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LCL Sprain

causes, symptoms, treatments, and Other Resources

What is the LCL?

To understand what an LCL sprain is, it important to get an understanding of the anatomy of the knee.

Your knee consists of three bones: your thighbone (femur), your kneecap (patella), and your shinbone (tibia).

The joints in the body are held together by ligaments. There are two types of knee ligaments:

  • Collateral ligaments surround your knee on all sides. The inner medial collateral ligament (MCL) joins your femur and tibia. The outer, lateral collateral ligament (your LCL) connects the femur and fibula. You can bend and extend your knee thanks to these ligaments. 
  • Your cruciate ligaments are located within the knee joint. They cross each other (the anterior cruciate ligament (ACL) is in the front and the posterior cruciate ligament (PCL) is in the back) and form an “X.” These ligaments regulate your knee’s backward and forward movements.

What is an LCL Sprain?

A strain or tear to the lateral collateral ligament (LCL) is known as an LCL injury. The LCL is a band of tissue that runs along the outer side of your knee. It aids in keeping the bones together while you walk, ensuring that your knee joint remains stable.

How you feel and what type of treatment you’ll require depends on how severely your LCL has been stretched or torn. If it’s only a minor sprain, self-care at home might help. However, if it’s a significant tear or sprain, you may need physical therapy, an injection-based procedure, or surgery.

Orthopedists categorize LCL sprain into 3 grades:

Grade 1 Sprain

A partial-thickness MCL sprain is where only a portion of the LCL is torn.  On ultrasound or MRI, a portion of the MCL would be torn but the remaining fibers would be normal. 

Grade 2 Tears

A grade 2 LCL tear involves a tear that extends across the entire LCL and therefore is referred to as a full-thickness tear.  The ligament has not pulled apart or snapped back upon itself and therefore is referred to as non-retracted. These types of tears can be treated with ultrasound-guided PRP or bone marrow concentrate.

Grade 3 Tears

A grade 3 tear is a full-thickness tear that extends across the LCL and, unlike a Grade 2, the ligament has pulled apart. This means that the two pieces of the ligament have pulled apart or maybe even snapped back like a rubber band.  This type of tear requires surgery.

What Causes LCL Sprains?

An LCL sprain is caused by the following occurrences:

  • A blow to the inside of the knee. The impact of the hit can stretch or tear the ligament along the outside edge of the knee. It’s prevalent among athletes who participate in sports such as football and hockey, in which players collide with one another.
  • Shifting directions quickly or pivoting on one foot are examples of this. Soccer and basketball players may make sharp, sudden turns or stops, which can induce LCL damage. When wrestlers’ legs twist outward in a quick motion while they’re on the mat, it’s possible that their LCL have been damaged.
  • Landing badly or awkwardly from a jump. You can sprain your LCL during a basketball or volleyball game, skiing, or slipping on ice.

Symptoms:

Fibular Head Pain

The proximal fibula is the part of the bone that lives just below the knee joint on the outside. It’s attached to the leg bone (tibia) via strong ligaments and there is a small joint here. There are many things that attach here, so it’s a critical point where pain can occur. There is a small joint between the fibula and the tibia known as the proximal tibiofibular joint. This is a plane-type joint which allows some sliding of the fibula on the tibia. It has cartilage just like the knee joint, so it can get arthritis which means worn down cartilage and bone spurs.

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Knee Buckling

Knees can buckle, causing a sensation of one or both knees giving out that affects nearly 17% of adults. The knees are regarded to be one of the most essential (and biggest) joints in the human body because they play significant roles in basic activities such as walking and sitting. When our knees begin to feel unstable, weak, or begin giving out, it is easy to become stressed since we rely so heavily on them for movement. The knee can become stable from numerous types of injuries. The knee is kept stable by the following structures: Tendons attach the leg muscles…

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Knee Hurts When I Bend It and Straighten It

