Medial collateral ligament syndrome is a painful issue that occurs usually as a result of playing sports.  The knee joint is composed of thee bones: the femur, tibia and patella.  Thee knee joint also has ligaments, which are tight bands that connect the bones to each other and provide stability and range of motion to the joint.  The are two cruciate ligaments, which cross each other to form an X; the anterior and posterior cruciate ligaments.  There are two collateral ligaments that are found on the outside of the knee; the medial and lateral collateral ligaments.  These ligaments can be injured during strenuous activity such as football or soccer.  Injuries of these ligaments are called sprains and are graded in severity from mild (level1) to severe (level3). The medial collateral ligament is the most frequently injured ligament.  Medial collateral ligament syndrome manifests as pain, swelling and limitation of motion.  The pain is located on the medial ( inside) aspect of the knee.  There may be tenderness along the course of the ligament and the joint may be unstable.  X-rays and MRIs of the joint are useful to determine the exact cause and extent of the injury. Treatment of Medial Collateral Ligament Syndrome begins with conservative modalities such as heat, ice, non-steroidal anti-inflammatory medications and physical therapy.  Surgery is reserved only for those severe cases which are unresponsive to the usual treatments.