LCL Tears

What are LCL tears?

A lateral collateral ligament (LCL) tear is a knee injury that causes pain, swelling and bruising. Your LCL is a band of tissue located on the outside of your knee (the side that faces away from your body). This tissue connects your lower leg bones to your thigh bone. It stops your knee from bending outward abnormally.

Athletes in sports like football, soccer and skiing are at higher risk for LCL tears, which can prevent you from competing. However, with time, treatment and rehabilitation, you should be able to play some sports again.

How does the knee usually work?

Three bones make up your knee joint:

• Your thighbone (femur).
• Your kneecap (patella).
• Your shinbone (tibia).

Ligaments hold the bones together. There are two types:

• Collateral ligaments: These ligaments are on the sides of your knee. The medial (inside) ligament connects your femur and tibia. The lateral (outside) collateral ligament (your LCL) connects the femur and fibula. Thanks to these ligaments, you can move your knee sideways.
• Cruciate ligaments: Your cruciate ligaments are inside your knee joint. They cross each other (the anterior cruciate ligament is in the front and the posterior cruciate ligament is in the back) and they form an “X.” These ligaments control the way your knee moves back and forth.

Who do LCL tears affect?

Anyone who makes stop-and-go movements or does a lot of twisting or bending could also tear an LCL. For example, football players who get hit in the knee, basketball players who jump, and soccer players with quick direction changes are at a higher risk.

How common are LCL tears?

It’s unclear what percentage of individuals tear an LCL. However, your risk is higher if you have had a previous LCL tear. An LCL tear is rarely an isolated injury. You’re likely to have an ACL tear or other knee problem at the same time as an LCL tear.

What causes LCL tears?

LCL tears typically happen when you’re playing a sport that involves:

• Bending.
• Hard contact.
• Quick changes of direction.
• Twisting.
• Jumping.
• Weaving.
• Stop-and-go movements.

The riskiest sports for LCL tears include:

• Football.
• Skiing.
• Soccer.

What are the symptoms of LCL tears?

The symptoms of an LCL tear include:

• Pain.
• Swelling.
• Tenderness.
• Bruising.
• An unstable feeling. Your knee might feel like it’s about to give out or buckle or lock up.

You might find that the sensation of being unstable on your feet continues after you’re walking again. While not unusual, it’s a good idea to tell your healthcare provider about it. Such instability can feel a little scary since you might fear injuring yourself again.

How are LCL tears diagnosed?

When you see your healthcare provider (which you should do as soon can), they’ll ask you questions about your injury and look at your knee. They’ll check for the following:

• Tenderness.
• Swelling.
• How your knee moves.
• How your leg moves.
• Other injuries.

Your healthcare provider might order tests, including:

• X-ray.
• MRI.
• Ultrasound.

What questions might a healthcare provider ask to diagnose a knee injury?

Your healthcare provider will ask you several questions as they assess your knee injury. Questions might include:

• What are your symptoms?
• How long have you had these symptoms?
• How did you injure your knee?
• Can you put any weight on your leg?
• What medications do you take?

How are LCL tears treated?

Healthcare providers categorize knee injuries in three grades:

• Grade 1: Knee injuries are mild. Your LCL is not completely torn. You should heal with only at-home treatment, including the use of crutches. Your healthcare provider might also have you wear a hinged knee brace when you’re allowed to put some weight on your knee. You’ll likely feel better after about three to four weeks.
• Grade 2: Knee injuries are considered moderate. You have a partial tear in your LCL. For a grade 2 injury, you’ll need to use crutches and then a hinged knee brace. Recovery will take about eight to 12 weeks.
• Grade 3: Knee injuries are severe. Your LCL is separated or torn completely and may take eight to 12 weeks to heal. You’ll use a hinged brace for several months. Your healthcare provider might recommend surgery.

You might need surgery if your injury is severe. Typically, providers consider a knee injury to be severe if you tear the LCL and another part of your knee, including your:

• Anterior cruciate ligament (ACL).
• Meniscus.

You may also need to go to physiotherapy (physical therapy). Physiotherapy will help you:

• Strengthen your muscles.
• Increase your range of motion.
• Learn exercises you can do at home.

Severe injuries require open surgery. Your surgeon will:

• Stitch up your torn LCL.
• Reattach the LCL to your bones.
• Reconstruct your ligament using other tendons or ligaments.

