The Lateral Collateral Ligament (or LCL) is a flexible band of tissue located on the outside of the knee joint. The LCL connects your thighbone to your fibula. The function of the LCL is to help limit twisting and side to side motions of the knee. It also contributes to the stabilization of the knee joint, along with the MCL (Medial Collateral Ligament). The MCL is located on the inside of your knee joint and connects your thighbone to your shinbone.
LCL injuries can range from mild sprains to partial tears to complete ruptures. They usually occur along with other knee injuries, such as meniscus tears and dislocated knees, which is why it's important to visit your doctor if you think your LCL may be damaged.
There are three different injury grades (levels of severity) when it comes to LCL Injuries:
Grade 1 - The ligament is mildly damaged. It has been slightly stretched, but is still able to help keep the knee joint stable. There is no laxity when stretched.
Grade 2 - Stretching the ligament to the point where it becomes loose. This is often referred to as a partial tear of the ligament. Minor laxity is present, but when the knee is stressed there is an endpoint, meaning the knee does not bend sideways.
Grade 3 - This type of sprain is most commonly referred to as a complete tear of the ligament. The ligament has been split into two pieces, and the knee joint is unstable. Significant laxity is exhibited.
While the LCL is less likely to be injured than the MCL, the LCL is more difficult to heal.
Signs & Symptoms
The symptoms of an LCL Injury depend on the severity of the damage. If you only have a mild sprain, you may not experience any symptoms at all. If you have a complete LCL Tear (also called a rupture), you may have difficulty walking.
Signs and symptoms of an LCL Injury include:
Swelling & pain on the outside of the knee
Stiffness in the knee joint
Locking & catching of the knee joint
Instability of the knee joint, feeling like it's going to give out
Lateral Collateral Ligament injuries are most commonly caused by the knee joint being pushed outwards due to a direct hit to the inside of the knee. These are known as acute injuries. This type of force causes stress and strain on the LCL, as it is located on the outside of the knee. This is often seen in contact sports such as hockey and football.
Another typical cause is sharp twisting movements of the knee, which are seen in sports such as downhill skiing, soccer and basketball.
Alternatively, LCL injuries can be caused by repetitive motions that lead to degeneration of the tissue over time. These are also known as repetitive strain or overuse injuries and are more likely to affect people that are over the age of 40.
There are many different treatment options for LCL injuries. You should always try conservative treatment before considering surgery. However, if your LCL is completely ruptured, (meaning your tissue is in two pieces and no longer held together) you may need to undergo surgery in order to regain proper movement of your knee.
First of all, you should rest your injured knee. You don't want to do any further damage to your LCL. Some people go as far as using crutches to avoid re-injury. Stay off your knee for the first several days after injuring your LCL and don't do any vigorous physical activity. During this time, you should definitely avoid doing the activity that caused your LCL injury.
Next, you need to ice your LCL to bring down the swelling and inflammation. You can use a cold pack or a bag of peas or ice from the freezer. There are also safer, higher quality cold compression wraps available online that do a much better job. Just make sure you don't put anything frozen directly on your skin, as this can cause severe damage. Wrap the ice in a towel or wear a layer of clothing between the ice and your skin. When you're icing the LCL, you can also elevate your knee above your heart by resting your leg on a pillow. This will aid in further reducing the inflammation.
Many people also find wearing a brace or splint effective in preventing movements that can lead to pain and further damage to the LCL.
Taking over-the-counter pain medications such as Advil and Aleve can help to relieve your pain and inflammation. However, painkillers should be limited to times when you are at rest. Taking them when you are active is dangerous. Painkillers block the pain signal, making you unaware of any further damage you're doing to your knee until the effects wear off and you have more pain than before.
It's important to know the difference between NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen and naproxen and analgesics like Tylenol. NSAIDs work to alleviate both pain and inflammation, while analgesics only relieve pain. If inflammation is a concern, try to stick with NSAIDs.
Once your swelling and inflammation have subsided, you need to stimulate healthy blood flow to your LCL. This will help speed up your recovery and help to repair your damaged LCL. While being physically active is one way to promote blood flow, this can lead to re-injury of your fragile tissue. When you're recovering from an LCL Tear, you want to rest and protect the area as much as possible. There are medical devices on the market that can do this for you. Improving blood flow is essential if you want to heal your LCL without resorting to surgery.