Your knees bend countless times throughout the day. Running up the stairs, down the hall after kids, and getting into the car. You straighten the knee as you walk, descend stairs or get into and out of the car. Bending and straightening the knee are necessary for daily activities. Knee pain with bending or straightening may be a mild, transient irritation or may indicate a more significant problem. Learn more below and avoid further injury and dysfunction. Knee pain can vary significantly depending upon many factors including the actual source of the pain, the severity of the injury, general health, and level of activity…

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Knee Pain

Knee pain can be caused by many factors. Overuse injuries, direct trauma to the knee and arthritis are the most common causes of knee pain. Damage to the knee structures may cause swelling, scar tissue formation (fibrosis), and loss of function of the joint. Pain is often accompanied by difficulty walking, weakness, and instability. When the knee is overused, the thigh and shin bones (femur and tibia), cartilage, or tendons may experience stress. This leads to pain and discomfort as well as stiffness in the knee. Overuse injuries are common among athletes who participate in sports that involve running, jumping…

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Knee Popping

Knee popping can be a sensation that something is moving around in the knee. There may also be an audible sound associated with the popping, which in medical terms is called crepitus. This can also cause what we call mechanical catching or locking, which may make the knee feel like it is stuck in an extended or flexed position, and you have to move it in certain ways to get out of that. This knee popping sensation or sound or could be a very simple issue or it could be a sign that more serious damage is going on in the knee, so determining what is causing it is very important. So, the knees may pop and get in a certain position….

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Knee Swelling

Swelling of the knee, also known as water on the knee, is a condition in which fluid collects around the knee joint. Swelling can occur for a variety of reasons and affect patients of any age. Some swelling can be treated with over-the-counter medicines, but persistent and continuous swelling might result in tissue damage, bone softening, and cartilage deterioration. Over-the-counter medicines will assist relieve pain for individuals with a history of osteoarthritis and swelling following physical activity, such as exercise or running. During and after activity, the patient may apply compression sleeves to reduce the inflammation. Ice is another method…

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Loose Knee Joint

Ligaments are fibrous bands that connect the bones together. If the ligaments inside your knee become damaged, your knee could feel loose (with or without pain). While walking, exercising, or simply standing, it may feel like your knee could collapse at any moment. If the knee muscles are damaged, they will be unable to contract properly, resulting in lack of strength and discomfort. Swelling might have a similar result. What Causes Laxity in the Knee Joint? Knee injuries are generally sports-related, although they may occur during any physical activity that puts stress on the knee and causes bending or trauma…

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Outside Knee Pain

What causes outside knee pain? How do you treat it? Let us go over all of this and also review how one patient avoided a huge surgery. What is On the Outside of the Knee? You have a couple of key structures here (1). They include the: Lateral meniscus, Lateral joint compartment, Popliteus tendon, Iliotibial band, Lateral collateral ligament , and anterolateral ligament, and Fibula. The meniscus is a figure-8 shaped fibrous structure (shown here from above) that is a shock absorber for the knee joint. It has an outside part (lateral meniscus) that cushions the joint. The meniscus can become torn or degenerated. If you are young…

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Tightness in Knee

What could tightness in your knee mean? When fluid builds up inside the knee as a result of an injury, overuse, or medical problem, the knees become swollen and tight. Swelling might be mild, so you may not always notice it unless it is serious damage. You may feel this as stiffness in the knee since swelling may not be visible. Swelling restricts movement since there is less room in the knee. Fluid buildup can be caused by irritation, internal bleeding, and injuries to the knee. Arthritis, gout, tumors, and baker cysts are all causes of swelling. Pain and swelling are the responses of your body to damage. Together they can lead to stiffness in your knee…

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Weak in Knees

Weakness in the knee can be a symptom of many different knee conditions. Some of the most common causes of weakness in the knee include ligament tears, meniscus tears, and arthritis. Another important but often overlooked cause of knee weakness is irritation or injury of the nerves in the low back. If you are experiencing any type of weakness in your knee for long durations of time (3 weeks), it is important to see a doctor to determine the cause. Some of the most common symptoms of knee weakness include difficulty standing up from a seated position, difficulty walking, climbing or descending stairs…

