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Despite significant efforts from several groups, the determinants for specificity remained ill-defined and controversial, with N, D1, M, D2 domains and combinations thereof, proposed as key elements 35,50,60

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For those with a grade 3 MCL tear, one should certainly make sure that the MCL has healed completely before they start any significant kicking in the pool, especially with the breast stroke, and avoid any flip turns at the end of the pool where they could stress their MCL