# MCL and meniscus injuries A caught ski edge or a knee forced inward can sprain the ligament on the inside of the knee (the MCL) and tear the cartilage cushion inside the joint (the meniscus). A hard twist or a deep squat can tear the meniscus on its own. Most settle without surgery. We assess the knee, brace it when needed, and rebuild strength and control before you return to sport. ## Symptoms - Pain on the inside of the knee after a fall or a twist - Swelling that comes on over the first day - Clicking, catching or locking in the joint - A knee that will not fully straighten - Pain when you squat deeply or twist on the leg - Tenderness when you press along the joint line - A knee that feels unsteady stepping sideways ## Assessment 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. ## Treatment 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](https://backinactionphysiotherapy.com/services/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](https://backinactionphysiotherapy.com/services/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. ## Getting back to sport 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](https://backinactionphysiotherapy.com/services/sports-physiotherapy). The same staging covers work, study and sport: kneeling, ladders and carrying loads over rough ground get their own steps. [Ski RAD](https://backinactionphysiotherapy.com/resources/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. ## When to come in 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 ## Who treats it - [Therese Leigh, Physiotherapist, BSc Physiotherapy, MHA, Dip Sport Physio, FCAMPT, GunnIMS](https://backinactionphysiotherapy.com/team/therese-leigh) - [Mike Conway, Physiotherapist, M. PT Sports, M. PT Manips, M. PT Studies, BSc Kin, CHT, GunnIMS, FCAMPT, CSCS](https://backinactionphysiotherapy.com/team/mike-conway) - [Bianca Matheson, Physiotherapist, BSc PT, Grad Dip PT Manips, Dip Sports Physio, FCAMPT, GunnIMS](https://backinactionphysiotherapy.com/team/bianca-matheson) - [Jian Soares, Physiotherapist, M ClinPhys, BSc PT, FCAMPT](https://backinactionphysiotherapy.com/team/jian-soares) - [Dana Elliott, Physiotherapist, MScPT, BSc](https://backinactionphysiotherapy.com/team/dana-elliot) - [Julie Charette, Physiotherapist, BSc PT, Cert. MDT](https://backinactionphysiotherapy.com/team/julie-charette) - [Emilie Noble, Physiotherapist, MSc PT, BSc Kines, AN-IMS](https://backinactionphysiotherapy.com/team/emilie-noble) - [Cameron Gant, Physiotherapist, BSc Physiotherapy, PG Cert Sports Physio](https://backinactionphysiotherapy.com/team/cameron-gant) - [Nicole Klopfer, Physiotherapist, B Physiotherapy (Hons) (UMelb), M Physiotherapy (Manips) (UWA), PGrad Cert Cont & PF Rehab (UMelb), GunnIMS](https://backinactionphysiotherapy.com/team/nicole-klopfer) - [Michael Pearce, Physiotherapist, BSc PT](https://backinactionphysiotherapy.com/team/michael-pearce) - [Kelsey Rey, Physiotherapist, MPT, BHK](https://backinactionphysiotherapy.com/team/kelsey-rey) - [Keeley Wentzel, Physiotherapist, BSc Physiotherapy (Hons)](https://backinactionphysiotherapy.com/team/keeley-wentzel) ## Services - [Physiotherapy](https://backinactionphysiotherapy.com/services/physiotherapy) - [Sports Physiotherapy](https://backinactionphysiotherapy.com/services/sports-physiotherapy) - [Splints and Bracing](https://backinactionphysiotherapy.com/services/splints-and-bracing) - [Manual Therapy](https://backinactionphysiotherapy.com/services/manual-therapy) - [Registered Massage Therapy (RMT)](https://backinactionphysiotherapy.com/services/massage-therapy) ## Programs - [Ski RAD](https://backinactionphysiotherapy.com/resources/ski-rad) ## Frequently asked questions ### Do I need a scan for an MCL sprain or a meniscus tear? Not always. A careful examination usually shows which structure is hurt and how badly, and treatment can start from that. A scan helps when the knee is locked, when more than one structure may be torn, or when a surgeon needs a picture before deciding on an operation. A doctor or nurse practitioner orders it. Scans of pain-free knees often show small meniscus tears, so a result is read alongside the examination, not instead of it. ### Do I need surgery for a meniscus tear? Not usually. Rehab comes first for most tears. A knee that moves fully and takes load without catching is usually left alone, even if the tear still shows on a scan. Surgery comes into it when a torn flap keeps locking the knee, or when a tear at the outer edge, which has a blood supply, may be repaired. That is a decision for you and your surgeon. We help by testing how the knee works and keeping the rehab going either side of any operation. ### Will I need a brace for an MCL sprain? Often, at first. The brace's job is to stop the knee being pushed sideways while the ligament knits, without stopping it bending and straightening, which it needs to do. How long you wear it depends on how badly the ligament was sprained and how the knee tests. It supports the rehab rather than replacing it. Some skiers keep wearing a ligament brace for a while after they return. ### Why does my knee catch or lock? Often a tear. A torn piece of meniscus can flick in and out of place as the knee bends, which feels like a click or a catch. If the piece jams between the bones, the knee locks and will not straighten. Swelling and a tight thigh muscle can also stop a knee straightening, which feels similar but is treated differently. We work out which it is. ## Massage for recovery Massage therapists do not diagnose, so start with a physiotherapist. Once you have a diagnosis and a plan, our registered massage therapists can help with the recovery. [About massage therapy](https://backinactionphysiotherapy.com/services/massage-therapy) *This page is general information, not a diagnosis or a substitute for an assessment. If you are unsure, see a health professional.*