Your healthcare provider might give you the go-ahead to return to your sports activities once you can walk without limping. First, you’ll have to go through what’s called functional progression. You’ll start with simple, gentle exercises and stretches, then move to moderate ones and eventually return to your normal activities. Be sure to check with your healthcare provider before starting a regimen of stretches and exercise.

Healing from an LCL tear can take time. It can be hard to be patient, but you can’t rush the process.

Are there any at-home treatments for LCL tears?

Yes, there are some things you can do at home to help your injured LCL heal:

• Rest your knee.
• Apply ice. Put an ice pack or cold pack on your knee for about 10-20 minutes. Repeat this every one to two hours for the first three days. Make sure you have some sort of cloth between the ice and your skin.
• Compress your knee by wrapping it with an elastic bandage.
• Prop your knee up (elevate it) on a pillow to reduce swelling. Try to keep it above your heart.
• Take anti-inflammatory medications (NSAIDs) such as ibuprofen (Motrin® and Advil®) and naproxen (Aleve®).
• Limit how much weight you put on your leg.
• Use crutches and wear your brace as instructed.
• Perform very gentle stretches and range-of-motion exercises as instructed by your healthcare provider.

How long does it take to recover from LCL tears?

Recovery time depends on the grade (severity) of your LCL tear.

• Grade 1 (mild): Three to four weeks.
• Grade 2 (moderate): Eights to 12 weeks.
• Grade 3 (severe): Eight to 12 weeks.

Do LCL tears heal on their own?

With time and at-home treatments, your LCL tear might heal on its own. But, your healthcare provider can evaluate the severity of your injury to determine the best treatment plan. If you resume your activities without seeing your healthcare provider, you risk further injury.

How can I reduce my risk of LCL tears?

Although you can’t prevent a knee injury like an LCL tear, there are some steps you can take to reduce your risk:

• Support your ligaments by wearing a knee brace when you’re playing sports.
• Make sure your knees are correctly aligned when you play sports. Ask your healthcare provider about how to keep your knee aligned during play.
• Stretch before practices or games.
• Do conditioning exercises to improve your strength and flexibility.

Take care of your knees. It might feel time-consuming to do extra exercises and stretches, but it’s worth it to keep your knees healthy.

What are the complications of a lateral collateral ligament (LCL) tear?

Like most injuries, LCL tears can come with complications. Report any of the following to your healthcare provider:

• A feeling of instability in the knee joint.
• A pop, or feeling of collapse or “giving out” of the knee.
• Numbness, tingling or weakness in your knee or lower leg.
• Stiffness.
• If you notice crunching or grinding in the knee joint.

Can LCL tears come back after they heal?

Yes, it’s possible to tear the same lateral collateral ligament again. In fact, you’re at a higher risk of an LCL tear if you’ve had one before. As a result, you might want to take extra precautions to reduce your risk, including stretching and wearing a knee brace.

Will LCL tears affect how I walk?

For a while, you’ll have to use crutches or a knee brace. Your healthcare provider will tell you how long you need to wait before putting weight on your knee. You’ll be back to walking normally after your LCL tear heals.

When should I go to the emergency department?

Immediately go to your emergency department if you have symptoms of a blood clot in your lung (pulmonary embolism), such as:

• Trouble breathing.
• Sudden chest pain.
• Coughing up blood.

You should also immediately see a healthcare provider if you have the symptoms of any type of blood clot, including:

• Pain in your thigh, groin or knee.
• Swelling or redness in your groin or leg.

Also, see a healthcare provider at your emergency department right away if you have the following symptoms:

• Increased pain.
• Your foot changes color or becomes cool or pale.
• Numbness, tingling or weakness in your toes.
• Inability to move your toes.

Keep a careful eye on your symptoms. You might feel tempted to “wait and see” if the symptoms get better, but it’s better not to hesitate. Instead, inform your healthcare provider or go to the emergency department.

What questions should I ask my healthcare provider about LCL tears?

Consider asking the following questions when you see your healthcare provider:

• What grade is my LCL tear?
• What’s the best treatment for me?
• How long should I use crutches?
• How long should I wear a brace?
• How soon can I return to sports?
• Do I need physical therapy?
• What dosage of NSAIDs should I take?
• Do I need surgery?
• What exercises or stretches are safe?

A note from Cleveland Clinic

LCL (lateral collateral ligament) tears can bench athletes for three to 12 weeks, or even longer. Although you may be anxious to return to play, it’s important to see your healthcare provider for a complete evaluation if you tear your LCL. With treatment, rest and rehabilitation, you’ll heal and reduce your risk of re-injury. Talk to your healthcare provider about additional ways to protect your knees.