Isolated LCL (Lateral Collateral Ligament) Injury
Lateral collateral ligament injury typically occurs with a force to the inner aspect of the knee causing the knee to bend outward and resulting in a tear of the lateral ligament. LCL injuries are very common injury seen in soccer, basketball and football.
Anterior view of the knee
Athletes will typically have swelling over the outside (lateral) aspect of the knee. There will also be tenderness to the touch over the lateral aspect of the knee. On examination, if the knee is pushed from the inner surface towards the outside, it can replicate the pain by stretching the LCL (varus stress test). The LCL ligament is located outside of the joint therefore should not result in dramatic fluid on the knee. If there is fluid on the entire knee (effusion), one should be concerned with other injuries, such as ACL or meniscal injury. A keen medical provider should be able to determine the diagnosis based on the mechanism of injury and physical exam. However, an MRI can be ordered to confirm the presence of a tear or exclude the presence of other injuries.
In general, isolated LCL injuries can be treated without surgery and will improve with time and proper rehabilitation. Usually the athlete is placed in a functional hinged knee brace (photo below), which will allow flexion and extension of the knee but limit side to side movement.
Return To PLay
A mild LCL strain (Grade 1) may only need 1 or 2 weeks recovery, up to about 4 weeks. A Grade 2, partial tear, typically will recover in 4 to 6 weeks. A Grade 3, complete tear, can take upwards of 8 to 10 weeks. Rarely, if the knee is very unstable, Grade 3 tears could require surgical intervention. An isolated LCL injury may have a greater impact on an athlete that has a greater need for side to side motions, as well as cutting, pivoting or change of direction.
Functional Hinged Knee Brace