Acupuncture vs. Physical Therapy for MCL Sprains

MCL (medial collateral ligament) sprains are one of the most common knee injuries I see in practice—often after a valgus stress moment when the knee collapses inward. If you’ve ever tweaked your knee skiing, playing soccer, or during a quick cut or pivot, the MCL is frequently the structure that takes the hit.

One of the first questions people ask (especially active adults here on the Peninsula) is: Should I do physical therapy, acupuncture, or both?

My clinical answer after 25 years of practice and thousands of musculoskeletal injuries treated is simple: they do different jobs, and a combined plan is often the fastest way to recover—especially in the first 4–8 weeks.

Quick MCL refresher

the MCL runs along the inner side of your knee and helps prevent inward collapse. MCL sprains are typically graded like this:

• Grade I (mild): micro-tearing, mild pain, minimal instability
• Grade II (moderate): partial tear, noticeable tenderness/swelling, some laxity, limited motion
• Grade III (severe): complete tear, significant instability, difficulty bearing weight

The good news: compared to the ACL, the MCL generally has a better blood supply and tends to heal well. The challenge is that many people either (1) rest too long and get weak/stiff, or (2) push too soon and keep re-irritating the ligament. The sweet spot is a plan that calms the tissue down while rebuilding strength and control.

What physical therapy does best 

PT is the gold standard for restoring knee mechanics—range of motion, strength, balance, gait, and return-to-sport progression. My colleague Garrett Akahoshi, P.T. (Peak Physical Therapy, Cupertino) describes a practical MCL progression like this:

• Weeks 0–2: reduce swelling, regain range of motion, keep the quad firing (quad sets are key because quads can “shut off” after injury)
• Weeks 2–6: regain full range of motion, begin strengthening (light leg press, wall sits), lots of glute work, normalize gait, quad/hamstring strengthening, balance work
• Weeks 6–10: continue progressive strength; toward the end, begin return-to-sport work and plyometrics as appropriate

One big PT focus (and it matters): minimize valgus stress—the same inward-collapse pattern that often caused the injury. That means neuromuscular control, glute strength, and well-programmed quad/hamstring work.

What acupuncture does best

Acupuncture is especially strong at the early-phase problems that slow recovery—pain, inflammation, swelling, and tissue irritability. Clinically, that translates into people walking more normally sooner, sleeping better, and tolerating rehab exercises with less flare-up. Acupuncture also supports local circulation and helps reduce muscle guarding around an injured joint.

When to start acupuncture

Right away. You don’t need to “wait until it becomes chronic.” In fact, early treatment is often when you get the most value—because controlling pain and swelling early can make the rehab phase smoother.

Typical acupuncture plan for an MCL sprain:

4–8 weeks total. Most patients do 2x/week for 2–3 weeks, then 1x/week as symptoms stabilize and you transition into more strengthening and return-to-activity work. (Teens and younger athletes often bounce back faster than adults; adults often benefit from a full, structured course.)

So… PT or acupuncture?

I think “both” for most people who want the fastest, most reliable outcome. Here’s why: PT restores function; acupuncture helps the tissue calm down and recover. In my experience, combining them can shorten the overall recovery timeline—sometimes substantially—because you spend less time stuck in the pain/swelling cycle and more time progressing your strength and control.

A simple combined program looks like this:

• Weeks 0–3: acupuncture to reduce pain/swelling + PT-style range-of-motion and muscle activation
• Weeks 3–6: progressive strengthening and gait normalization + acupuncture to support healing and prevent flare-ups
• Weeks 6–10: return-to-sport training + occasional acupuncture for recovery and symptom control

When PT is essential

If you have instability, difficulty trusting the knee, altered gait, or you’re returning to a sport that involves cutting/pivoting, PT is non-negotiable. It’s also crucial for preventing repeat injury.

When acupuncture is especially helpful

Early swelling and pain, sleep disruption, “hot” irritated knees that flare with activity, stiffness that slows rehab, or when you’re trying to minimize reliance on anti-inflammatories.

If you’re dealing with an MCL sprain and you want a clear plan, I’m happy to help you integrate acupuncture with (or alongside) PT. I’ve been practicing for 25 years, and my goal is straightforward: help you recover quickly, safely, and completely—so you can get back to the activities you enjoy.

Next step

• Book a consultation online.
• You can also learn more about our services.

References (acupuncture + soft-tissue injury recovery)

• Ankle sprain edema + analgesia with electrical stimulation acupuncture (2 Hz reduced edema): (PMC article)
• Systematic review/meta-analysis: acupuncture for ankle sprain (pain relief and return to activity, with study-quality caveats): (PMC article)
• Cochrane review: acupuncture for acute ankle sprains (evidence mixed/limited; highlights need for better trials): (Cochrane abstract)
• Electroacupuncture and biological repair signals (stem cell release; tendon-repair relevant findings in preclinical research): (VA Research summary)
• Acupuncture and muscle recovery (delayed-onset muscle soreness systematic evidence): (Frontiers article)