Once you are far enough along in the healing process to not experience pain or re-injury to the knee during light exercise, you are ready to begin physiotherapy. This will help you restore strength and flexibility to the knee and usually involves a combination of stretching and strengthening exercises. Physiotherapists also use other treatments, such as taping, cold compression and blood flow stimulation.
Taping your LCL can help by providing your injured tissue with additional support and protection. It can also work to relieve swelling by applying compression to your LCL throughout the day. Using sports tape (also called kinesiology tape and athletic tape) has been shown to prevent re-injury and even improve movement. Wearing tape during exercise is especially important, as it helps keep your tissue in place and prevents futher damage.
There are a variety of resources for taping online, including instructions on how to apply tape. Please try different applications for your LCL injury in order to find the one that works best for you. Here's an example below:
1. Position your knee to 90°.
2. Take a full length piece of tape (about 10 inches long) and cut it in half, rounding the corners, so you have two pieces that are each about 5 inches in length.
3. Take one of the 5 inch pieces of tape and tear the backing in the middle, peeling it away so you are holding onto the two anchor ends.
4. Using 100% stretch in the middle and no stretch at the ends, apply the tape horizontally over the point of pain on the outside of your knee.
5. Take the other 5 inch piece of tape and tear the backing in the middle, peeling it away so you are holding onto the two anchor ends.
6. Using 80% stretch in the middle and no stretch at the ends, apply the tape on an angle over the first piece to create an "X".
7. Take a full length piece of tape (10 inches) and tear the backing off one end, anchoring it right below the "X" with no stretch.
8. Apply the tape down over your point of pain with 80% stretch, bending it towards your thigh.
9. Lay down the end of the tape with no stretch, then rub the tape in to ensure it sticks to the skin.
Surgery should only be considered if conservative treatment has failed to improve your condition after 2-3 months. Surgery also may be required if you have a ruptured LCL (Grade 3 Tear).
The goal of LCL surgery is to improve stability and restore proper motion. If you are considering surgery, talk to your doctor about your options for surgery, as there are several different methods. The type of surgery required will depend on the severity of the tear, as well as the location. Most LCL tears can be repaired by stitching the tissue back together. However, some LCL injuries may require a graft, where tissue is taken from your quads or hamstrings to replace the torn LCL.
LCL Repair is performed either through arthroscopy (where a tiny camera is inserted inside a small incision) or an open incision in the skin. If your tear is located somewhere in the middle of your LCL, the two ends will be sewn back together. If your tear has caused your LCL to detach from your thighbone or shinbone, it will need to be re-attached with strong sutures or staples.
LCL Reconstruction is a bit more serious than LCL Repair, as it requires a tendon graft (surgical transplant of living tissue). This can either be an autograft, which is when healthy tissue from your own body is used, or an allograft, which is when tissue from a tissue bank is used. This is an open procedure (done through an open incision and not with arthroscopic tools) where the tendon graft is attached to the bones with screws in order to replace the damaged LCL.
LCL Tear Diagnosis
If you suspect you may have an LCL Tear, visit your doctor to have your knee examined. Your doctor will want to know what symptoms you're experiencing, how the injury occurred and how long you've been injured. Your doctor will take a look at your knee to see if you have any swelling on the outside of your knee. They might examine your knee in several positions and feel around the outside of your knee to see if it is tender. Your doctor will discuss your medical history with you to rule out any other issues, such as arthritis or gout.
In order to confirm a diagnosis, your doctor may send you to get an x-ray, MRI or ultrasound imaging test. You may need to wait until your inflammation goes down before having an imaging test done, so the tissue damage can be seen properly. An x-ray may be ordered if your doctor suspects an issue like arthritis, as soft tissue like the LCL won't show up on an x-ray. The LCL will show up on an MRI or ultrasound, however. These tests will allow your doctor to confirm the LCL Tear and get a gauge of how severe the injury is.
