If you’ve recently suffered a knee injury, you may be wondering whether it’s a ligament tear, strain, or another condition. Tears in the medial collateral ligament (MCL) and anterior cruciate ligament (ACL) are common causes of knee pain. It’s important to differentiate between the two, as they have different treatments and recovery timelines.
At Interventional Spine & Surgery Group, our multidisciplinary team provides fast access to orthopedic care and more, including treatment for ligament tears, in central and northern New Jersey. Here, we compare ACL and MCL tears, including differences in symptoms, treatments, and recovery, to help you know what to expect.
Key Takeaways
- The medial collateral ligament (MCL) and anterior cruciate ligament (ACL) are two types of knee ligaments that are commonly torn in athletes and active individuals.
- ACL tear symptoms include deep pain in the center of the knee, rapid swelling, severe instability, and a loud pop, while MCL tear symptoms include intense localized pain on the inner side of the knee, gradual swelling, instability, and stiffness.
- MCL tears are frequently treated with non-surgical treatment methods like the R.I.C.E. protocol, pain medications, support devices, and physical therapy.
- ACL tears can be treated non-surgically, but surgery may be required for young, active patients who participate in sports that involve pivoting and cutting, or who have persistent knee instability.
- Interventional Spine & Surgery Group provides orthopedic care for patients with MCL and ACL tears in central and northern New Jersey.
MCL vs. ACL: Anatomy and Function
In each knee, there are four main ligaments to connect the thigh bone (femur) to the shin bones (tibia and fibula), stabilizing the joint. Two commonly injured ligaments are the ACL and the MCL.
The ACL is located in the middle of the knee joint and is shaped like a small cross with two fiber bundles. It has a poor blood supply, which impacts its healing ability. Its purpose is to control sudden twisting or pivoting motions and prevent the shin bone from sliding too far forward.
The MCL runs along the inner (medial) side of the knee and is shaped like a wide, flat band. It has a rich blood supply, making it heal easily. It protects against side-to-side stress and prevents the shin bone from sliding too far forward.
What Are MCL and ACL Tears?
When an MCL or ACL gets damaged or torn, it is known as a tear. These common knee injuries affect the ligaments, resulting in pain, swelling, and other symptoms. These tears are categorized into three grades based on their severity. Grade 1 is mild, grade 2 is moderate, and grade 3 is severe.
An ACL tear occurs in the center of the knee. It is most often caused by sudden movements that force the knee beyond its structural limits. This may be rapid pivots, awkward jump landings, sudden deceleration, or hyperextension. ACL tears can also be caused by a direct blow to the knee. Although ACL tears are common in athletes, especially those who play soccer, basketball, and football, most tears occur without any physical contact.
An MCL tear happens on the inner side of the knee. They are typically the result of a direct impact to the outside of the knee, falls, forceful twisting motions, or sudden pivoting/cutting. MCL tears are common in football, soccer, and hockey players.
MCL Tear vs. ACL Tear Symptoms
Since both the ACL and MCL are ligaments in the knee, they have some overlapping symptoms. However, they vary in the location of the injury and the sound that the injury makes.
ACL Tear Symptoms
An ACL tear typically causes:
- Deep pain in the center of the knee
- Rapid swelling within the first few hours of the injury
- A loud pop heard or felt at the moment of the injury
- Severe instability
- Limited range of motion
MCL Tear Symptoms
Symptoms of an MCL tear often include:
- Intense pain and tenderness localized on the inner side of the knee
- Gradual swelling
- Stiffness and discomfort when bending the knee
- Instability with lateral movements or pivoting
- A minor pop during injury (occasionally)
If you experience symptoms of an ACL or MCL tear, seek medical attention promptly and avoid putting too much weight on the knee. A doctor can perform diagnostic tests and imaging scans to determine whether a ligament tear is the cause of the symptoms, or if there’s another potential cause.
MCL Tear vs. ACL Tear Table
| Symptoms | ACL Tear | MCL Tear |
|---|---|---|
| Pain | Yes, deep pain in the center of the knee | Yes, intense pain on the inner side of the knee |
| Stiffness | Occasionally | Yes, especially when bending the knee |
| Swelling | Yes, rapid | Yes, gradual |
| Popping sound | Yes, often a loud popping sound at the time of injury | Sometimes, although less likely than with an ACL tear |
| Instability | Yes | Yes, especially with side-to-side movements or pivots |
| Limited range of motion | Yes | Yes |
What Is MCL Tear Treatment?
To treat an MCL tear, doctors primarily use conservative, non-surgical treatment methods. Since the MCL has a rich blood supply, most injuries heal well without surgery. The non-surgical treatments that may be used include:
- R.I.C.E. protocol: The rest, ice, compression, elevation (R.I.C.E.) method is often recommended to reduce pain and swelling.
- Pain medications: Doctors often suggest over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation.
- Support devices: It’s often recommended to wear a hinged knee brace to stabilize the joint and use crutches to avoid putting full weight on the leg.
