How To Strengthen Knee Ligaments And Sports Injury Prevention
Knee ligaments cannot be strengthened in the same way as muscles, but they can become more resilient through proper training that improves joint control, movement awareness, and the strength of surrounding muscles. This article explains how ligaments function, why injuries occur, and how the nervous system, movement quality, and load management all contribute to injury risk.
The blog explores the roles of the ACL, PCL, MCL, and LCL, along with factors such as balance, joint position, hormones, and stress that influence ligament health. It also highlights practical exercises and principles used in sports injury rehabilitation to help build more resilient knees.
Rather than focusing on making ligaments stronger, the goal is to improve the body's ability to tolerate movement, react efficiently, and reduce the risk of future sports injuries.
4 min Read
One of the biggest misconceptions is that you can strengthen ligaments in the same way you strengthen muscles. Ligaments don’t work the same as muscles do.
You can't.
Though ligaments do adapt to training, it’s not by getting dramatically bigger or stronger like muscle tissue. Their job is different, and so is the way we must train them.
They also have a very limited blood supply, making healing a much slower process.
What ligaments actually do
The role of ligaments are mainly to hold two bones together (there are exceptions like the tibialmeniscal ligaments) So for every joint there are a minimum of two ligaments.
For the knee there are four main ligaments holding the Femur (thigh bone) and Tibia (shin bone) together.
One really big wide one on the inside the MCL (medial collateral ligament). It needs to be this big due to the amount of movement toward the midline of the body the knee can go…think cutting movements.
One relatively thin band on the outside LCL (lateral collateral ligament). There usually isn’t much movement for the midline of the body towards the outside.
The one that probably gets the most attention the ACL (anterior cruciate ligament) This one actually starts as two branches and crosses from the back part of the femur and attaches to the front of the tibia. Not only does it help resist forward and backward movement of the bones on one another, it also resists rotation so this is designed specifically for that
And finally the PCL from the back of the femur and attaches to the back part of the tibia. Also resisting the forward and backward motion.
So for healthy ligaments there is minimal direct strengthening. To protect joints from increased load you need to strengthen the muscles surrounding the joint and above and below it.
Why ligaments get injured
There are actually many layers that go into the Why
Strength
Load
Position
Neuromuscular
Hormonal
If you haven’t read my Blog on the Hierarchy of Protection go read that!
But if you twisted and injured a ligament in your knee, what state was your nervous system already in? If it was on high alert and then didn’t feel safe, there is likely a higher chance of injury, compared to being in a more relaxed state.
What position were you in and do you train your body in that position? Are you strong in that position?
How well is your knee communicating with your brain? Your ligaments are filled with tiny receptors called mechanoreceptors that send information to your brain informing it to what position the joint is in. How much stretch in the joint. How much compression. The better the communication the safer your body….your brain just has more information and can react better to what it knows it can handle and what it can’t.
Contact injuries a little different, sometimes the outside force is just too much for a ligament to handle and it tears
Research has also shown fluctuations in estrogen and progesterone may influence ligament laxity and ACL injury risk, particularly around certain phases of the menstrual cycle. Hormones are only one piece of the puzzle, but they are worth considering.
Anecdotal evidence
I just saw someone who was telling me that she injured her knee the day after she had a big fight with her parents. She was at the gym doing things she does every day but on this particular day she was still upset about the day before and twisted and hurt her knee. Has been unstable since and is awaiting her MRI results.
Am I saying the fight caused the injury? No. BUT her nervous system was in a state of high alert. What could/should have been a relatively normal movement for her turned into something more problematic possibly because her system just couldn’t take more stress.
What CAN you train?
What you CAN do though is train the ligaments better. Since the ligaments are full of the receptors mentioned above, doing movements that stress the ligaments in different directions is a great way to get the brain used to those movements so it doesn’t freak out while you are playing.
My Three Favorite exercises
My favorite example of this is doing ankle tilts for the outside of the ankle. This is the most common position of ankle sprains. But doing ankle tilts at differents speeds and degrees allow the brain to feel safe during these movements keeping you from actually injuring the area.
We can do the same thing with the knee.
My favorites are Knee Circles
These place your knee into positions that you don’t normally go in a controlled environment so if you happen to find yourself there it feels familiar and your body doesn’t freak out.
Next would be a Banded Lunge. This creates forces from different directions while also stressing the amount of movement of the femur on the tibia (which can be a cause of ACL tears) This also builds muscle strength in the supporting hip muscles to help protect the knee.
SLD. These are such a great exercise! This involves hip strength again huge in the supporting muscles of the knee. As well as adding a balance component which is also a huge part in injury prevention.
The Goal here isn’t indestructible ligaments, is a resilient joint that can handle load and forces because all the systems are firing on cylinders together!
If you live in the South Bay and have injured one of your knee ligaments, or you're looking to prevent another injury, I can help.
My approach goes beyond simply strengthening the knee. Together we'll identify why the injury happened, improve the way your knee moves and responds to load, and build a resilient joint that gives you the confidence to get back to the activities you enjoy.
Learn more on my Athlete Rehab Sports Injury Prevention page, or click below to schedule your Initial Assessment today.