Medical Evidence on Football and LCL Tears
The available medical evidence does not support a specific link between playing football and increased incidence of Lateral Collateral Ligament (LCL) tears. In fact, LCL injuries are notably rare in football compared to other knee injuries.
Key Epidemiological Findings
LCL Injury Incidence in Football
- LCL tears represent only 1.1% of all knee injuries in athletic populations, making them one of the least common knee ligament injuries 1
- In a comprehensive 10-year study of 7,769 knee injuries across multiple sports, LCL injuries were primarily associated with tennis and gymnastics, not football 1
- Football players predominantly sustain ACL tears (20.3%), medial meniscus tears (10.8%), and MCL injuries (7.9%)—not LCL tears 1
Most Common Football Knee Injuries
According to the American Academy of Pediatrics, the most commonly injured body parts in football at all ages are the knee, ankle, hand, and back, with most injuries being contusions, musculotendinous strains, and ligamentous sprains 2
When specific knee ligament injuries occur in American football:
- ACL tears are the predominant ligament injury 3, 4
- MCL injuries occur more frequently than LCL injuries 1, 3
- PCL tears represent only 0.65% of knee injuries 1
Contact Mechanism Considerations
Injury Patterns in Football
- Approximately 46% of severe football injuries involve direct contact, while 54% are non-contact mechanisms 5
- For ACL injuries specifically, 72.5% occur via non-contact mechanisms (except in offensive linemen where only 20% are non-contact) 4
- Tackling and being tackled account for approximately half of all high school and college football-related injuries 2
LCL-Specific Mechanism
The LCL is typically injured through varus stress (force pushing the knee inward), which is an uncommon mechanism in football compared to the valgus stress (knee pushed outward) that causes MCL and ACL injuries 1
Clinical Implications
There is no evidence-based reason to counsel patients that excessive football play specifically increases LCL tear risk. The injury pattern in football overwhelmingly favors:
- ACL tears (particularly from pivoting/cutting with dynamic valgus moments) 4
- MCL injuries (from valgus stress during contact) 1, 3
- Meniscal tears 6, 1
Risk Factors That Actually Matter
If concerned about knee injuries from football participation, focus on these evidence-based risk factors:
- Previous knee injuries increase severe injury risk by 24% 5
- Joint instability and poor physical conditioning 5
- Foul play accounts for 31% of severe injuries 5
- Game participation carries higher injury risk than practice (59% vs 41%) 5
Long-Term Considerations
While LCL tears are not a primary concern, moderate-certainty evidence shows that various knee injuries from football (cruciate ligament, collateral ligament, meniscal, chondral injuries) increase odds of symptomatic osteoarthritis 2. This represents a more significant long-term morbidity concern than LCL injury incidence.