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The Lateral Collateral Ligament (LCL) is located on the outside of the knee, linking the shin bone to the thigh. It effectively offers stability and stops your knee from moving too far outwards.
Injury to this ligament can occur where the knee is exposed to additional force, such as during some sporting activities, or if the knee is twisted in a fall or similar accident. Medically, ligament injuries are referred to as sprains and vary in their severity, with three different grades:
First degree: A small number of fibres within the ligament are damaged.
Second degree: Although still intact, a greater number of ligament fibres are damaged.
Third degree: The ligament is completely ruptured.
Following the initial injury your doctor or clinician may perform a varus stress test to help diagnose the problem.
Following a first degree sprain you experience swelling and area on the outside of the knee joint may painful to touch. Mobility may also be compromised, especially where stability of the knee joint is required such as getting in or out of a chair.
Where a second degree sprain has been diagnosed the ligament itself will be torn and as a result will be painful and stability will be compromised. As this is a more severe injury recovery times will be longer.
A grade three rupture of the ligament is the most severe diagnosis with stability of the knee joint fully compromised which can affect your ability to remain mobile given there is nothing stopping your knee from moving outwards. It is worth noting however that a complete rupture of the LCL is not typically seen as being as serious as an ACL rupture given the latter is located at the front of the knee and is the main ligament responsible for stability.
Following any suspected injury it is important to stop what you are doing and rest. Pushing through the pain can be a good thing in the gym but when you're injured it can do more harm than good. If you suffer a grade one injury and continue running then you are increasing the risk of causing further damage which could lead to a grade two or three injury and a longer spell on the sidelines.
It is very difficult to self-diagnosis an LCL injury without a scan as it can be difficult to pinpoint the ligament at fault. You will know when you have suffered a serious injury, in which case you should seek medical attention for a professional diagnosis.
Following a minor injury you should adopt the RICE approach in rest, ice, compression and elevation.
Protection: A support should be worn to protect the limb from further injury.
Rest: A period of rest for 48-72 hours. Rest is essential, allowing your body time to repair itself and heal naturally.
Ice: Applying ice for about 20 minute, every two to three hours in the initial days can help cool the tissues, reduce pain and limit swelling. Ice should be wrapped in a towel and never placed directly against the skin.
Compression: Swelling and pain can be limited using a cohesive bandage on the knee. Compression is often best applied through the use of a sports brace and also offers relieving qualities.
Elevation: Keep the knee elevated where possible. Elevating the affected area above the level of the heart can also work to control swelling by slowing down the flow of blood to the injured area.
Sporting activities will need to be avoided for about three weeks following a first degree sprain whilst you undertake a period of strengthening exercises. Those who have suffered a second degree sprain will require a longer period of recovery, usually between six and eight weeks. Often it will be necessary for a physiotherapist to oversee rehabilitation to prevent further knee ligament damage when returning to normal activities.
Third degree lateral collateral ligament sprains may need to be surgically repaired and as such recovery time can be much longer.
Bracing can also be used as part of your overall recovery, though the brace you select will depend on the grade of injury incurred. For minor injuries a soft support can be used, ensuring you select one with straps which act as external ligaments to offer additional stability when active. Following a grade three tear and surgery you may first be placed in a range of motion brace which restricts your movement and ensures you don't cause any damage post surgery. After this initial period you may consider wearing a rigid brace, especially for extreme sports, which offers stability and protects the knee joint against impact, perfect if you were to come off your bike.
Those who have previously suffered knee ligament damage are at an increased risk of a recurrence. During your retrun to full fitness a soft knee support can be used in conjunction with physiotherapy and strenghening exercises with the aim of removing the support as it is not intended to be used long term. Improving proprioception is also useful which can be achieved via the use of a Wobble Board.
For extreme sports such as skiing, mountain biking, wakeboardng etc this is where prevention is better than cure. In motocross a rigid knee brace is part of the standard equipment, almost as important as a helmet in protecting the knee from impact damage and serious damage.