- Physical therapy (PT): PT is a major part of treating MCL tears. Physical therapists prescribe guided exercises to help the patient improve their range of motion, strengthen the leg muscles around the knee, and prevent re-injury.
Surgery is not typically needed for isolated MCL tears. However, it may be considered if the tear is Grade 3, or if other knee ligaments, such as the ACL, are also injured.
What Is ACL Tear Treatment?
ACL tear treatment can range from non-surgical treatments to surgery. The options include:
- R.I.C.E. method: The R.I.C.E. method is used right after the injury to manage inflammation and pain.
- Activity modification: Patients with ACL tears should avoid sports that involve sudden stops, twisting, or cutting movements, such as soccer, basketball, and football.
- Bracing: Doctors often recommend wearing a hinged knee brace to support the knee during daily movements. Crutches may also be used to reduce weight-bearing on the leg.
- Physical therapy (PT): Physical therapy is key to treating an ACL tear. Using targeted therapeutic exercises, the patient helps strengthen the hamstring and thigh muscles, restore mobility, and prevent re-injury.
Although conservative treatment methods can effectively treat an ACL tear, sometimes surgery is required. It is most often used when the patient is young and active, participates in sports that involve pivoting and cutting, or has ongoing knee instability. The surgery, called ACL reconstruction, is typically completed as a minimally invasive procedure. It involves replacing the torn tissue with a tissue graft from another part of the patient’s body or a donor.
At Interventional Spine & Surgery Group, orthopedic procedures like ACL reconstructions are performed by Dr. Deramo, a board-certified orthopedic surgeon with experience in sports medicine and complex cases. Committed to personalized patient care, Dr. Deramo combines his extensive knowledge with a compassionate approach, ensuring each patient achieves the best possible outcomes.
ACL vs. MCL Tear Recovery Comparison
Typically, recovery from an MCL tear is faster than an ACL tear because surgery is not often required. The MCL has a strong blood supply that aids in healing, so patients can typically achieve a full return to activity by eight weeks. If a patient does need surgery, the recovery timeline takes between six and 12 months.
Recovery from an ACL tear will depend on the type of treatment received and the severity of the tear. For patients who don’t receive surgery, recovery can range from three weeks to six months or more. For patients who did get surgery, recovery is longer, spanning anywhere from six to 12 months. Patients must attend consistent physical therapy after surgery to restore strength and mobility and prevent re-injury.
Find Expert ACL and MCL Tear Treatment Near You in New Jersey
Whether you’re dealing with an MCL tear or an ACL tear, you can get fast access to treatment at Interventional Spine & Surgery Group. We’re run by a multidisciplinary team of orthopedic surgeons, neurosurgeons, physical therapists, chiropractors, and more, who collaborate to provide patient-centered care. At Interventional Spine & Surgery Group, we can see you now, we care, and we’ll help you get better. Contact us today to learn more about ACL vs. MCL tears or to request an appointment near you in central or northern New Jersey.
Frequently Asked Questions About MCL and ACL Tears
What is the difference between an MCL tear and an ACL tear?
Both MCL and ACL tears are injuries to the ligaments in the knee. However, an MCL tear happens on the inner side of the knee on the medial collateral ligament, while an ACL tear occurs in the center of the knee on the anterior cruciate ligament.
Can you walk on a torn MCL?
Yes, most people with torn MCLs can usually walk. However, it depends on the severity of the tear. Grade 1 tears allow walking with some pain, whereas severe Grade 3 tears make it harder to walk without crutches.
Does an MCL tear require surgery?
MCL tears typically do not require surgery, since the MCL has a strong blood supply and can heal itself quickly with conservative care.
Do ACL tears always require surgery?
No, ACL tears do not always require surgery. The type of treatment used depends on the severity of the tear, the patient’s activity levels, and the joint’s stability. Non-surgical treatment is often sufficient for partial tears or people with low-demand lifestyles.
How long does MCL recovery take?
The recovery timeline depends on the severity of the tear. Mild injuries can take one to three weeks, moderate tears can take three to six weeks, and severe tears can take six to 12 weeks or even longer.
How do you know if you tore your MCL?
Signs of a torn MCL include pain on the inner side of the knee, gradual swelling, knee instability, and a limited range of motion.
What is the pop sound when a knee ligament tears?
The pop sound when a knee ligament tears, most often the ACL, is a loud, distinct snapping sound that is the result of the sudden release of tension as the fibrous tissue breaks.
Can an MCL and ACL tear at the same time?
Yes, an MCL and ACL can tear at the same time. This often occurs during high-impact sports or hard twisting falls.
What tests diagnose an MCL or ACL tear?
To diagnose MCL and ACL tears, doctors use a combination of imaging scans like magnetic resonance imaging (MRI) and X-rays and physical tests. For ACL tears, the most common test is the Lachman test, and for MCL tears, the most common test is the Valgus stress test. In both cases, the doctor manipulates the leg to see how the ligaments respond and to assess the extent of damage.