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Treatment Options for LCL Sprain

Treatment options for LCL Sprain include:

  • Physical Therapy
  • Rest, Ice, Compression, Elevation (RICE)
  • NSAIDS (ibuprofen, motrin, naproxen, etc.)
  • Cortisone injection
  • PRP injections

Physical Therapy

Physical therapy can consist of many different options to decrease pain and increase range of motion at the knee. Bracing may also be suggested by a physical therapist in order to support the knee during activities that cause pain so that you do not have to worry about the pain as much. Physical Therapy is beneficial for lcl injuries because it decreases swelling and helps strengthen muscles around the knee so they can stabilize it more efficiently.

Surgery

There are different types of surgery that can be done for LCL tears. The most common type of surgery is arthroscopic repair. This surgery is done through a small incision and a tiny camera is inserted into the knee joint to view the tear. The camera will help the surgeon see what needs to be repaired and then they will fix it with small instruments. Other types of surgery that can be done for LCL tears include:

  • LCL reconstruction
  • Open repair
  • Arthrodesis

An LCL reconstruction is a more extensive surgery and requires the surgeon to use a graft. This type of surgery can be done through an open incision or arthroscopically. If it is done through an open incision, the entire knee will need to be opened and if it’s done arthroscopically then it will be similar to an arthroscopic repair. Arthrodesis is the permanent fixation of the knee which would require cutting out the ligament and fusing two bones together thus creating one completely rigid structure.

Knee Ligament Surgery

Knee ligament surgeries have become quite common, ACL (anterior cruciate ligament) surgeries average 250,000+ surgeries alone every year! These invasive surgeries have come under investigation in recent years, wondering the necessity, or need to be done. Your knee has 3 points of contact or compartments that house the cartilage of your knee: the patella-femoral compartment, lateral (outside) compartment, medial (inside) compartment. These compartments are held together by a network of ligaments that hold each bone together and allow the knee to move properly. The main knee ligament surgery…

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NSAIDs

The other day I was evaluating a patient and reviewing the treatment options for their spine condition.  After discussing prior treatments, we got to the topic of medications taken for pain relief. She explained that she mainly utilized anti-inflammatory (NSAID) medications and then she told me to hold much she takes and has been for many years…..she takes close to 2 grams (2000 milligrams) on a daily basis which equated to about 9-10 capsules of medication per day.  I was shocked, considering she was pre-diabetic and with high blood pressure plus the kicker of it is that her PCP (primary care physician) is ok with this…

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PRP Knee Injections

PRP stands for Platelet-Rich Plasma. Platelets are blood cells that prevent bleeding. They contain important growth factors that aid in healing. Plasma is the light yellow liquid portion of our blood. So PRP is simply a concentration of a patient’s own platelets that are suspended in plasma and are used to accelerate healing. PRP is NOT stem cell therapy. Regrettably, blood contains few circulating stem cells. Rich sources of stem cells are bone marrow and fat. PRP is rich in growth factors. There are many different types of growth factors with different properties. VEGF is a very important one as it can increase the blood flow to an area.

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Nonsurgical Treatment Options for LCL Sprains

Nonsurgical treatment options for LCL sprains include rest, ice, compression and elevation (RICE), and NSAIDS, cortisone shots, prolotherapy, and PRP. If the injury is less than two weeks old, then RICE may be all that is needed to allow the ligament time to heal. NSAIDS can help reduce inflammation and pain. If the injury is more than two weeks old, then a cortisone injection may be recommended. However, at the Centeno-Schultz Clinic, we recommend skipping the cortisone shot due to its inhibitory effects to stem cells and growth factors around the injury by using PRP (1).

