12.19.2012 / Blog Posts Health and Wellness
Redskins QB Robert Griffin III, suffered a Grade I LCL sprain during the Redskins-Ravens game on December 9th. The experts at Commonwealth Orthopaedics explain what a LCL Sprain is, break down three different grades of sprains and tells us how to treat them.
A lateral collateral ligament (LCL) sprain is an injury to the ligament on the outer surface of the knee joint.
The LCL connects the femur (thighbone) and the tibia, the outer bone of the two shinbones. It is a strong narrow rope of fibers that supports the outside of the knee, limiting sideways movement and keeping the outer surfaces of the joint in close proximity to each other.
An LCL sprain is usually caused by a direct blow to the inside of the knee that forces the joint outwards beyond its normal range of motion. It is a common injury amongst athletes, particularly those participating in football, soccer or wrestling. An X-ray and MRI may be used to visualize the bones and soft tissue and help diagnose the sprain.
Sprains are graded according to the severity of the injury.
Grade I:The ligament has been stretched, causing microscopic tears in the fibers, but the joint is still stable. There will be mild tenderness on the outside of the knee and little to no swelling. There will be some pain when the joint is stressed but no looseness of the joint. Treatment is usually conservative to reduce the pain and inflammation. Ice and NSAIDS can be used to reduce the swelling. Refraining from activities that cause pain will help rest the ligament to begin the healing. Following the acute phase of the injury, exercises to increase flexibility can begin. A gradual progression to strengthening exercises will be initiated and a return to full activity should be accomplished within 8 weeks.
Grade II:There is a partial tear in the ligament and mild to moderate instability in the joint. There will be moderate tenderness over the LCL area and some swelling. There is pain when the joint is stresses and some looseness in the joint. The treatment for a Grade II tear is similar to Grade I with the exception that a Grade II injury may require some non-weight bearing time.
Grade III:The ligament has been completely torn, either in the middle of the ligament, or at the point of attachment to one of the bones and the joint is unstable. There will be variable pain from moderate to very severe. There is significant looseness in the joint and the knee feels unstable like it may “give out”. Grade III sprains are often repaired by surgery. The torn ligament can either be stitched together or reconstructed using part of a tendon. Rehabilitation includes using a crutch and wearing a hinged knee brace, and a graduated program of exercises. A return to full activity might take months to accomplish, but the prognosis is excellent as surgical repair of the LCL is highly successful.
Christopher Annunziata, MD, a team physician for the Washington Redskins; Commonwealth Orthopaedics
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