MCL Tear Singapore: Grades and Recovery Time

Written by Fairuuz Saleh, Principal Physiotherapist at Phoenix Rehab, AHPC A1301092H.Clinically reviewed by Louise Yow, Principal Physiotherapist & Director, AHPC A1300363H.Last reviewed 3 November 2026.

The surgeon reconstructed the ACL and left the MCL to heal in the brace. Or there was no operation at all, just a hinged brace and the words “it will heal on its own”. Eight weeks on, why does the inside of the knee still ache stepping off the kerb, and why won’t it trust a sidestep?

The MCL is the ligament on the inside of the knee. Most tears of it heal without surgery, which is exactly why the recovery gets left to time. This page covers the three grades, when the MCL is operated on, how long each grade usually takes, the signs that mean a doctor first, and what to do when the knee will not settle.

What is an MCL tear?

The medial collateral ligament (MCL) runs down the inner side of the knee, from the thigh bone to the shin bone, and stops the knee buckling inward. A tear usually comes from a blow to the outside of the knee or a twist with the foot planted. It is graded 1 to 3 by how far the knee opens when a clinician stresses it. Most isolated tears heal without surgery.^1,2

Key takeaways

The MCL is the ligament on the inside of the knee that stops it buckling inward. It is the most commonly injured knee ligament.
Tears are graded 1 to 3 by how far the knee opens when a clinician stresses it, tested with the knee straight and slightly bent.
Most isolated MCL tears heal without surgery, often with a hinged brace. Surgery is mainly considered when the ACL or other ligaments are torn as well, or a grade 3 tear stays unstable.
Severe swelling within hours, a knee that locks, or a knee that keeps giving way suggests more than the MCL, and needs a doctor and usually an MRI.
The ligament heals before the thigh and the knee’s control are back. Those are measured against the other side, not judged by how the knee feels.

First, the signs that mean a doctor, not this page

Call 995 if the knee is visibly out of shape after a heavy injury, or the foot below it is cold, pale or numb. That can be a knee dislocation with damage to the artery.
Go to the emergency department now if you cannot take any weight on the leg after the injury, or there is bone tenderness at the top of the shin or the kneecap.
See a doctor the same day if the whole knee swelled up within a few hours of the injury, the knee is locked and will not straighten, or it is hot and red with a fever, or one calf is swollen and tender.
See a doctor soon if the knee keeps giving way, or the pain on the inside has not eased after three to four weeks.

None of these? Then the rest of this page is for you.

The three grades, and what each usually means

Grade	What it means	What the knee does when tested	Usual care	Typical return to sport
1	Stretched, a few fibers torn	Tender on the inside, no extra opening	Exercise, sometimes a brace for comfort	About 1 to 2 weeks
2	Partly torn	Opens a little more than the other side, with a firm end point	Hinged brace and exercise	About 3 to 6 weeks
3	Torn through	Opens clearly more than the other side, with no firm end point	Hinged brace for several weeks, or surgery where other ligaments are torn or the knee stays unstable	About 6 to 12 weeks, longer after surgery

The test is a valgus stress test: the clinician pushes the knee inward with it straight and again slightly bent, and compares it with the other knee. A doctor confirms the grade with an MRI when needed, and checks for an ACL or meniscus tear at the same time.^1,2,3

Had surgery, or told you might need it?

The MCL is mostly operated on when it is torn together with the ACL or other knee ligaments, when the ligament has pulled off the shin bone in a way that will not heal back, or when a grade 3 tear leaves the knee opening on the inside despite bracing.^1,3 Often the ACL is reconstructed and the MCL is left to heal in a hinged brace, so the plan after surgery is the ACL protocol plus the brace settings your surgeon gives.

Your surgeon’s protocol sets the timeline and the brace. Recovery after an ACL reconstruction is covered in ACL injury, and how we work inside a surgeon’s protocol in physiotherapy after surgery. Bring the operation note and the brace settings.

Do you need surgery for an MCL tear?

Usually not. Most isolated MCL tears, including many grade 3 tears, heal well with a hinged brace and a graded exercise program.^1,2 The decision to operate is your orthopedic surgeon’s, and it mostly comes up when other ligaments are torn too.

How long does an MCL tear take to heal?

A grade 1 tear typically takes one to two weeks, a grade 2 tear three to six weeks, and a grade 3 tear six to twelve weeks before sport.³ The ligament keeps remodeling for months after that. Combined injuries with surgery follow the surgeon’s protocol, usually measured in months.

Can you walk with a torn MCL?

Usually yes, within comfort, and with a hinged brace for grade 2 and 3 tears. If you could not take weight at all after the injury, or the knee locked, that is the doctor signs above, not a walking question.

Why the brace came off and the knee still is not right

The thinking goes: ligaments heal on their own. The brace is off. Give it time.

At week eight you are back at work and fine on the flat. You still step off the MRT carriage with the other leg first when the crowd pushes. The first sidestep at Thursday futsal stops you dead. You kneel on the good knee to tie your son’s shoelace. The season starts in January.

