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Our team OrthoSpec recommends early operative repair of both. I have done some research and am having trouble finding anything conclusive on the best way to manage prehab and initial post-op care. My goal is to find a balance between allowing the MCL to heal without too much stress, while still working to prevent decreased ROM and strength loss. The most important piece of initial ACL rehab focuses on early motion and quad control/strength, while on the other hand the MCL is under the most stress in full extension and full flexion.