected motion |
What modalities are used in MAX phase? | E-stem, US, RICE to control pain and swelling |
What Isometric are done in MAX phase? | QS SLR and AP are done ASAT |
Gait WBAT with crutches in Max phase with immobilizer. But how is some ex done? | Without immobilizer daily with PROM/AROM knee flex and ext |
Mod Phase what happens to the brase? | Hinged brase allows full flexsionand ext but limits valgus stress |
Mod phase what ex are done? | Crutches desgarded as pain > and quad strength < with CKC ex and Isometics ADD with brace on |
What about pain with ex in MOD phase or any phase? | Pain free ex AROM for knee flex progress steadily |
What if the progress is slow and c/o of pain? | Meniscus tear maybe involved |
Min phase what happens? | Full body fitness program that does not produce unwanted valgus or rot. forces |
What activities are done in MIN phase? | Lateral slide board, running drills, start with functional brace progress to no brace |