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LCL sprain? Eight LCL exercises to regain your former strength

Updated: Feb 15

Detailed LCL (lateral collateral ligament) exercise descriptions with recommended sets and reps, as well as video demos, to help you recover from your LCL sprain. Also, what you need to avoid doing to prevent further injury to your LCL. Remember, if you need more help with an injury, you're welcome to consult one of our physios online via video call.


Exercises for LCL sprains, strains and tears.

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In this article:


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Basic LCL exercise principles

 

Your LCL is on the outer side of your knee, and its main job is to stop your knee from gapping on the outside.


Knee anatomy

When it's injured, some of its fibres are torn. If you want it to recover, you've got to:

  1. Remove that gapping strain for a little bit so that the fibres can grow together again,

  2. and then you want to strengthen those new fibres as well as the supporting muscles.

 

The eight LCL exercises below are arranged more or less from early rehab to later rehab, and they aim to achieve the following:

  • Restore the range of motion in your knee, so that it can bend and straighten fully.

  • Regain control of your leg by improving your balance and strengthening the muscles (mainly your core and glutes) that keep your leg stable.

  • Strengthen the muscles that support your knee and lighten the load on your LCL.



1. Leg slides

 

A good first exercise is simply bending and straightening your knee.



Aim: Improve range of motion and feed the joint



Instructions:

  1. If you have been prescribed a knee brace, do this exercise with the brace on. For a serious LCL sprain, your brace will have been set for the first part of your rehab so that you can’t bend or straighten your knee beyond a certain range.

  2. Sit on a flat surface with your legs in front of you. Your uninjured leg can be straight or bent, whichever is more comfortable.

  3. Slowly bend and straighten your injured leg.

  4. Depending on the grade of your LCL sprain, it may be painful to straighten your knee fully at this stage. Only go as far as it is comfortable; don’t bend and/or straighten your knee into a painful position.

  5. Once you can get your leg fully straight, you can also then start tensing your quad muscles to help you get that last bit of range of motion. This starts to get your quad muscles activated. You want to hold that for about 10 seconds before you relax it, but only if it's comfortable.

 

Dosage:

  • 10 to 20 reps

  • 1 set

  • 2 to 3 times per day

 

💡Top tips:

  • Sit on a bed or a couch – it will be kinder to your injured knee than having to lower yourself down to the floor.

  • It can be useful to have one hand free to help your leg if you find it difficult to move it on its own.

  • Especially at the start, the first few times can be really uncomfortable, and then, as it warms up, it gets easier.

 

2. Crunches


Crunch exercise works well for LCL injuries because it doesn't place any force through your knee.

Aim: Improve core strength. A strong core helps improve your control and movement patterns.



Instructions:

  • Lie on your back, feet on the floor, with your uninjured leg bent about 90 degrees.

  • If your injured leg is happy to be in same position, good. If not, have it in any position that’s comfortable.

  • Tighten your stomach muscles and press your lower back into the floor.

  • Place your hands behind your ears – just for a bit of support, not to pull your head up.

  • Curl up by first lifting  your head and looking at your toes. Then lift your shoulders and upper back off the floor. Your lower back must remain flat and in contact with the floor.

  • Hold this for a second, and then reverse the position slowly, lowering first your upper back, then your neck, and lastly your head.

  • Keep your stomach muscles contracted as you lower down; don’t just plonk down onto the floor.

 

Dosage:

  • 12 to 15 reps

  • 3 sets

  • 2 to 3 times per week

  • At least one rest day between sessions

 

💡Top tips:

  • Don’t strain to do the full recommended sets and reps in the first session; start with what you can manage and then gradually build it up.

  • On the other hand, if you find the exercise too easy right from the word go, you can make it harder by placing a weight on your chest.



3. Russian twists


The Russian twist exercise targets your oblique muscles.

Aim: The Russian twist targets especially the oblique muscles (the muscles either side of your “six pack”) of your core.



Instructions:

  1. Sit on the floor with your uninjured leg bent and your injured one in whatever position is comfortable – you can put something like a rolled-up exercise mat under your knee for support if needed.

  2. Tighten your stomach muscles and lean slightly backwards so that your back is about 60 degrees to the floor.

  3. Place your hands on their opposite shoulders.

  4. Slowly twist your upper body to the left as far as it will comfortably go, come back to the centre, and then the same to the right – that is two reps.

 

Dosage:

  • 12 to 16 reps

  • 3 sets

  • 2 to 3 times per week

  • At least one rest day between sessions

 

💡Top tip: If you find this too easy at the recommended sets and reps, take a weight and touch it to the floor as you twist.

 

4. Glute bridges


The basic glute bridge exercise.

 

Aim: Glute, hamstring, back, and core strength.



Instructions:

  1. Lie on your back, feet flat on the floor, knees bent.

  2. If your injured knee is not happy to bend all the way, you just have it straighter, to where it's comfortable, and place most of your weight through the other leg as you do the exercise.

