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Knee Braces and Supports for LCL (Lateral Collateral Ligament) Injuries

Knee Braces and Supports for LCL (Lateral Collateral Ligament) Injuries

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Injury Information and Rehab

Introduction

The knee can be thought of as a major junction in our musculoskeletal system. Three bones meet at the knee: your thigh bone, shin bone and kneecap. They’re all held together with the equivalent of straps - the four knee ligaments. Inside the knee, there are two cruciate ligaments in the shape of the letter X. Then there is the ligament we’re going to look at here: the lateral collateral ligament (LCL). There are two of these, both running the length of the knee - one on the inner leg side of the knee and one on the outer leg side.

Ligaments have to be sturdy because they hold the knee together, even when you’re twisting and turning while taking part in a strenuous sports session. When you need to stand or sit, they also have to keep the knee stable, so they are tough bands of connective tissue strapping the knee together. That’s why you may find braces useful if you have an injury. They replicate the strapping and stability functions of the natural knee while allowing some movement.

Torn Lateral Collateral Ligament

Who gets an LCL injury?

Figures for how many people suffer from lateral collateral ligament injuries in a year aren’t readily available, partly because those with mild problems don’t seek out medical help. The NHS estimates that each year, 10,000 people in the UK have cartilage damage that is troubling enough to take them to the doctor. However, anecdotal evidence from sports injury clinics and physiotherapists suggests that knee injuries in general are extremely common.

Accidental damage to the lateral collateral ligament is more common in people under 35 because they are more likely to be playing sports. One Yorkshire NHS hospital says that LCL injury is less common than some other knee injuries and that they are more often linked to a significant trauma to the knee or force being applied to the inside of the thigh or knee. It’s clear that contact sports such as football or rugby, where players can get kicked during tackles, are prime candidates for picking up LCL injuries caused by trauma - in this case, the force of the kick.

Symptoms and degrees of LCL injury

Damage to the LCL is graded into three levels:

  • First degree: The ligament is mildly stretched but not to the point where it has become loose.
  • Second degree: The ligament is partly ruptured.
  • Third degree: The ligament is completely torn and there is instability in the joint as a result.

The options available for treating the injury will depend on the degree of the injury and other factors such as your age and occupation.

First degree injuries - mild damage

The knee will be tender when pressed, especially on the outer side, and it may be swollen. You will have trouble standing on it.

Some people with mild damage decide to give the PRICE treatment a go before they seek professional assistance:

  • Protection: Use a support or brace to protect the area from further injury, and don’t attempt to return to your usual sports until you are completely healed.
  • Rest: The body is amazing at healing itself provided you let it do the job. Be sure to rest, do less than usual, and use a walking stick - a Nordic pole can work well - if you find it painful to put weight on the joint.
  • Ice: This can help to reduce the inflammation and bring swelling down whilst providing some mild anaesthesia. Be careful to wrap the ice in a towel rather than applying it directly to your bare knee. You don’t want an ice burn on top of your LCL injury.
  • Compression: This is the use of bandages, braces or other aids to limit the swelling. There is a wide range of these, so you should be able to find one that suits your daily activities.
  • Elevation: You can also help reduce swelling in the knee by lying on the sofa or a bed and raising the knee above the level of your heart.

Pain relief can help, especially at night when turning over in bed may cause additional pain. Paracetamol is safe for most people, but don’t exceed the stated dose in any 24 hours. Tablets containing ibuprofen have an anti-inflammatory effect whilst reducing pain, so they’re a good choice for this type of injury. There are now also a number of creams and gels on the market that are specifically aimed at this type of injury. The pharmacist at your local chemist will be able to point you towards the most suitable one for you and offer advice on how long you should continue to use it.

Some doctors suggest that in addition to the PRICE regimen, you use a lightweight brace that will allow your knee to make backwards and forwards movements but not side-to-side ones. If that works, you can see the physiotherapist for advice on exercises to help rehabilitate the knee.

Second degree LCL injury - more serious with partial rupture

The symptoms may include those for the first-degree injuries, such as pain and swelling, but with more intensity and affecting the inner side of the knee. The knee is noticeably loose when you move it by hand because the strapping that the ligament would normally provide is damaged.

Treatment will depend on the extent of the injury. In this case, you must seek professional help. It can be difficult for doctors to find out the precise extent of the damage because the swelling and the patient’s pain may make it difficult to examine the knee. If they suspect a serious injury, they may wish to carry out further investigations such as an MRI scan or X-ray.

With these kinds of injuries, the force that produced them may also have damaged other structures in the knee, such as the anterior cruciate ligament and this can also complicate diagnosis.

Third degree injuries - ruptured LCL

You will experience marked tenderness and pain on the inner side of your knee. There will be swelling, and the knee joint will not be stable. If you remember the three bones mentioned at the start of this piece, the LCL may have been torn at the point where it meets the thighbone or at the other end where it connects with the shinbone.

The surgical procedure for an LCL injury that has resulted in rupture will involve reattaching the LCL to the bone it has come away from. However, sometimes the tear is in the middle of the LCL; in other words, it has been torn into two pieces. In these cases, the surgery will involve stitching the torn ends together again.

In the worst cases, a repair may not be possible. The surgeon may have to take some tendon from another part of your body or use donor tissue to construct a replacement, which is a more complex procedure.

Some of these procedures can be carried out as keyhole surgery. It depends on the complexity and specific features of your injury. Open knee surgery may be necessary in more complex cases.

Getting back to normal

How long it takes to get back to normal will depend on the grade of your injury and whether you have had surgery. Rehabilitation can take anywhere from one to eight weeks or even longer if you have a very complicated full rupture and other accompanying damage.

Making full use of braces, splints and walking aids may help your rehabilitation, as will exercises prescribed by a physiotherapist. Just be careful not to overstress the ligament, and don’t return to sporting activity until you’ve regained full fitness.

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