LCL Sprain Rehabilitation

Lateral knee ligament sprain LCL rehabilitation exercise

Here we outline an LCL sprain rehabilitation program for grade 1, 2 and 3 lateral knee ligament sprains. This will vary from patient to patient depending on a number of factors including the grade or severity of the injury.

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The following example is for information purposes only. We recommend seeking professional advice before attempting any rehabilitation.

Aims of rehabilitation

The aims of lateral ligament injury rehabilitation are:

  • To reduce pain and swelling.
  • Restore full mobility to the knee.
  • Improve strength and stability with a gradual return to normal training.

Below are examples of lateral ligament rehab programs for grade 1, grade 2 and grade 3 ligament injuries:


Grade 1 LCL sprain rehabilitation

Phase one: Immediately following injury

  • Duration: 1-7 days.
  • Aims: Reduce pain and swelling (if any), and ensure your knee can be fully straightened and bent to 90 degrees.
  • Stop play or competition immediately.
  • Apply ice or cold therapy, as soon as possible following injury to reduce pain and any swelling. a compression bandage can also be worn all the time to reduce swelling.
  • A doctor may prescribe NSAID’s (Non-Steroidal Anti-Inflammatory Drugs) e.g. Ibuprofen. Do not take Ibuprofen if you have asthma.
  • As soon as possible providing there is no pain, try to walk normally without a brace or support.
  • Start gentle stretching for the hamstrings and quadriceps, providing there is no pain. Flexion and extension exercises are a good place to start.
  • As soon as pain allows begin static/isometric strengthening exercises.
  • Massage may be applied after the first 2 days.
  • Maintain aerobic fitness with cycling.

Phase two: 7-14 days after injury

  • Duration: 2 weeks.
  • Aims to eliminate any swelling completely, regain full range of motion, progress strengthening exercises.
  • Rest from painful activities, however, the athlete should be able to walk normally now.
  • Apply cold therapy and compression 3 times a day for 15 minutes, particularly following exercise or rehabilitation exercises.
  • In addition include half squats, step-ups, hip raises and hip strengthening exercises and single-leg calf raises.
  • Cross friction massage to the ligament can be applied on alternate days.
  • Maintain aerobic fitness with cycling, stepping machine, and gentle jogging although no sudden changes of direction allowed.

Phase three: 2-4 weeks after injury

  • Duration: 2 weeks.
  • Aims to maintain a full range of motion, equal strength of both legs, return to running and some sports specific training.
  • Continue with stretching exercises daily and sports massage techniques every 3 days. Build on dynamic strengthening exercises such as leg extension and leg curls exercises as well as squats to horizontal.
  • Increase the intensity/weight lifted and a number of repetitions.
  • Aim for between 10 and 20 to failure. In addition to straight running, start to include sideways and backwards running, increasing speed to sprinting and changing direction drills.

Phase 4: After 4 weeks after injury

  • Duration: Ongoing.
  • Aims to return to full sports specific training and competition.
  • Sports massage for surrounding muscles on a weekly basis.
  • Continue with strength training as above but start to include hopping and bounding exercises.
  • You should now be ready to gradually return to full sports specific training and then competition.
  • A knee support or a strapping/taping techniques may provide extra support on return to full training, however, do not become reliant on this. Use initially for confidence building.

Grade 2 LCL sprain rehabilitation

For grade 2 are more severe and require a slower and longer rehabilitation program. The rehabilitation guidelines for a grade 2 lateral ligament sprain can be split into 4 phases:

Phase 1: Immediately following injury

  • Duration: 3 weeks.
  • Aims to reduce pain and swelling, ensure the knee can be fully straightened and bent to 90 degrees.
  • Stop play or competition immediately. Apply cold therapy and compression.
  • Apply ice or cold therapy for 15 minutes every 2 hours for the first 2 days and gradually reduce the frequency to 3 times a day over the next week. Crutches may be needed.
  • Wear a knee brace to support and protect the ligament.
  • Pain-free stretches for the hamstrings, quads and calf muscles in particular.
  • Gentle cross friction massage may be possible from day 3 but allow a week for more severe injuries.
  • As pain allows, static quads and hamstring exercises, double leg calf raises.
  • Maintain aerobic fitness on stationary cycle as soon as pain allows

Phase 2: 3 weeks following injury

  • Duration: 3 weeks.
  • Aims to eliminate swelling, full weight bearing on the injured knee, full range of motion, increase strength in the injured leg.
  • Continue with cold therapy and compression to eliminate swelling, particularly following exercises.
  • Strengthening exercises to include half squats, step-ups, hip raises, hamstring curls and single-leg calf raises.
  • It may be possible to begin to swim although avoid not breaststroke! Or use a stepper for aerobic fitness.

Phase 3: 6 weeks following injury

  • Duration: 4 weeks.
  • Aims to regain full range of motion, strength, and return to light jogging and by week 8.
  • Continue with cold therapy following training sessions and wear a brace or support as required.
  • Cross friction massage can be applied to the ligament 2 to 3 times a week.
  • Strengthening exercises should be continued from phase 2 but increasing intensity and moving double leg exercises to single-leg exercises.
  • After week 8, no sooner, begin to run but no sudden changes of direction though.

Phase 4: 10 weeks following injury

  • Duration: 2 to 4 weeks.
  • Aims to return to full sports specific training and competition without a brace for support, full strength and mobility.
  • Start to add in sideways and backward running drills followed by a change of direction and agility drills.
  • Kicking a ball should now be possible for football (soccer) players.
  • Start to return to training, provided all exercises so far are pain-free.
  • Gradually bring into training more and more sports specific drills, changing direction and plyometric, hopping and bounding exercises

Grade 3 LCL sprain rehabilitation

  • These are generally full ruptures.
  • An injury this severe should require professional treatment, including an X-ray or MRI to rule out associated fractures or damage to other soft tissues such as cartilage.
  • A full tear may require casting or even surgery.
  • Rehabilitation exercises will be the same as for a grade 2 injury once the ligament has healed.
This article has been written with reference to the bibliography.
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