MCL Sprains and Tears: Causes and Risk Factors

Injury to the medial collateral ligament (MCL) of the knee typically is typically caused by a one-time trauma. While any active adult can sustain an MCL injury, there are certain activities and risk factors that increase the likelihood of it occurring.

Causes of MCL Tears and Sprains

MCL injuries are regularly seen in contact and non-contact sports and often occur in the following instances:

• When the knee is hit directly on its outer side, such as from a football tackle
• As a result of cutting maneuvers, when an athlete plants a foot and forcefully shifts direction¹Chen L, Kim PD, Ahmad CS, Levine WN. Medial collateral ligament injuries of the knee: current treatment concepts. Curr Rev Musculoskelet Med. 2007;1(2):108-13.
• Squatting or lifting heavy objects, such as weight lifting
• Landing awkwardly on the knee, such as when jumping in volleyball
• Hyperextending the knee, such as when skiing
• Through repeated stress to the knee, which causes the ligament to lose its elasticity (like a worn-out rubber band)

While sports injuries are the most common cause of MCL tears and sprains, any direct blow, such as during a car accident, can cause the ligament to be damaged.

See Common Running Injuries: Knee Pain

Risk Factors: MCL Tears and Sprains

While anyone can injure their MCL, certain factors can put people at higher risk:

Previously torn MCL
Once an MCL has been strained or torn the chances of the injury occurring again increase.

Participation in certain sports
People who participate in sports, such as soccer, football, hockey, and basketball are at higher risk to injure the MCL. Additionally, people who compete in these sports—especially at collegiate or professional levels—are at higher risk because of the intensity of play.²Bollen S. Epidemiology of knee injuries: diagnosis and triage. Br J Sports Med. 2000;34(3):227-8.

Female sex
Some studies have found that women, especially high school age, are more likely to sustain an MCL injury.³Stanley LE, Kerr ZY, Dompier TP, and Padua DA. Sex differences in the incidence of anterior cruciate ligament, medial collateral ligament, and meniscal injuries in collegiate and high school sports: 2009-2010 through 2013-2014. Am J Sports Med. March 2016:0363546516630927. doi:10.1177/0363546516630927. Other studies have found that college age men are more likely to sustain an MCL injury.⁴American Academy of Physical Medicine and Rehabilitation. https://now.aapmr.org/medial-and-lateral-collateral-ligament-injuries/ Many experts believe MCL injuries occur equally in both men and women.²Bollen S. Epidemiology of knee injuries: diagnosis and triage. Br J Sports Med. 2000;34(3):227-8.

Having a risk factor does not mean a person will definitely get an MCL injury.