Here we outline some rehabilitation exercises for a lateral knee ligament sprain (LCL sprain). Strengthening exercises can begin almost immediately the initial acute period has passed, as long as you avoid any sideways (lateral) stress on the knee.
Strengthening exercises can also begin as soon as pain allows. The further you can get with strengthening exercises prior to surgery then the more likely you are to have a faster recovery post-operation.
Isometric quadriceps exercise
- Contract the quadriceps muscles and hold for 5 to 10 seconds.
- Relax for about 3 seconds and repeat 10 to 20 times.
- It is especially important you feel the vastus medialis muscle on the inside of the knee working when doing this exercise.
- Place the fingers on the muscle towards the inside of the leg above the knee (vastus medialis oblique (VMO) muscle).
- It is important that this muscle is developed and this one should be felt contracting whilst performing the exercises.
Isometric quads in standing
As above but performed in the standing position. This exercise is performed from phase 3 onwards of the post-surgery rehabilitation program. These exercises should be performed on a daily basis.
Static/isometric hamstring contractions
- Lie on your front in the prone position.
- The partner or therapist provides resistance as the athlete contracts the hamstring muscles, hold for 3 or 4 seconds then relaxes.
- The angle of knee flexion is changed and the exercise repeated.
- Once a range of angles have been worked the whole process is repeated with the foot first turned first inwards then outwards.
- This exercise targets the inner and outer hamstring muscles at varying angles of flexion or knee bend.
- This exercise will strengthen the calf muscles which consist of the gastrocnemius and soleus muscles.
- Rise up and down on the toes in a smooth movement.
- You should be able to progress quite quickly with this one but aim for 3 sets of 10 and build up steadily, a few each day.
- This exercise can be progressed later in the rehabilitation process by doing single leg calf raises and then single leg calf raises without leaning against a wall or holding onto anything.
- You can also perform these on a step as shown in the video, allowing the heel to drop down past the level of the step.
- This exercise works the buttock muscles and hamstrings.
- Stand with the band around one ankle and attached to a fixed point in front. Use something to hold onto if you need to.
- Keeping the leg straight extend the hip as far as comfortable and return to the start position. Keep the hips square on facing forwards and perform the exercise in a slow and controlled manner.
- You should feel it working the buttock muscles.
- This can also be done without a band on all fours lifting the leg up behind.
Hamstring curls with band
- Lying on your front with the foot pointing down over the edge of the couch, the athlete fully bends the knee.
- Provided this is pain-free, a resistance band or ankle weight can be used to increase difficulty.
- Squat down to about a quarter of the way down and return to the starting position. Aim for 3 sets of 10 to 20 repetitions.
- Progress this by going down to halfway (Phase 3 of rehabilitation) and then full squats (to horizontal) in the sports-specific stages. Increase the intensity by adding weight.
- Ensure stomach muscles are kept firm when performing squats.
- Standing one leg in front of the other as shown.
- Bend the front leg to lean forwards and return to standing.
- Aim for 3 sets of 10 to 20 repetitions.
- Increase intensity by adding weight.
- Ensure stomach muscles are kept firm when performing this exercise.
- Step up and down on a bench about 9 inches high.
- Step up with the recovering leg and step down with the same leg.
- Change round and do the same number of repetitions on the noninjured leg.
- The bridge exercise can be used for glute and hamstring strengthening after injuries to the hip or knee.
- Lay on the floor on your back.
- Bend your knees and place your feet flat on the floor, halfway towards your buttocks.
- Lift the hips and thighs off the floor to form a straight line between your knees and shoulders.
LCL sprain proprioception exercises
Proprioception is similar to balance but means the awareness of where your body (or body part) is in space. These exercises help in controlling the movement of the limb and preventing re-injury.
- The athlete begins by standing on the injured leg only for 30 seconds.
- Once this is accomplished the athlete closes their eyes to increase the difficulty.
- The next step is to balance on an unstable surface such as a trampette, wobble cushion or half foam roller.
Functional exercises for LCL sprain
Plyometric exercises involve dynamic and sometimes explosive movements. They bridge the gap between basic LCL sprain strengthening exercises and returning to full training and eventually competition.
Resistance band jump
- A resistance band is wrapped around the waist and anchored or held behind the athlete.
- They then perform side to side or forward and backward jumps.
- The resistance from the band provides a challenge to the balance.
- The exercise can be made more difficult by increasing the thickness of the band or aiming to hop or jump further.
Hopping exercises for LCL sprain
- Many variations on hopping exercises are available. Start with a small hop on the spot and gradually increase the height jumped.
- Try hopping to the front, to the side and backwards.
- Try hopping from one leg and landing on the other.
- Equipment such as hoops, agility ladders, and minim hurdles can all be used to add further challenge.
- Start standing on a small step.
- Take one leg backwards, touch the foot on the floor and push off with the forefoot to move it back onto the step.
- Alternate legs.
- This can be increased in difficulty by performing on a higher step or at a faster speed.
- Numerous exercises can be created using a box or step to jump over.
- To start the athlete may jump sideways over the box, moving rapidly from one foot on one side, to the other foot on the other side. This may also be performed front to back.
- A further progression is high jumps over the box, firstly landing on two feet and progressing to one.
Sports specific drills
- Practice drills that are used in training for your particular sport.
- Start off doing them slowly and under control. Gradually pick up the pace and competition level until you’re back to full training mode.
- Here is an example of a sports-specific drill which involves reacting, accelerating and changing direction.
- For more examples of agility drills visit teachpe.com.