From the Trainer’s Room: Knee MCL injuries in hockey
The medial collateral ligament in the knee, or MCL, was the second-most common injury in NCAA hockey in 2013 as stated by Grant, Bedi, Kurz, Bancroft & Miller.
The study showed that only concussions had a higher injury rate in male collegiate players.
The MCL is one of four ligaments in the knee and is located on the inside or medial portion of the knee connecting the femur and tibia. The ligament’s purpose is to provide support to the inside of the knee helping prevent a valgus or inward movement of the joint. This ligament can be injured when a player is either hit from the outside of the knee placing an inward force on the knee or can also be damaged when the player pivots or twists the knee and the skate sticks into the ice.
Though MCL injuries can be painful and debilitating, they rarely require surgery to repair them. Since the MCL is located outside the joint capsule, unlike the ACL and PCL, it typically gets decent blood flow and heals fairly well. Recovery time usually ranges between two and eight weeks to a full recovery.
Initial management of these types of injuries include a short period of rest and ice to reduce any swelling or inflammation. Early range of motion exercises as soon 24-48 hours have shown to speed recovery and the rehab initially should be focused on regaining full motion of the knee, reduce swelling and regaining strength.
As the ligament heals, the rehab should be focused on linear or straight forward movement which does not place any inward force on the knee. The unfortunate thing here is that skating and shooting does place this type of force on the knee and will be one of the last phases of the rehab. Once linear exercises and drills can be performed, lateral movement can be introduced.
As these exercises and drills become pain free and there is no feeling of instability, the athlete can typically return to the ice and slowly integrate back into playing again. When the athlete returns, he or she may benefit from wearing a hinged knee brace to provide extra support to the knee.
Overall, though MCL sprains are pretty common in ice hockey, they heal fairly quickly and most fully recover without any long-term issues.
Chris Phillips is an athletic trainer and strength and conditioning specialist with 30 years’ experience in professional sports, including eight in the NHL. Chris currently owns Compete Sports Performance and Rehab in Orange County, Calif., and can be reached at www.competeperformance.com.
(February 1, 2023)