Doctors That Assist with LCL Sprains

Christopher J. Centeno, MD

Christopher J. Centeno, M.D. is an international expert and specialist in Interventional Orthopedics and the clinical use of bone marrow concentrate in orthopedics. He is board-certified in physical medicine and rehabilitation with a subspecialty of pain medicine through The American Board of Physical Medicine and Rehabilitation. Dr. Centeno is one of the few physicians in the world with extensive experience in the culture expansion of and clinical use of adult bone marrow concentrate to treat orthopedic injuries. His clinic incorporates a variety of revolutionary pain management techniques to bring its broad patient base relief and results. Dr. Centeno treats patients from all over the US who…

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John Schultz, MD

My passion and specialization are in the evaluation and treatment of cervical disc, facet, ligament and nerve pain, including the non-surgical treatment of Craniocervical instability (CCI). I quit a successful career in anesthesia and traditional pain management to pursue and advance the use of PRP and bone marrow concentrate for common orthopedic conditions. I have been a patient with severe pain and know firsthand the limitations of traditional orthopedic surgery. I am a co-founder of the Centeno-Schultz Clinic which was established in 2005. Being active is a central part of my life as I enjoy time skiing, biking, hiking, sailing with my family and 9 grandchildren.

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John Pitts, M.D.

Dr. Pitts is originally from Chicago, IL but is a medical graduate of Vanderbilt School of Medicine in Nashville, TN. After Vanderbilt, he completed a residency in Physical Medicine and Rehabilitation (PM&R) at Emory University in Atlanta, GA. The focus of PM&R is the restoration of function and quality of life. In residency, he gained much experience in musculoskeletal medicine, rehabilitation, spine, and sports medicine along with some regenerative medicine. He also gained significant experience in fluoroscopically guided spinal procedures and peripheral injections. However, Dr. Pitts wanted to broaden his skills and treatment options beyond the current typical standards of care.

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Jason Markle, D.O.

Post-residency, Dr. Markle was selected to the Interventional Orthopedic Fellowship program at the Centeno-Schultz Clinic. During his fellowship, he gained significant experience in the new field of Interventional Orthopedics and regenerative medicine, honing his skills in advanced injection techniques into the spine and joints treating patients with autologous, bone marrow concentrate and platelet solutions. Dr. Markle then accepted a full-time attending physician position at the Centeno-Schultz Clinic, where he both treats patients and trains Interventional Orthopedics fellows. Dr. Markle is an active member of the Interventional Orthopedic Foundation and serves as a course instructor, where he trains physicians from around the world.

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Matthew William Hyzy, D.O.

Doctor Hyzy is Board Certified in Physical Medicine and Rehabilitation (Physiatry) and fellowship-trained in Interventional Orthopedics and Spine. Dr. Hyzy is also clinical faculty at the University of Colorado School of Medicine in the Department of Physical Medicine and Rehabilitation; In addition, Dr. Hyzy is an Adjunct Clinical Assistant Professor at The Rocky Vista University College of Osteopathic Medicine. Dr. Hyzy also maintains an active hospital-based practice at Swedish Medical Center and Sky Ridge Medical Center. He is also recognized and qualified as an expert physician witness for medical-legal cases and Life Care Planning. He is published in the use of autologous solutions including…

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Brandon T. Money, D.O., M.S.

Dr. Money is an Indiana native who now proudly calls Colorado home. He attended medical school at Kansas City University and then returned to Indiana to complete a Physical Medicine and Rehabilitation residency program at Indiana University, where he was trained on non-surgical methods to improve health and function as well as rehabilitative care following trauma, stroke, spinal cord injury, brain injury, etc. Dr. Money has been following the ideology behind Centeno-Schultz Clinic and Regenexx since he was in medical school, as he believed there had to be a better way to care for patients than the status quo. The human body has incredible healing capabilities…

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Mairin Jerome, MD

Mairin Jerome, MD

Dr. Mairin Jerome is a physiatrist with subspecialty fellowship training in Interventional Orthopedics and Regenerative Medicine. This subspecialty serves to fill the gap for patients who are interested in therapeutic options that lie between conservative treatment and surgery. Dr. Jerome uses regenerative medicine techniques, including prolotherapy and orthobiologics, via X-ray or ultrasound guidance to precisely deliver injections to areas of musculoskeletal injury or degeneration. Orthobiologics refers to tissue harvested typically from a person’s own body, such as platelets (platelet-rich plasma, PRP) or bone marrow, for use in treating painful musculoskeletal conditions. The goal is to stimulate the body’s healing mechanisms to improve pain, function, and decrease inflammation.

