Medial collateral ligament injury

Hi All

I've been suffering since Feb 1st with a grade 1 MCL strain this has been diagnosed by my physio who reckons three weeks to heal.

Last week I done a valgus stress test and thought I was ready to try running but when I did after a few miles I was back to square one with the injury. Not good.

I am really peed off but am prepared to do anthing to get back to fitness. I have a full year of races lined up (maras and ultras) which I am cancelling as and when.

Need advice on getting back. I've started pool running this week and use a cross trainer daily. Are these exercises enough not to loose fitness? I have trained for years to get to my current level and don't want to lose it all now. Also when should I try to run again? I'm confused If I feel ok under a stress test you would think I'm ok to run but as I proved this is not the case.

I feel your pain Dill but at least you have a diagnosis, I've been to three physios, an osteo and two sports masseuses and I'm still not sure what's going on in my knee.

  As far as retaining fitness I don't think anything other running is enough to retain running fitness, the best I've been able to come up with is high rpm cross training, set the resistance to between 7-10 and keep the revs above 190 and just crack on.

 I take it this means you're not going to make the Wye Valley?

Not sure mate. I hope so.

 Already missed Thames trot and the Moonlight last night. Got back to back maras booked for first weekend in March I suppose they will have to go.

 My first goal is to make London but i'm in the NDW100 so that is my main event this year. So i'll be gutted to miss that.

So what's up with you? Are you running at all?

Running badly at the moment, I strained my MCL  at the becons 40 just before Christmas and while that's cleared up nicely after a few weeks rest it'sopened the door to another injury that's proving quite difficult to diagnose. Essentially I'm getting pain right on the outside of the knee after about ten or fifteen minutes into the run, it feels quite weak on rough ground, particularly painful on uphills and downhills but rarely goes over five or six on the pain scale.

 I keep going out for runs, having the pain come on but think I can run through it but it gets to a point where it starts to affect my gait and that's never a good thing. It's also always there and it prevents my getting into any kind of rythm and fifty miles without one pain step being pain free is a long way to go.

   So at the moment I'm spending far too much money on trying to find someone who'll say, 'I know what it is and how to fix it' without any success so far.

  As it stands I haven't run further than 12 miles in a couple of months and much as you do I have a full year booked with the CCC as my main goal.

Why is it  knees that are so hard to sort out. I had a torn cartilage quite a few years ago and the surgeon told me that after the op I would be running again in 12 weeks. I woke up to find he had done an OATS procedure which took me over 2 years to recover from. That really done my head in!

I'm climbing the walls at the moment the dog has never had so many walks. I'm praying I can get over this quickly.

BTW Extreme running finally paid up! Tos*ers.

Well there's some good news at least! I've done my very best to tell everyone I can about Extreme Running and how useless they are, thankfully the words gone out here anyway and the corresponding threads for their next few runs have been comprehensively tagged for any new members to read.

 Best of luck with the recovery, I'm not going to give up hope for the 50 just yet, I reckon I can still make it if I use crutches.....

I've been looking for a thread to help diagnose my problem.

Lirish I was wondering whether we share the same injury. Pain developes on the outside of the knee as the run progresses. Not in the joint but in the boney bit level with the cap and an inch or two lower. Gets to the point where speed drops, and eventually walking for a couple of hundred yards then OK to run a bit more. All went wrong after a few few longer runs and then half way through 20 m. So limped home.

Does this sound familiar. Anybody got  name for it?

Dill, 

The time scale to heal for the MCL is correct however once you have an injury unfortunately the muscles around it adapt which could be the problem for you now. The MCL ligament actually needs to slide slightly when your knee flexes and extends therefore the surrounding muscles and fascia may be causing the problem.

 The hamstring could potentially be increased in tone along with the popliteus muscle to protect the knee joint. Have you had soft tissue work to these by your physio?

 Youl would need to strength the glutes/hamstring/quad in a co-contracted manner to stabilise the knee joint again as things begin to switch off. This exercise below is an example of one such exercise:

 http://prosportphysiotherapy.co.uk/blog/

 Also the mechanism of injury is also important, how did you do this? If non-contact then I would be more interested in why you done this in the first place.

 Hope this helps.

 kind regards,

 Dave.

 www,prosportphysiotherapy.co.uk

Just to add regarding Knee Injuries,

Knee pain is usually the site of the pain but RARELY the cause of the pain. The knee is stuck in between the ankle and hip and if either of these are not working correctly then the knee pays the price!

