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The lateral collateral ligament (LCL) of the knee is a strong ligament on the outside of the knee, attaching the femur to the fibular. It is one of the four main ligaments of the knee, which include the medial collateral ligament, and the anterior and posterior cruciate ligaments. Ligaments are strong bands of connective tissue which stabilise the joint by preventing movement in specific directions.
The LCL restricts the movement of the knee out to the side, away from the other knee. This is known as varus movement. Injury to the lateral collateral ligament can be mild and resolve within a couple of weeks in the case of a grade 1 tear or can be more severe and take months, or may need surgery in the the case of a grade 3 tear. In some cases other structures within the knee will also be damaged. For example, the anterior cruciate ligament (ALC) or the lateral meniscus.
Treatment not only depends on the extent of the injury. It also depends on the health and activity of the individual pre-injury, and what exercise and function they need or want to return to.
Here we will discuss the options for LCL tear treatment and typical LCL injury recovery time. If you want to read more about the anatomy, symptoms and causes of LCL injuries, and how it is diagnosed please read our related article: LCL Injury.
The acute treatment for LCL injury is similar to most acute musculoskeletal injuries, involving relative rest, ice, compression and elevation. The duration of this will depend on the extent of the injury. Relative rest will also depend on several factors: the individual injury and the normal activity levels of the individual. If poorly managed in the acute phase, the healing time can be prolonged and the risk of long-term effects of the injury are increased.
Rest will need to be for several days and may involved stopping sports, reducing walking and putting your feet up to elevate your leg. In a minority of cases crutches might be offered to help mobility in the first week or two if pain is high with movement.
Moderate injuries will require complete rest, this may include a period of 2-4 weeks of using crutches and/or wearing a hinged brace, to completely offload the joint.
Severe injuries or complete ruptures will need a much longer period of complete rest. A brace and crutches will be necessary for 6 weeks or more, and some will need surgery, for the reconstruction of the injured ligament.
Following the initial phase of rest, active treatment can be started. The most effective rehabilitation comes from individually prescribed exercises. A physical therapist should assess you to learn your strengths and weaknesses, as well as your flexility, and understand your short and long term goals. This will help to formulate your recovery plan. You can read more about the commonly prescribed exercises in our related article: LCL Injury Exercises. In addition to rehabilitation exercises, some other treatments can aid recovery.
If there is excessive tightness in certain muscles of the leg then massage can be an effective adjunct to rehabilitation exercises. Massage can help reduce the tone on a muscle. Tone is the amount of tension in a muscle and the level of resistance to movement.
Deep tissue massage, remedial massage and sports massage are all forms of effective massage. They reduce tone by applying deep pressure and passive stretches to the muscles.
Massage should be directed at the quadriceps, hamstrings, adductors and glutes to reduce tension in the leg that can aggravate the symptoms of an LCL injury.
Elasticated tapes such as Kinesio tape can be effective for pain relief of lateral knee pain from many causes such as an LCL injury. This tape improves the proprioception of the joint. This video shows how to tape the knee with KT tape.
Rigid taping can be applied to improve the stability of the knee and prevent the outward movement (varus) that lengthens and strains the LCL. This taping is often used after an injury to prevent further stress to the ligament on return to sport.
If an injury is not recovering with conservative treatment or in the case of a complete rupture, surgery may be considered. An operation to perform a ligament reconstruction can return the knee to full stability and function. Success after surgery will be vastly improved with good rehabilitation that should be guided by a specialist and experienced physical therapist.
This is not medical advice. We recommend a consultation with a medical professional such as James McCormack. He offers Online Physiotherapy Appointments for £45.