A basic rehabilitation program for a lateral knee ligament sprain. This will vary from patient to patient depending on a number of factors including the grade or severity of the injury.
On this page:
- Grade 1 LCL sprain
- Grade 2 LCL sprain
- Grade 3 LCL sprain
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 rehab program
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 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
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
- 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.