This blog is about a patient I had when I first started out as a Sports Therapist, and was able to see from Day 1 of the injury through to full MCL rehabilitation with acupuncture. (nothing more satisfying than that!).
My patient was a 20 year old male, playing regular football for his university team, and generally quite fit. Unfortunately, during one of his games, he was tackled and kicked on the inside of his right shin. The force of this tackle was too much for his knee to handle and he went straight to ground.
He came to me the following day, limping and in excruciating pain. However, I was unable to assess the situation as the swelling around the knee and his pain level was hindering my ability to diagnose which structure had been damaged. So he was sent home and advised to RICE (Rest, Ice, Compress, Elevate). 2 days later, I was able to diagnose the injury as a Grade 1 tear of the Medial Collateral Ligament and the rehabilitation process started.
Week 1 consisted of gentle massage to reduce swelling, use of the friction technique along the MCL to encourage healing of the fibres in the correct direction, and gentle pain-free movement to increase range of motion (ROM). At home, he was applying ice for 15 minutes, 3 times a day and trying to stay mobile.
Week 2 and 3 is where rehabilitation gains traction. In addition to the treatment given in Week 1, we started strengthening exercises. Initially starting with knee extension and flexion against resistance, we moved on to bridging, mini squats with a Swiss ball against a wall, mini lunges and single leg calf raises.
At week 4, he had full strength, full ROM and was pain free most of the time. He had started jogging again but was complaining of a sharp pain when kicking a ball. To address this, we continued manual therapy, and practiced kicking with a sponge ball while he was building up strength. We went into the gym and started full squats, full lunges, single leg bridges, leg press, proprioception/balance exercises on the wobble board and agility training (sport specific).
At week 5, he was pain-free, able to do a full squat on an unstable Bosu ball, able to change direction quickly and back to football training. I devised a detailed home exercise plan to continue the strength and conditioning of his knee and was able to discharge him.
There is nothing better than a patient who attends all treatment sessions, does their home exercises and is as dedicated to their rehabilitation as the therapist is.
If you are ever in this situation, please remember to implement the RICE protocol as soon as possible and try to keep moving in a pain-free range. For further rehabilitation and your successful return to sport, give us a call!
Monica has recently joined the team at Holistic Health and Healing and is an experienced sports therapist. We are delighted to have her as part of our team.
To make an appointment, or to find out more about sports massage please call us on 0800 093 7615.
We look forward to hearing from you.
By Monica Bhojani
