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Medial collateral ligament sprain
 A sprain of the medial collateral ligament is a frequently seen lesion in the knee.
Diagnosis is not always abvious since, in the knee, after a trauma there can be a confusing, masking posttraumatic capsular reaction. History will provide important information.
In an acute, subacute and chronic stage we provide a specific treatment consisting of transverse friction massage and mobilisation.
In the medial collateral ligament, the lesion lies at one of the following three sites :
generally at the joint line.
Adhesions here cause a slight limitation of flexion. The clinical examination shows :
passive extension and passive lateral rotation are slightly painful
valgus strain markedly painful
slightly painful limitation of flexion (-5°,-10°)
the pain is felt medially.
This is the typical pattern of adhesions in the MCL.
The lesion can also lie at the femoral insertion or at the edge of the tibial condyle.
Adhesions at the femoral insertion do not cause limitation of range, making manipulation unnecessary (see further).
(Part I, p131-133 ; Part II, p29-30)
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