Lateral Collateral Ligament Strain

Editor: Dr. Amy Spencer, PT, DPT, OCS, MTC, CSCS, CKTP - A Board Certified Clinical Specialist in Orthopedic Physical Therapy and Certified Manual Therapist. Owner and Physical Therapist, Specialized Physical Therapy in North Reading, MA.

The lateral collateral ligament (LCL) runs along the outside of the knee and connects the thigh bone (femur) to the fibula. The fibula is the small bone in the Specialized Physical Therapy Lateral Collateral Ligament Strainlower leg that turns down the side of the knee and connects to the ankle. Like the MCL, the LCL’s main function is to keep the knee stable as it moves through its full range of motion. An LCL injury typically results from a direct blow to the inside of the knee, causing increased stress to the outside of the knee. The stress causes the outer knee to widen and when the LCL is stretched too far, it is susceptible to tearing and injury.

Causes of a LCL Strain:

Tears to the lateral collateral ligament normally occur from a direct blow to the inside of the knee. This can stretch the ligaments on the outside of the knee too far and cause them to tear. This type of injury occurs in sports that require a lot of quick stops and turns, such as soccer, basketball, football, hockey, and skiing.

Symptoms of a LCL Strain:

LCL tears are classified based on the extent of the injury:

  • Grade 1 LCL Tear: This is a minor sprain of the LCL. There is mild tenderness on the outside of the knee over the ligament. Typically there is no swelling. When the knee is bent to 30 degrees and force is applied to the inside of the knee (stressing the lateral ligament) pain is felt, but there is no joint laxity (looseness).
  • Grade 2 LCL Tear: This is a partial tear of the LCL with significant tenderness. Swelling is seen over the ligament. Laxity in the joint exists and there is moderate pain.
  • Grade 3 LCL Tear: This is a complete tear of the ligament. Pain can vary and may be actually less than a grade 2 sprain. When stressing the knee there is significant joint laxity. The athlete may complain of having a very unstable knee.

Treatment of a LCL Strain:

Physical therapy treatment of a lateral collateral ligament (LCL) tears depend on the severity of the injury. Treatment may include modalities for swelling and pain relief, such as ice and ultrasound. A knee brace may also be used for treatment of LCL injuries. Physical therapy will be aimed at improving your knee’s range of motion and regaining muscle control and strength of the knee. Fortunately, surgery is not normally necessary for the treatment of an LCL tear. However, surgery is more likely in LCL injuries than MCL injuries, since the ligament does not heal as easily, and surgery for MCL injuries is rare. For those injuries requiring surgery, physical therapy is needed to increase strength and flexibility. In some cases, a brace will need to be worn during therapy to keep the knee joint stable and to prevent further re-injury.

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