MCL and meniscus injuries

We start with how the knee was hurt, whether it was pushed inward or twisted, and whether it has caught, locked or given way since. Then we examine both knees: the swelling, how far the knee bends and straightens, and the joint line, where a torn meniscus is tender.

For the MCL, we gently push the knee sideways to feel how much the inside of the joint opens compared with your other leg. For the meniscus, we bend, load and turn the knee to see whether that brings on pain, a click or a catch. We test the ACL too, because a caught edge often hurts all three at once.

Signs of more than one injury are a reason to see a doctor or nurse practitioner, who can arrange a scan and a surgeon's opinion.

The MCL sits outside the joint and has a good blood supply, so most sprains heal without surgery. Early on, a hinged knee brace keeps the knee moving while it blocks the sideways strain. We supply standard and custom knee ligament braces; see splints and bracing.

Many meniscus tears settle with rehab. The aim is a knee that straightens and bends fully, takes load without swelling, and twists under control. A knee that stays locked, because a torn flap is caught between the bones, needs a surgeon's opinion.

• Hands-on care: joint and soft-tissue mobilization eases pain and wins back the last few degrees of straightening a swollen knee loses, so the exercise can do its work. See manual therapy.
• Strength and control: exercise is the main treatment for both injuries. It builds the thigh and hip muscles that hold the knee in line, then adds balance, hopping and changing direction at the pace your symptoms allow. Deep squats, kneeling and twisting under load come back in steps.

You go back when the knee passes testing, not on a date. The tests stress what the injury was: a sideways push the MCL must hold, and squatting, hopping and turning the meniscus must take without pain or catching. After surgery, your surgeon's timing counts alongside those tests.

Before that, we train for what the sport asks. On skis, that means a low stance through long turns and a knee that stays over the foot when an edge catches. On the bike, it means standing through rough descents with a foot clipped in. A knee that drops inward through a turn gets technique work too; see sports physiotherapy. The same staging covers work, study and sport: kneeling, ladders and carrying loads over rough ground get their own steps.

Ski RAD is our dynamic mobility warm-up for ski days: six short video streams from plank to jump, with a sheet to print. Do it before every day on snow, the first one back included.

Book an assessment if the inside of your knee hurts after a fall or a twist, it has swollen, or it catches, clicks or locks. Come in early for a suspected MCL sprain, so a brace can do its work. After a meniscus operation, come in when your surgeon says you can start physiotherapy.

Go to the emergency department right away, or call 911, if any of these happen:

• the knee looks out of shape
• you cannot put weight on the leg, even for a few steps
• your lower leg or foot is numb, cold or pale
• the knee is hot, red and swollen, and you have a fever