Here is the reason. The ligament heals with scar tissue that takes months to mature, and for weeks the thigh and hip muscles that protect the inside of the knee were held still in a brace. The ache settles first. The control that stops the knee falling inward when you land, cut or get bumped is the last thing to come back, and it comes back only when it is trained.

Has anyone tested how far the knee opens at a slight bend against the other side, how strong the thigh is against the other leg, and whether the knee drops inward on a single-leg squat? If not, nobody yet knows whether this is a ligament still healing, a weak thigh, or a meniscus that was missed.

What a physiotherapist does with it

Finding the real problem is half the battle. Treating it is the other half.

At the Assessment & Treatment, a physiotherapist asks how it happened, in your words, then tests: the valgus stress test with the knee straight and slightly bent against the other knee, swelling, how far the knee bends and straightens, thigh strength against the other leg, a single-leg squat and step-down, and, once it is safe, hop tests. If anything points to an ACL or meniscus tear, we tell you and write to your doctor. MRI and surgical decisions are theirs. After surgery, your surgeon’s protocol and brace settings are followed exactly.

Most of the 45 minutes is treatment: hands-on work for the knee, a loading program for the thigh and hip that starts where they are and is measured up at each review, and the landing, cutting and balance work the sport asks for. You leave knowing which stage you are in, what is limiting the knee, and a written plan.

More on inside knee pain if you are not sure it is the MCL, the ACL injury that often comes with it, and the meniscus tear that can hide behind it. Every appointment is one to one with your physiotherapist for the full 45 minutes, at five clinics: Orchard, Tampines, Serangoon, Tanjong Pagar and Jurong East. Bring your brace and any scan report you have.

Questions about MCL tears

How do I know if my MCL is torn?

Pain and tenderness along the inner side of the knee after a blow to the outside of the knee or a twist, sometimes with a feeling that the knee could give inward. The grade is found by a clinician pushing the knee inward with it straight and slightly bent, compared with the other knee. A doctor orders an MRI when needed.

How long does an MCL tear take to heal?

Typically one to two weeks for a grade 1 tear, three to six weeks for grade 2, and six to twelve weeks for grade 3 before returning to sport. Combined injuries that need surgery follow the surgeon’s protocol, usually over months.

Does a torn MCL need surgery?

Usually not. Most isolated MCL tears heal with a hinged brace and an exercise program. Surgery is mainly considered when the ACL or other ligaments are torn as well, or a grade 3 tear leaves the knee unstable. The decision is made by an orthopedic surgeon.

What are the symptoms of a grade 3 MCL tear?

Pain on the inside of the knee, swelling, and a feeling that the knee opens or gives inward, especially when changing direction. When tested, the knee opens clearly more than the other side with no firm end point. A doctor checks for other ligament injuries, usually with an MRI.

Can I test my MCL at home?

Not reliably. The test compares how far each knee opens when pushed inward at two angles, and it needs a trained hand and a relaxed leg. If the inside of the knee is painful after an injury, a physiotherapist or doctor can test it. Severe swelling within hours or a locked knee needs a doctor first.

Eight weeks after the injury and the knee still will not trust a sidestep? Get Assessed & Treated, and leave knowing how the knee tests against the other side, which stage you are in, and what the next stage asks of it.

Sources: 1. Phisitkul P, James SL, Wolf BR, Amendola A. MCL injuries of the knee: current concepts review. Iowa Orthop J. 2006;26:77-90. 2. Andrews K, Lu A, McKean L, Ebraheim N. Review: medial collateral ligament injuries. J Orthop. 2017;14(4):550-554. 3. Kim C, Chasse PM, Taylor DC. Return to play after medial collateral ligament injury. Clin Sports Med. 2016;35(4):679-696.

Where are you with this right now?

1. It is settling on its own

Most injuries and most flare-ups settle over weeks with sensible load management and a return to normal movement. Improvement is judged over a month, not over a day, and good days and bad days inside that are usual. If you are doing more this month than last, and sleeping better, it is behaving the way it should. You do not need us for this, and we would rather say so.

2. It has stopped improving

You have adapted without noticing. The other side takes the load, you plan movements you used to make without thinking, and you have quietly dropped things you used to do.

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Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. That is the gap worth measuring, and it is not measured by how you feel on the day.

The Stalled Recovery Review is three appointments over three weeks with the same therapist, because what a joint does under load cannot be read in one visit. The first finds what is limiting it. The next two measure how it responds. $690, nett, no GST, which is three appointments at $230.

3. You have had surgery, or you have a date

Recovery after an operation has a shape, and knowing which stage you are in tells you whether you are on it. If the MCL was repaired or left to heal alongside an ACL reconstruction, bring your surgeon’s protocol and brace settings and we work inside them. See ACL injury, physiotherapy after surgery, or all the recovery programs, hand and physiotherapy.

All of it runs on the same four stages. The Phoenix Recovery Protocol explains what each stage works on and what you have to meet to move up. No referral needed to start.

Next step

Find out which stage you are in

Pain is the first thing to leave. Movement and strength are the last things trained back, and most people stop before that part is done. One Assessment and Treatment is a single 45-minute appointment at $230, nett, no GST. Your therapist finds what is actually limiting you, treats it in the same appointment, and you leave with your current stage and a written plan.

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