MCL, LCL & Knee Ligament Injuries: Physiotherapy Assessment, Rehabilitation & Return to Activity
Knee ligament injuries, including medial collateral ligament (MCL) and lateral collateral ligament (LCL) sprains, are common in sports and accidents. At Fit2Function Allied Health, our physiotherapists provide evidence-based assessment, rehabilitation, and return-to-sport programs for ligament injuries to restore stability, strength, and confidence in your knee.
This page explains what these ligament injuries are, common causes, early management, when imaging is required, non-surgical and surgical options, and rehabilitation phases.
What are MCL & LCL injuries?
MCL (Medial Collateral Ligament)
The MCL runs along the inner side of the knee and stabilises against valgus (inward) forces. MCL injuries commonly occur with:
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A blow to the outer side of the knee
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Sudden twisting or pivoting
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Sports collisions
LCL (Lateral Collateral Ligament)
The LCL runs along the outer side of the knee and stabilises against varus (outward) forces. LCL injuries are less common and may occur with:
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Direct impact to the inner side of the knee
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Hyperextension or twisting injuries
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High-energy sports or accidents
Other ligaments (e.g., PCL) may be injured in multi-ligament knee trauma, requiring specialised assessment.
Symptoms
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Pain along the inside (MCL) or outside (LCL) of the knee
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Swelling or bruising
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Instability, especially during side-to-side movements
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Difficulty walking or weight-bearing
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In severe cases, associated injuries (ACL, meniscus) may occur
Early Management
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RICE / PEACE principles: Protect, Elevate, Avoid excessive anti-inflammatories, Compress, Educate
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Gradual loading as pain allows
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Early gentle range-of-motion exercises
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Avoid activities that stress the injured ligament
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Bracing may be used in moderate to severe injuries
When urgent referral is needed
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Severe instability or inability to bear weight
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Multi-ligament injury suspicion
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Associated fractures or locked knee
Imaging
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MRI is preferred to confirm ligament injury and assess associated structures (ACL, meniscus, cartilage)
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X-rays primarily rule out fractures or avulsion injuries
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Imaging is often ordered if the injury is severe, not improving, or surgical intervention is considered
Non-Surgical Rehabilitation
Most isolated MCL and LCL injuries are managed conservatively:
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Rest and protection early, then gradual loading
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Strengthening of quadriceps, hamstrings, glutes, and hip muscles
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Balance and proprioception exercises
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Functional and sport-specific training before return to activity
Recovery time varies by grade of injury: 2–8 weeks for mild to moderate sprains, longer for severe injuries.
Surgical Pathways
Surgery is typically reserved for:
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Complete tears of the ligament with knee instability
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Multi-ligament injuries
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Failure of non-surgical management
Post-surgery rehab focuses on:
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Controlling swelling and restoring range of motion
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Progressive strength and neuromuscular control
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Gradual return to sport-specific drills
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Return to play guided by strength and functional criteria, not just time
Preventing Future Injuries
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Maintain leg and core strength
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Train neuromuscular control and balance
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Address movement patterns that increase knee stress
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Follow a structured return-to-sport program
Book a Knee Ligament Assessment
If you’ve injured your knee or suspect a ligament injury, our physiotherapists can provide a thorough assessment, guide imaging if needed, and create a personalised rehabilitation plan to help you return safely to your sport or daily activities.
Learn More About Knee Injuries & Physiotherapy
Explore our other knee condition pages to understand evidence-based assessment, rehabilitation, and return-to-activity strategies: ACL Injuries | Meniscus & Cartilage Injuries | Patellofemoral Pain | MCL & LCL Injuries | Patellar Tendinopathy| Knee Osteoarthritis.
Our physiotherapists provide tailored programs to restore function, reduce pain, and support safe return to your activities.
