Medial Collateral Ligament (MCL) Tears in Skiers

Kenzie, a college student, is excited for the opening day at her favorite ski resort. Her gear is packed, her boots fitted, and she is ready to hit the slopes.

On the fresh powder, Kenzie warms up on the goat trails. She’s feeling good and decides to take a run.

After a small jump, she feels a pop on the inside of her right knee. Immediately, she feels pain and can no longer support her leg. At the bottom of the hill, Kenzie struggles to walk and realizes something is seriously wrong.

In the emergency room, Kenzie learns she has torn her medial collateral ligament (MCL).

The MCL is a small ligament located on the inside of the knee that helps with knee stabilization and joint support. MCL tears usually occur when blunt force trauma hits the side of the knee or a direct blow to the knee that tears the MCL from the tibia.

20-25% of ski injuries are MCL tears, rips, or injuries. There are a few different ways that someone can injure their MCL and orthopaedic surgeons like Dr. Keith would grade them based on the level of severity:

  • Grade Level 1: Least severe. This kind of injury is means that the ligament was stretched and is not completely torn.
  • Grade Level 2: At this grade, the MCL has been torn but not completely ripped. There could be some instability to the joint.
  • Grade Level 3: This grade is when the entire ligament is ripped apart and the knee is extremely unstable.

After determining the grade level of Kenzie’s injury, which is a Grade Level 3 considering she could hardly walk on it, Dr. Keith suggests a treatment plan to help get her back on the slopes.

Typically, MCL tears will heal on their own. Time and the typical R.I.C.E. (rest, ice, compression, elevation) method will help ease swelling and pain. A Grade Level 1 MCL tear can heal in just a few weeks if the patient is very careful.

Grade Level 2 MCL tears with joint instability might need more than the R.I.C.E. method. Dr. Keith recommends bracing the knee and perhaps some physical therapy to help the knee stay strong while healing itself. These MCL tears will typically take 4-6 weeks to completely heal.

If the tear is bad, like Kenzie’s is, surgery could be required to get the knee back to full functionality. Surgery is rarely needed in this case. But, if it is required, the orthopaedic surgeon will do one of the following:

  • Reattach the MCL to the leg with large stitches or bone staples.
  • A metal screw will help keep the ligament in place.
  • Or, if the tear is along the middle of the ligament, the surgeon will stitch it back together.

Grade Level 3 tears can take months to heal, meaning that Kenzie is probably out for the season. With strict adherence to her physical therapy program, Kenzie will be back out doing what she loves.

We hope you have a great ski season, injury-free, but we’ll be here if you do get hurt.