  3. Tighten your stomach muscles, tighten your glutes, and squeeze your bum to push your hips upwards until your stomach and the front of your thighs are more or less in a straight line. If you go further than this, it means that you are overusing your back muscles, which is wrong. Another sign that you’ve gone too far up is if your neck hurts.

  4. Hold the position for about a second, and come back down slowly.

 

Dosage:

  • 12 to 15 reps

  • 3 sets

  • 2 to 3 times per week

  • At least one rest day between sessions

 

💡Top tips:

  • If your hips are not flexible enough to straighten all the way, place something under your feet – this will give your glutes a bigger range of motion to work through.

  • And of course, if it's too easy, you can place a weight over your hips, or later on you can start doing it on one leg.



5. Balance exercises

 

As soon as your leg is happy to be fully straight and you can place your weight on it, it's time to start with balance exercises.


These are important because when we injure a knee, the connection between it and your brain gets a little bit scrambled; so, you're not as good at controlling it as usual. We need to reteach that control so that the LCL doesn't take too much strain.


You should only start balancing exercises once your LCL has recovered enough that you can get your knee straight.

Aim: Improve control



Instructions:

  1. Hold on to something solid at the beginning, for two reasons. First, you may not trust your injured leg and may worry that you may re-injure it, so holding on will help you overcome that fear. And secondly, you don’t want excessive side-to-side movement of the knee, which may actually re-injure it.

  2. Stand on both feet with the support that you hold on to opposite to your injured side.

  3. Stand up tall, tighten your stomach muscles, and bend your knees slightly.

  4. Slowly shift your weight to your injured side, slowly lift your foot on the uninjured side off the floor, and hold the position.

  5. Concentrate all the time on what you feel on your injured side and what corrections you have to do to maintain your balance.

  6. If you’re happy with your balance, let go of your hold a little. If you’re stable enough to let go altogether, great! But if you start to feel wobbly, rather hold on and wait for your strength and control to improve over time before letting go.

 

Dosage:

  • Hold for 10 to 30 seconds

  • 2 to 3 reps

  • Once a day

 

💡Top tips:

  • Keep your foot stable. You want equal pressure on the big toe side and the little toe side of your balancing foot. You don’t want it rolling in our out excessively.

  • If/when you find the exercise too easy, you can make it harder by moving your head side-to-side or up-and-down, or by moving your arms.

  • Even harder is closing your eyes, but first get the go-ahead from your physio that you’re stable enough, because it can be quite tricky.

 

6. Calf raises

 

Another important muscle group to start strengthening is the calves, because the gastrocnemius (the big one of the two) comes up behind the knee and attaches above it. So, in addition to propelling you forward when you walk or run, it helps to stabilise the knee joint.

 

Usually, you can start doing the calf raises quite early on – as soon as you're allowed to weight-bear and you're comfortable weight bearing.


Double leg calf raises strengthen your calf muscles and improve the stability around the back of your knee.

Aim: Strengthen the calf muscles and improve stability in the outer back corner of the knee.



Instructions:

  1. This is not a balancing exercise, so you have to hold onto something for stability.

  2. Stand with your feet hip distance apart.

  3. Go up onto your toes, and then slowly lower yourself down in a controlled way.

  4. Check that your feet move in a straight line, with equal pressure under the big and little toes, so that your feet don’t end up turning outwards or inwards, especially when you get to the top.

 

Dosage:

  • 12 to 15 reps

  • 3 sets

  • 2 to 3 times per week

  • At least one rest day between sessions

 

💡Top tips:

  • If/when you find the double-leg calf raises too easy at the recommended sets and reps, rather add some weight (carry it in a backpack) and continue with the double-leg exercises, than switch over to single leg.

  • Please do these exercises in running shoes. Doing them barefoot on a hard surface can cause an injury to the balls of your feet – one that is much harder to get rid of than an LCL sprain!

 

7. Double-leg box squats

 

Squats are very good for exercising the muscles we use for running and walking, and for simulating those motions. It strengthens your quads, which are important for stabilising your legs and knees, taking strain off your LCL, and it also works your glutes and hamstrings.


Box squats stops you squatting too low.

Aims:

  • Strengthen quads, glutes, and hamstrings

  • Teach running and walking movement patterns



Instructions:

  1. We’re using box squats, because the box prevents you from squatting down lower than you should at any given stage, either because your knee doesn’t want to bend that far yet or because you have an LCL knee brace that allows only a certain range of motion.

  2. If you don’t have access to a gym box, use something else, e.g. a chair with cushions piled on to the desired height. The idea is not to put all your weight on the box (or cushions), it is just there as a reference point to tell you where to stop.

  3. Stand in front of the box (or chair) with your feet about hip distance apart. It doesn’t matter if your feet don’t point straight forward, but your knees must stay in line with the middle of your feet during the whole squat movement.