In all honesty the whole body needs to be evaluated as even a shoulder issue can cause a problem for opposite knee but i dont want to confuse things. I hope your hips and ankles have been looked at and you have got some soft tissue work also.

 Also the adductor muscles can also be a massive infleunce in knee pain which often goes untreated.

Dave

Thanks alot for such a good response.

Firstly the injury had no cause as such I was tapering for a big race and it was just an easy run when I got home I felt the pain and that was that.

My physio told me nothing about muscle adaptation the advice was to rest and wait. There was no soft tissue work either.

Prior to this injury I had been having occasional hamstring pain and bouts of pain in my pirifomis. I have also suffered ITBS all on the same side so I'm a bit of a mess really.

 I've tried the exercise you suggested and hope it helps make a difference. I completed a six mile easy run this morning it felt ok not 100% but ok. No pain just an awareness of the injury if you know what I mean. Is this normal? Or is it still too early?

Thanks Dill.

     Dill.

             It does indeed sound familiar, I twinged my MCL on the Brecons 40 but thought it was ok after a few weeks rest, then I started to get a dull pain in what I can only describe as the hinge part of the outside of my knee just below the actual bone, it started about six miles into a fairly hilly run when I first got it, starts off just above the hinge then settles into a 5-6 scale pain with occasional bursts up to 7-8. It doesn't come on at any other time, there's no pain on cycling, swimming or even cross training, no pain on lunges or stair climbing and there's no pain or discomfort on lateral or medial movement of the actual knee joint.

 As you've described the pain stops when I do but comes on again almost immeadiately upon running. I've been absolutely beasted by my sports masseuse, who I have a great deal of faith in, as well as my physio but it hasn't shown any improvement whatsoever, I went for a short run last night and again this morning which had to be curtailed as it was starting to affect my gait and I didn't want to bring any other complications into it.

   My physio seems to think it's a tightness in the distal part of the ITB where it runs below the joint and joins up to the bone under the knee but despite all the treatment so far I haven't seen any improvement which I would expect if it was just tightness?

   Dave.

           I'm also seeing an osteo who's said pretty much what you've said in your post above, I've done some mobilisation exercises for my ankle but we're concentrating mostly on my hip capsule, adductors and piriformis, again thus far without success.

 At the moment it's snafu, though I am considering amputation if things don't improve

Hi Lirish

What you are describing is everything I felt when I suffered with ITBS. Especially when and how it comes on. V painfull.

Shouldn't joke about amputation but I did mention to my wife that with modern prosphetics it could be the way forward

Interesting stuff.

I have been diagnosed with a MCL strain (thanks to google, then confirmed by my Physio!!). Yes, pain in inside of knee. It's been the guts of 3 weeks since it happend. First few days it was very sore, and I could hardly bent leg at all. Ice and rest initially.

As time has passed  pain has eased. I am stretching, doing squats, using excercise bike to strengthen knee/ ligament.

The state of play at the minute, is that I can walk normal, bend leg normal, walk fine, and pretty much do everything as normal.

BUT, dull pain is still there, very slight, but just there is you know what I mean. Physio advised me to only run once pain has totally gone.

This has wrecked my Half marathon plans for middle March, and it is very frustrating not getting out running. I'm worried all my good training will be lost, and I will be back to square one, once this thing finally heals (if ever)

Hedgerow

I could have wrote that myself. You have hit the nail on the head I need to wait untill I am pain free before I can start running again. That is so difficult tho. I went out yesterday and managed six miles but tried again today and turned round and went home after a mile because it just didn't feel right. 

I think it will be a confidence thing with me as well. I can accept (just!!) having to sit it out for a while if I know it is not going to go all Pete Tong first run out.

I suppose if there is any consolation, apparantly of the 4 knee ligaments the MCL is the quickest healer, good blood flow etc.

And most importantly once healed, the chances of getting MCL strain again is the same as any other runner.

What caused it in the first place - Now that is the question.....................

     Dill what is OATS ? I had an op for torn cartilage in August,my knee has not settled since,Having an other op next week to see whats going on inside, VERY FUSTRATING

OATS stands for osteochondral autograft transfer system.

Basically the surgeon goes into the knee using keyhole surgery and takes a core of bone and cartilage from a none weight bearing bit. He then drills out the torn bit to the same size and plugs it with the healthy bit. The new bit is then left for several years to heal along with the hole left in the none weight bearing bit.

Please excuse the the layman description but I'm gas engineer so my knowledge of the knee is quite limited.

Hope yours heals quicker than mine did but I will say that knee is now my strong one and the other side causes all my grief.