Read more

Other Resources

Free Download: The Knee Owner’s Manual

This e-book by Dr. Chris Centeno examines the knee and its role in the human musculoskeletal system and the body as a whole. The Knee Owner’s Manual provides a series of tests and clearly defined exercises that you can perform on your own to assess and monitor your own knee health. It will allow you to look for trouble spots where your own body may be having difficulty with stability, articulation, symmetry, and neuromuscular function. You’ll be able to see how these deficits in other regions of the body relate to the knee.

The Knee Owner’s Manual also discusses how Regenexx is pioneering the development of interventional orthopedics, a new branch of medicine that employs regenerative biologic therapies such as adult bone marrow concentrate and platelet-rich plasma to help repair and strengthen damaged tissues in other areas of the body.

This is contrasted with invasive knee surgeries, which often remove important tissues or replace the entire knee itself when it becomes damaged. With hyperlinks to more detailed information, related studies, and commentary, this book condenses a vast amount of data, images, and resources into an enjoyable and informative read. This is the first edition of The Knee Owner’s Manual, a companion book to Orthopedics 2.0.

  • How to Avoid Knee Replacement: A Quickstart Guide

    Your knee pain initially was intermittent and mild.  Unfortunately, It is now constant and debilitating.  Your doctor recommends knee replacement surgery. What is the knee composed of?  What are the most common knee injuries?  What is knee replacement surgery? What are the different types of knee replacements?  What is knee replacement surgery success? What are … Continued


  • 7 Most Common Symptoms of a Loose Knee Replacement

    Walking became impossible.  Each step was associated with severe pain.  Knee replacement seemed like a good solution.  Unfortunately, months after the surgery problems exist.  Your doctor thinks you have a loose knee replacement.  What is a knee replacement?  What causes a knee replacement to become loose?  What are the 7 most common symptoms of a … Continued


  • How Likely Is a Second ACL Tear On the Same Knee?

    Anterior Cruciate Ligament Injuries and Treatments The ACL (anterior cruciate ligament) is an important knee stabilizing ligament. It prevents the tibia from moving too much frontward (anterior translation) and twisting too much (internal rotation).  It is under most stress with landing from a jump, or a planted foot with twisting, and this is how it … Continued


  • Regenexx ACL Repair vs Reconstruction Surgery for Knee ACL

    Regenexx ACL Repair vs Reconstruction Surgery for Knee ACL Today I’d like to highlight a patient named Joe’s story.  Joe is unique in that he has had the non-surgical Regenexx Perc-ACLR procedure which uses your own cells injected via a small needle, and a surgical ACL reconstruction, so he can compare the two. So let’s … Continued


  • ACL Tear Treatment Without Surgery: The Truth You Need to Know!

    The Anterior Cruciate Ligament (ACL) is a key stabilizer in the knee that is frequently injured. Dr. Schultz discusses what an ACL is, the major causes of tears, symptoms associated with a tear, what ACL surgery is, its risk, and effective ACL tear treatment without surgery. He shares a recent clinical success with a 14y/o soccer player who avoided ACL surgery by using her own stem cells at the Centeno-Schultz Clinic.


  • 14 Disadvantages of Knee Replacement Surgery

    Every step is a reminder of your knee pain.  Physical therapy and steroid injections did not help.  Your doctor is referring you for surgery.  What is knee replacement surgery?  What are the disadvantages of knee replacement surgery? What is the success rate of knee replacement surgery?  What are the alternatives to knee replacement surgery?  Let’s … Continued


References:

  1. Shahid M, Kundra R. Platelet-rich plasma (PRP) for knee disordersEFORT Open Rev. 2017;2(1):28-34. Published 2017 Mar 13. doi:10.1302/2058-5241.2.160004

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