Strengthening exercises for a lateral ligament sprain can begin almost immediately after injury.
Static quads contractions
This exercise may be started as soon as pain will allow and can be done on a daily basis. It may even be possible to continue with this exercise if the athlete is in a plaster cast. Contract the quadriceps muscles at the front of the thigh. Hold for 10 seconds. Relax and rest for 3 seconds. Repeat 10 to 20 times. You can also perform this exercise with a rolled up towel or foam roller under the knee as shown. Contraction will cause the foot to lift off the floor as the knee straightens.
Stand with feet shoulder width apart and close to something to hold on to for balance. Lift your heels up as high as possible off the floor. In the early stages this exercise must be done with both legs at the same time. Slowly lower back to the floor. Aim for 2-3 sets of 15-20 repetitions. Later this exercise can be progressed by moving to single leg calf raises.
Isometric hamstring contractions
This exercise will maintain some of the strength in the hamstring muscles. The hamstrings are contracted against the resistance of a partner, held, then relax before repeating. Aim for 10 to 20 repetitions. The exercise should then be repeated for varying amounts of flexion or bend in the knee.
The quad muscles are responsible for straightening the knee. This exercise can be performed using no weight, ankle weights, a resistance machine or resistance band. Start with no weight and then progress to either ankle weights or a resistance band. Straighten the knee then slowly return to the start position. Start with 2 sets of 10 reps and gradually increase to 3 sets of 15 gradually increasing the weight or resistance when comfortable to do so.
Seated hamstring curl
This is a deceptively difficult exercise which works the hamstring muscles specifically in a very contracted close range of movement.One end of a resistance band is tied to a fixed point or held by a partner and the other end secured to the foot. The athlete pulls the heel into the buttocks contracting the hamstring muscle to do so. Aim for 3 sets of 8 reps to begin building up to 3 sets of 12 or 15.
The athlete lies on their back, knees bent and pushes the hips upwards to work the gluteual miuscles and hamstrings. Use both feet on the floor pushing up to begin with. Hold the position briefly and then lower. Begin with 3 sets of 8 reps building to 3 sets of 12 reps then progress the exercise to single leg bridges.
Single leg bridges are done in the same way ensuring you squeeze the gluteal muscles and aim to maintain a straight line from the shoulder on the ground to the knee at the top point of the exercise. Again, begin with 3 x 8 reps and build up.
Stand with the feet just wider than shoulder width and back straight. Squat down half way to horizontal or about 45 degrees and return to standing. Aim for 3 sets of 10 to 20 repetitions during rehabilitation. Progress this exercise by adding weight, increasing the depth of the squat to 90 degrees or near horizontal thighs or moving to single leg squats.
Lunges are a slightly easier version of a squat and are sometimes called split squats. Start with a wide stance. Bend the back knee towards the floor, but don't let it touch. Keep your back upright throughout and don't let the front knee move forwards past the toes. Start with 2 sets of 10 reps with the injured leg in front and then do 2 sets of 10 with the injured leg behind. Gradually increase to 3 sets of 15. To make it harder, you can add either a dumbbell in each hand of a barbell over the shoulders.
Balance board exercises
Wobble boards are most commonly used in the rehabilitation of ankle injuries such as ankle sprains, although they should also be used for other lower leg and knee injuries. They can also be used for upper limb injuries, especially the shoulder. This is important in people involved in throwing or similar activities.
Plyometrics or plyometric exercises are a form of strengthening exercise, incorporating jumping, bounding and hopping movements, which works to increase power in the muscles. Power is used in the vast majority of all sports and so plyometrics can be used to help develop this for most athletes.