John,

First of all thank you for all of the information that you have put up on the site. The advice and WODs have really helped me bring my Rugby to the next level. About three months ago I hurt my knee while running on a trip in China. I didn't give it proper treatment and kept walking on it for two and a half more weeks (I was in China, and kind of dumb). Today my knee is still bothering me and I have a diagnosis of a sprained MCL. I was instructed by my doctor to not go beyond 90 degrees and to keep icing/elevating it, and not to run. I am getting very frustrated as I was only 25 pounds away from my double body weight squat and I can't run, more specifically I can't sprint. I don't believe I am injured; just hurt enough to change up my routine. My question is what can I do to best maintain my strength without reinjuring myself? Also I'm very concerned about my speed, I'm a flanker on the rugby field and speed is key to chasing down those backs. Thank you in advance, and thanks again for all of the free advice and knowledge that you give.

Kaleb S.

MCL#1
Kaleb,

You are not in an easy spot, but three months is about average for dealing with an MCL injury. The good thing about an MCL injury is it just needs support to make it feel better. When you have an ACL injury you have a lack of stability front to back, with an MCL it is a lateral instability. That makes it tough to compete in a sport where you have to change direction.

First you need to start doing stability work. Remember all the annoying balance stuff you did when you sprained your ankle? Get on it.

Second, find a brace. You need some from of brace to create stability in the injured knee. Talk to your doctor or check out VQOrthoCare. I like the single hinged lateral support brace. Start training in the brace. You might have to tape your knee for rugby, as I am 99.9% sure they wont let you wear hard plastic during the game.

Third, you need to start squatting. If you can only go to 90 degrees than so be it. I rather see you go only a few inches down than not squat at all. Take it slow on the decent and do not bounce off the bottom. You need to start a cervical loading of the spine in preparation for your sport. Remember toes forward with a knee path that follows the feet. You need to strengthen the knee in a controlled plane of motion.

I have been rehabbing my knee and at 7 weeks out and I am finally cleared to squat. I have been doing 5 sets of 10 with 155 lbs with bare feet making sure to control the descent. I have been squatting with a close & wide stance working on the flexibility in my hips, ankle and knee to gather range of motion (think stretching with weights). Turning my toes out and driving my knees out helps me get a ton of range of motion from my mechanics but I need increased flexion, ankle flexibility and hip range.

Fourth, keep the hamstrings and the ad/abductors strong. I cannot stress this enough. When the body is damaged it will have to lean on the strongest parts. Make the hamstrings like steel cables and you can get away with a lot of slop in the knees. I am living proof of this.

Fifth, you need to start conditioning in a safe manner. A C2 rower or Airdyne need to be in your wheelhouse.  And my favorites conditioning tool when rehabbing a knee…the slide board. Start with the shortest side-to-side distance and work up keeping a smooth and controlled motion. Remember to use your brace and progress to not wearing a brace.

Sixth, ice the shit out of it. Right after training, 45 minutes after that, 45 minutes after than and so on.

Hope this helps.

John