If you have a lateral collateral ligament (LCL) sprain, it's important that
your chiropractor examine your knee immediately, as damage to one knee ligament
often occurs in conjunction with damage to other structures in the knee. While
it's often difficult to perform an adequate exam in the acute stage of an LCL
sprain, due to pain and muscle spasm, your chiropractor can estimate what damage
has occurred and after about a week, or when most of the pain has subsided, make
a more accurate diagnosis and care for damaged structures accordingly.
At this point, your chiropractor will probably use a three-grade system to
classify the injury. If you have tenderness on the outside of the knee and the
ligament is only slightly damaged, your chiropractor will probably classify the
injury as a grade one sprain. If damage to your ligament is more severe and the
joint is loose, your chiropractor will probably classify the injury as a more
serious grade two sprain. Grade three sprains are the most severe, and your
chiropractor will probably reserve this classification for injuries that involve
a very unstable and extremely loose knee joint, indicating a completely torn
LCL. In such case, your chiropractor will probably refer you to a medical doctor
for surgery immediately.
To care for a grade one sprain, your chiropractor will probably begin a
rehabilitation program that involves the use of physiotherapeutic devices such
as ultrasound and interferential current (IFC). Ultrasound refers to any sound
wave that has a frequency above the range the human ear can perceive. To produce
these waves, chiropractors use a machine that channels electricity through a
crystal located at the end of an applicator. The crystal vibrates in response to
electricity, and the machine allows users to alter the electrical current to
affect the waves' frequency. Depending on the frequency, this can increase blood
flow, decrease pain, reduce muscle spasm, lessen nerve root irritation, break
down scar tissue and speed healing.
IFC works in a similar way, but instead of sound waves it uses a mild
electrical current. IFC machines work by sending this mild current through the
skin into nerve fibers below, which causes the body to produce endorphins, its
natural painkillers. By aiming the impulses at the injured area, your
chiropractor can cause endorphins to interrupt the flow of pain signals from the
affected tissues to the brain, as well as decrease inflammation and speed up
healing.
If you have a grade two sprain, your chiropractor will probably use similar
tools and techniques as well as some type of knee support. Depending on the
severity of the injury, crutches or a knee brace with a side hinge can be
essential, sometimes for an extended period of time. This is necessary to take
pressure off your knee so that it has time to heal.
If you have a grade three sprain, which involves a complete tear of the LCL,
and your chiropractor refers you to a medical doctor for surgery, he or she can
subsequently offer conservative comanagement and rehabilitation. Surgery,
although rarely necessary, can partially restore a fully torn LCL, but does
involve a risk of infection and postoperative pain. Following surgery, your
chiropractor can provide care similar to that for a grade one sprain.
Some rehabilitative tools and techniques will also apply to every grade of
LCL sprain. Regardless of what grade injury you have, your chiropractor may
initially recommend you follow the acronym RICE, which stands for rest, ice,
compression and elevation. Rest allows your knee time to heal, ice reduces
inflammation and pain, compression reinforces stability and reduces swelling and
elevation allows inflammatory fluid to drain.
While rest is important, don't keep your knee immobilized for too long. Your
chiropractor may recommend a number of exercises to help you regain mobility,
but by simply bending and straightening your leg repeatedly you can increase
blood flow to the knee, which helps clean out chemical irritants and retrains
the knee to move properly through its full range of motion. When your knee is
healing, your chiropractor may recommend that you perform more intense
strengthening exercises to preserve muscle tone in the quadriceps muscle group,
as well as stretching exercises, proprioceptive exercises and aerobic exercises
to promote joint health.
To fix any joints that have become subluxated (stuck or misaligned) your
chiropractor may also need to perform an adjustment to your low back or other
parts of your body. An adjustment is a quick, strategic thrust with either the
hands or a special tool called an activator that can help restore joint function
and the health of surrounding tissues. Your chiropractor can perform this on
dysfunctional joints in the foot, knee, hip and low back. When you walk, these
joints must work together to allow you to move efficiently. When movement of any
joint is altered, which can happen in your knee if you have an LCL sprain, it
can affect other joints that work with it.
Think of your body as a long chain connected by links. If one of the links is
broken, the other links can't provide the same stability they did before. This
is similar to a bicycle chain with a broken link that prevents the whole chain
from working. Your chiropractor can restore the links in your body by applying a
force or thrust to dysfunctional joints, shifting them back to their original
placement, restoring their motion, increasing blood flow and decreasing
inflammation.