A mild LCL injury or sprain will take about 4-6 weeks of conservative treatment to heal. Even then, you should continue to stimulate blood flow to ensure complete healing and to prevent re-injury.
A moderate LCL tear will take about 2 months to fully heal. At the 2 month mark you should be able to resume most of your regular activities.
A complete LCL tear will take 3+ months to heal, with the aid of surgery.
While most people who have recovered from an LCL tear should be able to resume all of their usual activities eventually, some people will never regain the same stability and strength their knee had previously.
It is recommended that when you are recovering from an LCL tear, you gradually work your way back to your former activity level. If you are used to doing high intensity workouts or exercise, start with something more low-impact. For example, if you are a cyclist, start with soemthing like water aerobics, then move onto using a stationary bike once you've built up more strength and accomplished more healing. Eventually, you should be ready to start cycling regularly again.
If you are recovering from LCL surgery, you may be required to wear a cast or brace for several weeks, in order to keep the weight off your tender knee. You will also have to use crutches to help you get around while your knee heals.
The below exercises are designed to maintain the strength and stability of the knee joint when the LCL is injured. Just make sure you don't attempt these exercises too early in the recovery process, as this could cause re-injury. If it hurts, don't do it!
Sit on the floor with your injured leg stretched out straight in front of you, with your uninjured leg bent so your foot is flat on the floor. You may want to roll up a small towel and place it under your injured knee for support. Tense up the quad muscles in your injured leg (the muscles in the front of your thigh) by pushing your knee into the floor (your heel should lift slightly off the ground). Hold for 5-10 seconds, then relax your leg again. Do 10 reps 3 times a day.
Lie down on the floor, on your uninjured side. Bend your hips and your knees at 45 degrees, with your feet together. Still keeping your feet together, slowly raise the knee that's on top as far as you can. Hold for a second, then lower your knee back down. Do 10 reps 3 times a day.
You will need an exercise platform or something of a similar size (about 5 inches or 13 centimeters high) in order to complete this exercise. Take the platform and step up on it with the foot on your injured side, keeping your other foot flat on the floor. Transfer all of your weight to the injured leg and straighten it as your other foot lifts off the ground. Lower the foot on your uninjured side back down to the floor, so it's at the starting position. Do 10 reps 3 times a day.
Make sure you do the following exercise with something nearby you can hold onto to keep your balance. Stand with your feet shoulder width apart and lift your heels off the floor, as high as they will go, so you are standing on the balls of your feet. Lower your heels back to the floor slowly. Do 15 reps twice a day.
Lie down on the floor, on your back. You may want to roll a towel and place it under your neck for support. Bend your knees so your feet are firmly planted on the floor. Keeping your knees bent and your feet in contact with the floor, raise your hips up towards the ceiling. Hold for a few seconds and lower your hips back down. Do 10 reps 3 times a day.
Stand with your feet hip width apart. Keeping your back straight, step forward several feet with your right leg. Lift your left heel slightly off the ground, but make sure you keep your toes touching the floor. Bend both of your knees to a 90 degree angle. Hold for several seconds and rise. Go back to the starting position and repeat the lunge with your left leg. Do 10 reps 3 times a day.
Lie down on the floor with your legs stretched out straight in front of you. Take your injured leg and slide your heel towards your glutes (your knee will start to bend) until your knee is at a 90 degree angle. Hold for several seconds, then slowly return your leg to the start position. Do 15 reps twice a day.
Straight Leg Raise
Lie down on the floor with your legs stretched out straight in front of you. Bend your uninjured leg so your foot is lying flat on the floor. Keep your injured leg straight and tighten your thigh muscles. Raise your injured leg up off the floor about 8-10 inches. Hold for 5 seconds. Slowly lower your injured leg back to the floor. Do 10 reps twice a day.
Lie down on a flat surface on your stomach, with your legs stretched out behind you. Cross your arms under your head so you can rest your head on your arms. Tighten your buttock muscles. Keeping your knee straight, lift your injured leg off the floor about 8-10 inches and hold for 5 seconds. Lower your injured leg back down to the floor. Do 10 reps 3 times a day.
Related Forum Content from the makers of the BFST→
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