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Lateral Collateral Ligament Sprain

A lateral collateral ligament (LCL) injury is usually caused by your knee being pushed outwards (away from your other knee). This may happen if you have a blow to the inside of your leg, which can happen during contact sports such as football.

What is a Lateral Collateral Ligament sprain?

The Lateral Collateral Ligament (LCL) is found on the inside of the knee and is a tough fibrous tissue that attaches bone to bone.

This ligament, along with the Medial Collateral Ligament (MCL), helps to form the knee joint by attaching to the shin and the thighbone, it also provides stability and ensures that the knee functions properly when you move.

Ligament sprains most commonly happen when the ligament is very quickly put on an excessive stretch, has a large force applied to it or takes direct contact. That is why ligament injuries are often easy to identify as they are normally linked to a traumatic incident such as a slip, trip, fall or collision.

In some cases, low-level LCL sprains are caused by repeated stress being applied to the knee causing the ligament to stretch. This can often be seen in dancers and gymnasts.

There are different levels of a sprain.

Grade 1 is an overstretch of the ligament, leaving small tears to some of the fibres.

Grade 2 is a partial tear. Somewhere along the ligament, there will be a significant tear to the ligament but it will still be attached

Grade 3 is a complete tear through the centre of the ligament. There is also something called an avulsion where the ligament is intact but has been pulled from the bone.

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How to test for a lateral collateral ligament sprain.

We strongly recommend that you have any suspected injuries fully assessed by a medical professional.

It can be difficult to fully test this yourself because the medical test, the Varus/Valgus test, involves a medical professional supporting the leg and applying forces in different directions in an attempt to replicate your pain.

The best way to identify if you have a possible LCL sprain is by;

Palpating the outside of the knee with your thumb using a moderate to firm pressure to test the lateral collateral ligament (LCL). Start on the outside of the knee, using your fingers to feel down to the top of the lower leg for a bony lump. Switch to your thumb and apply pressure to the area gradually moving upwards. The ligament is only about 3 inches long.

Pain = possible ligament sprain

Things to be aware of

There are a lot of different structures that attach to those points around the knee and it may not necessarily be a ligament sprain. As an example, the ITB inserts on the outside of the knee and can produce similar pain to the outside of the knee, especially when it is palpated.

However, pain is a good indication that something might be going on and it is definitely worth speaking to a medical professional to have it checked out.

What does a Lateral Collateral Ligament sprain feel like?

You will feel the pain on the inside of the knee. Depending on the level of the injury there may be some swelling and mild bruising to the area.

An LCL sprain will feel like a constant pain with intermittent moments of sharp pain when the ligament is put under stress. It will hurt to put weight through the leg and the ligaments work to stabilise the joint. The knee will also feel stiff after periods of rest or in a fixed position.

You may not have the full range of movement in the knee due to pain or the build-up of scar tissue in the ligament.

If there has been a partial or complete tear to the ligament then it will feel unstable and the knee may wobble as you put weight through it. In some cases, you may also experience weakness or numbness in the foot depending on the severity of the injury.

What can cause a Lateral Collateral Ligament sprain?

A direct blow to the inside of the knee. This is common in sports like football, hockey or rugby. An impact on the inside of the knee will push the knee out stressing the lateral collateral ligament on the outside of the knee.
Changing directions quickly or pivoting on one foot. This happens when the foot is planted and your body twists outwards in movements such as stopping quickly and changing direction. It is common in sports like basketball and tennis.
Landing badly from a jump. If you land awkwardly taking most of your weight through one leg, the force through can cause the knee to fall outwards putting stress on the LCL. Often you may find that the ankle is injured also in movements like this.

How to treat an LCL sprain

The following protocol can immediately help a Grade 1&2 sprain or can be used after surgery on an LCL rupture.

The POLICE protocol

When acute pain first appears follow this protocol:

P: Protect the area. This can be changing footwear or wearing a supporting knee brace
OL: Optimal Loading. Take as much weight as you can without making things worse. You may need rest or crutches.
I: Ice the area for 20 minutes at a time to relieve inflammation.
C: Compress the area to help reduce any swelling.
E: Elevate the area by putting your leg on a few pillows

Exercises to help an LCL sprain.

Heel Slides

This exercise is designed to strengthen the hamstrings and improve the range of movement in the knee

Lie on your back on the ground.
Place a tea towel, plastic bag or sheet of paper under your foot.
Slide your heel towards your bum making sure to keep contact with the ground throughout the movement.
Slide your foot back out.

Frequency and duration

Slide your foot in for a count of 2 seconds
Hold for 1 second.
Slide your foot out for a count of 2 seconds.

Quads Contraction

This exercise targets the small quad muscle on the inside of the knee that controls the last 10 degrees of extension and helps stabilise the knee.

Lie on the ground with a rolled-up towel or foam roller under your mid-thigh causing a bend in your knee.
Contract the quads lifting the foot off the ground.
Hold at the top then lower the foot back to the floor.

Frequency and duration

Raise for a count of 1 second.
hold for a count of 3 seconds.
lower for a count of 1 second.
3x sets of 15 each leg.

Alternatives

Easier - remove the towel and just press the knee into the ground.
Harder - add weight around the ankle

Hamstring Curl

This exercise is designed to strengthen the hamstring muscles on the back of the thigh.

Stand on one leg with one foot behind you.
You can lean on a pole or wall for stability.
Raise your heel to your bum making sure to keep your knees aligned.
Lower your foot back down until your toes are touching the ground.

Frequency and duration

Raise for a count of 2 seconds.
Hold for 1 second.
Lower your foot for a count of 2 seconds.
3x sets of 12 on each leg.

Alternatives

Easier - reduce the height you lift your foot off the ground.
Harder - add weight to the ankle.

Lateral Step-ups

This exercise is designed to improve leg strength, balance and neuromuscular control.

Stand with one foot on a step and one foot on the ground.
Push through the foot on the step to raise yourself up.
Drive the trailing leg up till the knee is at 90°.
Hold at the top then lower yourself back down.

Frequency and duration

Raise for a count of 2 seconds.
Hold for 2 seconds.
Lower for a count of 2 seconds.
3x sets of 12 on each leg.

Alternatives

Easier - side step up entirely placing both feet onto the step.
Harder - hold weights in your hands

Wall Squats

This exercise is designed to build leg and core strength

Stand with your feet shoulder-width apart and your back leaning against the wall.
Slide down the wall until you are in a seated squat position.
Hold at the bottom then return to the sanding position making sure that your back remains in contact with the wall at all times.

Frequency and duration

Lower down for a count of 3 seconds.
Hold for a count of 2 seconds.
Return to standing for a count of 3 seconds
3 sets of 12 squats

Alternatives

Easier - change the exercise so that you are sitting down and standing up from a chair.
Harder - Hold for 4 seconds in the squat position.

The information on this site is intended for educational purposes.

You must not rely on the information on this website as an alternative to medical advice from your doctor or other professional healthcare provider. If you have any specific questions about any medical matter you should consult your doctor or other professional healthcare provider. If you think you may be suffering from any medical condition you should seek immediate medical attention. You should never delay seeking medical advice, disregard medical advice, or discontinue medical treatment because of information on this website.

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