Collateral Ligament Injury

Collateral Ligament Injury

Ligaments are like strong ropes that help connect bones together and provide stability to joints. In the knee, there are four main ligaments. On the inner (medial) aspect of the knee is the medial collateral ligament (MCL) and on the outer (lateral) aspect of the the lateral collateral ligament (LCL). The other two main ligaments are found in the centre of the knee. These paired ligaments are called the anterior cruciate ligament (ACL) and the posterior cruciate ligament (PCL). They are called cruciate ligaments because the ACL “crosses” in front of the PCL.


Trauma to the ligaments holding the knee can be caused by different things. However the most common causes of knee ligament injuries are.

Twisting injury to the medial collateral ligament (as happens in a skiing accident).

Deceleration injury. Often seen in football where the studs effectively “stop the lower leg” whilst the rest of the body continues its original path of motion.

Trauma. Seen in contact sports where contact with another player causes heavy forces on or around the knee causing medial collateral ligament damage.

The medial collateral ligament is usually injured by a “blow” to the outer side of the leg (valgus force). A “blow” to the inner side of the leg (varus force) may injure the Lateral collateral ligament. Medial collateral ligament injuries are far more common than lateral collateral ligament injuries injuries


At the time of the injury there is often immediate pain and sometimes swelling can occur. A “pop” or “snap” may be felt or heard and the knee may feel “unstable” during certain movements.

Tears of the MCL or LCL may be mild (grade I), moderate (grade II) or severe (grade III). MCL and LCL injuries differ from anterior cruciate (ACL) and posterior cruciate (PCL) injuries in that mild to moderate tears have the ability to heal following injury.

Injuries to other structures inside the knee can occur when either the MCL or LCL are injured. The cartilage (menisci) inside the knee can be injured as can the ACL or PCL (the cruciate ligaments). Injuries to other structures are more likely if there was a significant force or if there was a rotational component at the time of injury. A bone injury or fracture can occur, particularly, in young growing athletes.

Examination techniques that detect side to side (valgus-varus) looseness in the knee are effective in detecting collateral ligament tears. Tests that detect forward-backward (anterior-posterior) or rotational looseness can help detect other ligament injuries. X-rays are often done at the time of injury to make sure the bones of the knee are not broken. Tests such as Magnetic Resonance Images (MRI) are rarely required for collateral ligament injuries but are occasionally used to rule out other injuries to the knee.



Remember, many patello-femoral problems  occur at contact phase of gait (when the foot hits the ground) due to increased biomechanical stress at this point. It is therefore vital to improve your biomechanics with orthotics designed for you chosen sport.

Golden rule- Don’t ignore the problem, it won’t go away!

The way we function biomechanically is predominantly controlled by genetics, its hereditary (runs in the family). The way you function is set and cannot be cured.

What you can do however is control lower limb biomechanics by altering foot position during the contact phase of gait. This can only be done by wearing a good shoe (see our shoe guide) and with orthotics  (foot beds). This is the cheapest and most cost effective way for any athlete to reduce the risks of injury from occurring and from helping to prevent re-injury. Overall costs for the average athlete will run into pennies per mile/hour of sport.

Orthotic are designed to alter the biomechanics during the time the foot is on the ground. They are also used to provide increased shock absorbency working in harmony with the sport shoe worn.

Consider purchasing a knee brace . This device provides extra stability to the knee when playing sports. The material also causes localised vasodilation (opening of the blood vessels) increasing circulation to the area. This is vital as all ligaments have a notoriously poor blood supply. Increasing circulation to the ligaments can reduce the chance of injury. Have a look at the knee brace information page in our online store.

Wobble boards- Designed to improve proprioception these devices used as per the manufacturers instructions will improve the connection between the brain and the nerve fibres in the leg.

*please see terms & conditions

Check your running shoes, are they worn, how long have you had them? Trainers used for running are designed to last at most about 750 miles. If you think you have done more mileage then replace them with a new pair. Read the running shoe page to get practical advice on running shoes.

Returning to Activity

The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your activity is determined by how soon your knee recovers, not by how many days or weeks it has been since your injury occurred.

You may safely return to your sport or activity when, starting from the top of the list and progressing to the end, each of the following is true:

You have full range of motion in the injured leg compared to the uninjured leg.

You have full strength of the injured leg compared to the uninjured leg.

You can jog straight ahead without pain or limping.

You can sprint straight ahead without pain or limping.

You can do 45-degree cuts, first at half-speed, then at full-speed.

You can do 20-yard figures-of-eight, first at half-speed, then at full-speed.

You can do 90-degree cuts, first at half-speed, then at full-speed.

You can do 10-yard figures-of-eight, first at half-speed, then at full-speed.

You can jump on both legs without pain and you can jump on the injured leg without pain.