Lateral Collateral Ligament Injuries
Following on from last week’s blog on medial collateral ligament injuries, in today’s post we are going to take a closer look at the ligament on the outside of the knee, the Lateral Collateral Ligament or LCL.
The LCL is a thin band of tissue running along the outside of the knee. It connects the femur to the fibula, which is the small bone of the lower leg that runs down the side of the knee and composes the outside of the ankle.
Like the medial collateral ligament (MCL), the LCL’s main function is to keep the knee stable by reducing lateral or varus movement of the knee.
Because the knee joint relies on the ligaments and surrounding muscles for stability, it can be injured easily. Any direct contact to the knee or hard muscle contraction — such as changing direction rapidly while running — can cause injury to knee ligaments.
Due to the more complex anatomy of the outside of the knee, if you injure your LCL, you usually injure other structures in the joint, as well.
LCL injuries usually arise in one of two different ways:
1. A direct blow to the medial (or inner) aspect of the knee that creates a distraction or stretching force on the lateral (outer) structures in the knee.
2. Hyperextension of the ligament due to sudden changes in movement.
LCL injuries are common among athletes who play sports like football or hockey, in which players collide with each other. It can also happen during fast-paced sports like netball, soccer or basketball, in which players make sharp, sudden turns or stops.
All Injuries to ligaments are considered "sprains" and include some tearing to the ligament fibres. They are graded on a severity scale as follows:
Grade 1: The ligament is mildly damaged resulting in mild pain. It has been slightly stretched but is still able to help keep the knee joint stable.
Grade 2: The ligament has been stretched to the point that it partially tears and becomes loose, resulting in moderate pain and moderate to severe instability.
Grade 3: The ligament has been stretched to the point of complete rupture or tearing into two separate pieces (pic above). This type of injury is initially very painful which then quickly subsides giving way to severe instability.
Symptoms of an injured LCL include a combination of the following:
· An acute feeling of sharp pain on the outside of the knee when changing direction
· A feeling that the knee may give way under stress and isn't stable
· A locking or catching in the joint when it is moved
· Numbness or weakness in the foot may occur if the peroneal nerve, which is near the ligament is stretched during the injury or is pressed by swelling in surrounding tissues
· Pain that can be mild or acute
· Swelling and tenderness along the outside of the knee
Diagnosis of LCL damage should be conducted by a Physiotherapist and will involve the history of the injury, palpation of the area for tenderness, obvious swelling and in some cases, you may need to have an MRI to conclusively rule in or out a tear and to what degree.
Treatment for an LCL injury will be determined on the basis of the severity of the sprain. LCL tears are less frequent and harder to heal than MCL tears however successful rehabilitation without the need for surgical intervention is high. In some cases, all that is required is managing the pain, rest, and wearing a brace that allows your knee to move backward and forward but restricts side-to-side movement.
This is usually worn for 72 hours. Depending on how well your pain and swelling reduces, you may be able to start a rehabilitative program within a few days. When the pain and swelling have gone down, you should be able to start exercises to restore strength and range of motion to your knee.
It may take up to eight weeks to fully recover, depending on the grade of your injury. Grade 3 sprains may require surgery if they don’t respond to conservative therapy, which will result in a lengthened recovery time.
It’s difficult to prevent knee ligament injuries because they’re often the result of an accident or unforeseen circumstance. However, several preventive measures can help minimize the risk of a knee ligament injury, including:
1. Using correct technique and alignment when performing physical activities, including walking
2. Stretching regularly to maintain good range of motion in the body
3. Strengthening the muscles of the upper and lower legs to help stabilize the joint
4. Using caution, including protective equipment, when playing sports where knee injuries are common, such as soccer and football
So that’s a brief overview of how lateral collateral ligaments can occur and how to avoid it. If you have questions or comments feel free to e-mail us at firstname.lastname@example.org and we will happily answer them for you.