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What is it?

A ligament is a strong, fibrous connective tissue that connects bone to bone. They help to increase joint stability through limiting the movement between bones. The lateral collateral ligament, also known as the fibular collateral ligament, is found on the outside of the knee joint. 

The knee joint consists of three bones: the tibia (shin bone), femur (thigh bone) and patella (knee cap). The lateral collateral ligament runs from the top of the fibula to the lower femur. This is shown below as the fibular collateral ligament.

Causes

Injury to the lateral collateral ligament is most commonly caused by a high impact force to the inside of the knee when it is fully extended. This is often seen in sports where there is high speed jumping and pivoting.

Common Signs and Symptoms

  • Pain 
  • Swelling 
  • Difficulty weight bearing when the knee is fully extended
  • Decreased knee movement
  • Pain and/or tenderness over the outside of the knee
  • Instability/ giving away 

Diagnosis

A diagnosis can be determined through a thorough Physiotherapy assessment involving both a subjective and physical component. Depending on the mechanism and findings from the examination, your Physiotherapist may also refer you for imaging such as an MRI or Ultrasound to determine the severity of the injury. 

The level of injury may range from grade I (sprained), to grade II (partially ruptured) and grade III (completely ruptured). In higher grade sprains, injury to the lateral collateral ligament is often seen in combination with injury to other structures around the knee such as muscle, tendon and meniscus. 

Management

Lower grade sprains can be effectively managed conservatively through exercise and physiotherapy. For higher grade sprains, and where there is suspicion of the involvement of other structures, operative management may be indicated. 

Acutely, all grades of sprains should be managed with rest, ice over the outer knee for greater than 15 minutes, compression and elevation. Your physiotherapist may also prescribe crutches and a hinged knee brace.

Once pain and inflammation are managed, your physiotherapist will work with you to gradually increase knee movement, muscle strength and activation and restore your function to pre-injury levels. For a sporting population, this may also include proprioception, high-level strengthening, plyometrics and sport-specific retraining. 

Depending on your functional goals and the severity of injury, recovery times may vary from 4-12 weeks up to 6-12 months.

Return to Sport

Unmanaged LCL injuries may lead to long-term complications such as instability and chronic knee pain. With adequate rehabilitation, the majority of individuals are able to return to sport following LCL injury to pre-injury levels of function. Evidence suggests that individuals may return to sport within 4-10 weeks, and for those requiring surgical management, within as early as 6 months.

Although participating in activities requiring repetitive jumping and high impact forces through the knee does increase the risk of re-injury, taking precautions such as wearing a brace or applying tape may provide additional support and reduce the risk of re-injury.

If you have injured yourself or have any questions, call us today to secure an appointment. 

References

Yaras, R. J., O’Neill, N., & Yaish, A. M. (2020). Lateral Collateral Ligament (LCL) Knee Injuries. PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK560847/

Haddad, M. A., Budich, J. M., & Eckenrode, B. J. (2016). CONSERVATIVE MANAGEMENT OF AN ISOLATED GRADE III LATERAL COLLATERAL LIGAMENT INJURY IN AN ADOLESCENT MULTI-SPORT ATHLETE: A CASE REPORT. International journal of sports physical therapy11(4), 596–606.

Nusia, J., Xu, J. C., Knälmann, J., Sjöblom, R., & Kleiven, S. (2023). Injury risk functions for the four primary knee ligaments. Frontiers in bioengineering and biotechnology11, 1228922. https://doi.org/10.3389/fbioe.2023.1228922