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A doctor will perform an assessment and give the injury a grade based on the degree of damage. Grade 1 and 2 injuries are either stretched or partially torn ligaments, respectively. A grade 3 tear means the ligament has either detached from the bone or torn fully. The degree of damage is a strong indicator for surgery. Grade 1 and 2 ligament injuries can heal without surgical intervention.
Doctors will use a combination of bracing, physical therapy, heat therapy, and medication to help with healing. The ligament responds well to these methods with a high overall success rate. The only caveat is the recovery time as ligaments and tendons lack blood vessels and have a low blood supply.
Most nutrients come from the surrounding fluid at the joint. So the healing time can take weeks or even months compared to a muscle injury.
A fully torn ligament, or grade 3 tear, can cause chronic pain and joint instability. Complete tears rarely heal naturally. Surgery also helps the joint heal correctly and reduces the chances of re-injury. Once the pain and swelling subside, you'll begin a physical therapy program, which will include exercises to restore strength and normal range of motion.
If your knee feels sore while doing these exercises, proceed slowly to prevent further irritation and consult your physical therapist. Depending on the injury's severity, these methods — a period of rest, bracing and physical therapy — usually suffice to heal the tear. However, if the torn ligament doesn't heal sufficiently, you may experience instability and be more susceptible to reinjury.
Surgery may be required in rare cases. Once the MCL has fully healed, you should have minimal long-term effects, provided your knee suffered no other damage. While most MCL injuries can resolve without surgery, there are instances where surgery is the best treatment option. The surgery will either repair or reconstruct the MCL. To repair the ligament, your surgeon will make an incision at the torn area and use fixation devices called suture anchors to secure the ligament back to the bone.
The problem is that if a ligament heals but is no longer as strong or as tight as it originally was then the knee will be less stable than it was, which would leave you more vulnerable to further injury. Grade 1 and 2 tears have the potential to heal themselves as the ligament is still intact. Because a grade 3 ligament tear is a complete rupture then the capacity to heal itself is much less.
Of the 4 knee ligaments, a significant tear of the ACL, PCL, or LCL are more likely to require surgery if you are planning to return to a sport that requires a lot of twisting and turning.
The MCL is the most stable of the knee ligaments as it attaches to bone all the way along its course, therefore is rarely requires surgical repair.
The reality is that the different knee ligaments have varying healing times and different rehab protocols due to the nature of their specific functions.
There are different protocols depending on which ligament is damaged. For example some knee ligament injuries might require a brace to be worn in the initial stages of healing to protect the ligament from further damage. Whether the ligament is allowed to heal conservatively or if surgery has been done, the goals are to:.
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