  4. Stick your arms out in front of you for balance.

  5. Then, slowly squat down, sticking your bum out to the back as far as possible (this works the glutes better).

  6. Touch the box gently with your bum and come back up slowly.

 

Dosage:

  • 12 to 15 reps

  • 3 sets

  • 2 to 3 times per week

  • At least one rest day between sessions

 

💡Top tip: If/when the recommended sets and reps are too easy, rather start adding some weight and continue with this exercise on two legs than going straight on to single-leg squats.

 

8. Single-leg mini-squats with band

 

What single-leg squats bring to the party that double-leg ones don’t is that they help to teach you good balance and leg control in addition to the strength training. But it is good to strengthen up properly with the double-leg squats before moving on to single ones in the later stages of your rehab.

 

By doing squat with an exercise band around your legs, it trains your glute med muscle to stabilise and control your leg better


The mini-squat exercise teaches you good balance and control after an LCL sprain.

Aims:

  • Strengthen quads, glutes, and hamstrings

  • Improve balance and leg control



Instructions:

  1. Stand with your feet together and tie the exercise band around your thighs – start with an easy tension.

  2. Go into a shallow double-leg squat and move your feet about hip distance apart.

  3. The band will try and pull your knees in, don’t let it. Turn your knees out against the resistance so they remain pointing in line with your feet..

  4. Shift your weight over to one leg, lift the other leg off the floor.

  5. Straighten the leg you’re standing on while maintaining the tension on the exercise band. And then go slowly back down into a mini-squat – that is one rep.

  6. The knee of your squatting leg must stay in line with your foot.

  7. When you’re done with the reps for one leg, rest at least a minute before switching to the other leg, because the latter has also worked to keep the tension on the exercise band. If you switch legs too quickly, the leg that must now do the squatting will be too tired and you won’t have good form. Rather go for quality than rushing to get all the reps in.

 

Dosage:

  • 10 reps

  • 3 sets each leg

  • 2 to 3 times per week

  • At least one rest day between sessions

 

💡Top tips:

  • Make sure the exercise band doesn’t press on the injured part of your knee, and have it flat rather than scrunched up, so that it doesn’t dig into your leg.

  • If you struggle to balance, it’s OK to have a finger on something stable until your balance is better.


⚠️Exercises to avoid

 

You want to avoid any exercise that causes a gapping force on the outside of the knee.


Examples  include:

  • The classic glute strengthening exercise of side leg lifts. If your LCL is injured and you do a side leg lift, gravity will pull your leg down, and that will create the gapping force on the outside of your knee that injured your ligament in the first place.

  • Side planks with your legs extended.


It is best to avoid these exercises when you have a new LCL sprain.

👉These exercises are absolutely fine to do once your ligament has recovered, and they may even help it regain the final strength it need. The key lies in introducing them at the correct time in your rehab.

 

Further reading

 

LCL sprains – the bigger picture

If you want to understand better how LCL sprains happen, what the recovery times will be, and how you can assess it or understand whether this is what you've injured, I've written a detailed article about that: Lateral collateral ligament (LCL) tears or sprains – Symptoms, treatment, recovery times.

 

LCL braces

Not all LCL sprains need a knee brace. Learn which LCL injuries require a brace, which type of knee brace is best and when to wear it, and which types of brace to avoid: Knee braces for lateral collateral ligament (LCL) injuries – What works best.


Examples available on Amazon:


How we can help


Need more help with your injury? You’re welcome to consult one of the team at SIP online via video call for an assessment of your injury and a tailored treatment plan.

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Maryke Louw

About the Author

Maryke Louw is a chartered physiotherapist with more than 20 years' experience and a Master’s Degree in Sports Injury Management. Follow her on LinkedIn and ResearchGate.


References


  1. Bushnell, B. D., et al. (2010). "Treatment of magnetic resonance imaging-documented isolated grade III lateral collateral ligament injuries in National Football League athletes." The American Journal of Sports Medicine 38(1): 86-91.

  2. Davenport, D., et al. (2018). "Non-operative management of an isolated lateral collateral ligament injury in an adolescent patient and review of the literature." BMJ Case Reports 2018: bcr-2017-223478.

  3. Petrillo, S., et al. (2017). "Management of combined injuries of the posterior cruciate ligament and posterolateral corner of the knee: a systematic review." British Medical Bulletin 123(1): 47-57.

  4. Ramos, L. A., et al. (2019). "Treatment and outcomes of lateral collateral ligament injury associated with anterior and posterior cruciate ligament injury at 2-year follow-up." Journal of Orthopaedics 16(6): 489-492.

  5. Sikka, R. S., et al. (2015). "Isolated fibular collateral ligament injuries in athletes." Sports Medicine and Arthroscopy Review 23(1): 17-21.

  6. Yaras, R. J., et al. (2022). "Lateral collateral ligament knee injuries.” StatPearls Publishing.


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