Collateral Ligament Injuries

   Knee is the largest joint in your body. Knee ligaments connect your thighbone to the lower leg bones. Knee ligament sprains or tears are a common sports injury. Normally, sportsmen participating in football or soccer are more likely to injure their collateral ligaments.

   Knee joint is formed by three bones- femur (thighbone), shinbone (tibia) and kneecap (patella). Your kneecap sits in front of the joint to provide some protection. Bones are connected to other bones by ligaments. Ligaments act like strong ropes and hold the bones together. It keeps your knee stable. There are four primary ligaments in your knee.

Cruciate Ligaments:

   This controls the back and forth motion of the knee. Cruciate ligaments arebfound inside the knee joint and cross each other to form an “X”. The anterior cruciate ligament is in front and the posterior cruciate ligament in the back.

Collateral Ligaments:

   The collateral ligaments control the sideways motion of the knee and brace it against unusual movement. These are found on the sides of your knee. The medial collateral ligament (MCL) or inside collateral ligament connects the femur to the tibia. The lateral collateral ligament (LCL) or outside collateral ligament connects the femur to the smaller bone in the lower leg (fibula).

How do we classify a ligament injury?

   The knee joint depend highly on ligaments and surrounding muscles for stability and as a result can easily get injured. Any direct contact to the knee or hard muscle contraction like changing direction rapidly while running can injure a knee ligament.

   An injured ligament is considered as “sprain” and depending on the severity of injury, the injuries are graded.

  • Grade 1: If the damage is mild, it is a Grade 1 Sprain. The ligament may be slightly stretched, but is still helping the knee remain stable.
  • Grade 2: If the sprain stretches the ligament to the point where it becomes loose, it’s a Grade 2 sprain. This is also been called a partial tear of the ligament.
  • Grade 3: This condition is the complete tear of the ligament. In this condition, the ligament has been completely torn into two pieces. The knee joint becomes fully unstable. The MCL is injured more often than LCL due to the complex anatomy of the knee.


  • If there is an MCL injury, the pain is on the inside of the knee and if it is on the outside of the knee, it is an LCL injury.
  • Swelling over the site of the injury.
  • It also creates instability (feeling that your knee is giving way).

   While doing the physical examination, doctors will check the structures of the injured knee, and compare them with the non-injured knee. A thorough physical examination would help the doctors to diagnose most of the ligament injuries.

   To confirm your diagnosis, doctors would use:-

   X-rays. X-rays can show whether the injury is associated with a broken bone. However it will not show any injury to your collateral ligaments.

   MRI Scan. This study creates better images of soft tissues and identifies any injury to the ligaments.


   Grade 1 and 2 injuries are usually treated conservatively while grade 3 LCL/MCL needs surgical intervention.

Surgical Treatment:

   Most isolated collateral ligament injuries can be successfully treated without surgery. If the collateral ligament is torn in such a way that it cannot heal or is associated with other ligament injuries, your doctor may suggest surgery to repair it.

Non-surgical Treatment:

   Ice.Icing is important in the healing process. Crushed ice can directly be applied to the injured area for 15 to 20 minutes at a time. At least 1hour gap is needed between the icing sessions.

   Bracing. You have to change your daily activities to avoid risky movements. Normally, doctors recommend a brace to protect the injured ligament from stress. It must be protected from the same sideways. You may be given crutches to keep you from putting weight on your leg.

   Physical therapy. Doctors may suggest strengthening exercises. Specific exercises will restore function to your knee and strengthen the leg muscles that support it.

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