When it comes to running-related knee injuries, the first thing most people think of is an ACL tear. That’s not the only thing that can go wrong with your knee while you run, though.

Medial-collateral ligament (MCL) tears are also common among runners and other athletes.

Like an ACL tear, and MCL injury can be seriously debilitating and can sideline you for weeks or even months. To avoid having to take an unexpected break from your daily runs, read on to learn everything that runners need to know to prevent MCL tears.

What is an MCL Tear?

MCL tears are a type of knee sprain that occurs when the medial-collateral ligament is damaged. This ligament is located on the inside of the knee. It connects the bottom part of the femur to the upper part of the tibia to stabilize the inner knee and prevent the tibia from twisting outward.

Common Symptoms of an MCL Tear

An MCL tear is usually characterized by the following symptoms:

• A popping sound or sensation on the inside of the knee

• Pain, swelling, and/or bruising

• A feeling of instability

Types of MCL Tears

MCL tears can be broken down into three different categories:

• Grade 1 tears: In this type of tear, the MCL is overstretched and small tears in the ligament fibers may occur. Grade 1 tears are usually painful, but there isn’t much, if any, swelling. They can usually be treated with a combination of rest, ice, elevation, and compression.

• Grade 2 tears: An MCL tear is considered a grade 2 tear when the tears in the ligament are larger and there is swelling and inflammation present around the knee. Grade 2 tears often require longer rest times than grade 1 tears, along with physical therapy.

• Grade 3 tears: In a grade 3 tear, the ligament is totally ruptured. Often, the pain is less severe with a grade 3 tear, but there is more instability. Grade 3 tears often require surgery and up to six months of rehabilitation to help athletes make a full recovery.

Preventing MCL Tears

There are several steps that runners can take to prevent MCL tears, including the following:

1. Understand What Causes Them

The first prevention step is to work on understanding sprains and knowing the types of behaviors are most likely to cause an MCL tear.

For runners, MCL tears are most often the result of changing direction too quickly or coming to a sudden stop and then swiftly rotating the knee.

2. Strengthen Your Muscles

Weak leg muscles, which can cause the knees to cave in while running, are also often responsible for MCL tears. The following are some of the best exercises you can do:

• Lying or seated hamstring curls

• Wall sits

• Lateral step-ups (with or without weights)

• Lying adductor lifts (with or without weights)

3. Work on Balance and Stability

In addition to strengthening the muscles in the legs, it’s also important to strengthen the core and practice stability with balancing exercises.

A balance board (sometimes known as a wobble board) is a great tool to improve balance and minimize injury risk. Simply standing on the board can be a great exercise, but you can do calf raises, squats, and single-leg exercises on them, too.

4. Improve Your Flexibility

Poor mobility and flexibility increase your risk of experiencing all kinds of injuries, including MCL tears. Making both active and passive stretching a regular part of your routine, you can reduce injury risk and improve performance.

Multi-directional leg swings are a great active stretch to do before you run, and passive quadricep and hamstring stretches are good to do as you cool down at the end of your runs.

5. Use Proper Form When Running

Finally, make sure you’re using proper form when you run. Some basic cues to keep in mind include:

• Keep the knees soft and slightly bent

• Make sure your feet are pointing in the direction your traveling to prevent twisting

• Run with a faster cadence

• Let your legs move in a slightly circular motion instead of swinging backward and forward

• Avoid heel striking, especially when running downhill

Final Thoughts

MCL tears, especially grade 2 or grade 3 tears, can have a major impact on your running performance. Whether you’ve got a race coming up or are just running for fun, be sure to consistently apply these prevention tips into your training regimen to avoid being sidelined for weeks or even months.