Posterior Cruciate Ligament (PCL) Injury

What is a PCL Injury?

The posterior cruciate ligament is one of the ligaments found in the outer part of the knee which attaches the front of the thigh bone found at the knee (Femur) to the back of the shin bone (Tibia) to ensure knee stability. PCL tears are common sport-related injuries to the ligament and usually come as a result of a twisting force or hyperextension of the knee or from a direct impact to the area. This is a common injury in contact sports such as football, rugby and hockey due to the tackling and collisions involved. PCL tears are also common in basketball and netball when the knee twists after landing hard from a jump. The severity of a PCL tear can vary from partial damage or tearing to a complete PCL rupture.

PCL Injury Symptoms

Patients of a PCL tear usually complain of a sudden onset of severe pain in the inner knee at the point of injury with a sensation of the knee ‘popping’ or ‘tearing’. The pain will usually be enough to prevent the patient continuing with activity however those who do continue are likely to stop soon after due to an increase in pain in the knee and an inability to bear weight on the leg as a result. This is usually followed by swelling and inflammation in the area. Pain will often subside after the initial onset however the patient will usually feel discomfort and stiffness in the area and an inability to straighten the knee.

PCL Injury Diagnosis

Diagnosis of a PCL tear is usually carried out by a doctor or physiotherapist who will examine the area before diagnosing the injury. It is also common for the patient to have an X-Ray or MRI to confirm the diagnosis and to rule out any further complications

PCL Injury Treatment

In order to treat a PCL tear, rest is crucial so to not damage the ligament any further and to stay away from any activity that could aggravate the knee or cause any pain and discomfort to the area. Continuing any strenuous activity or resuming sport will not only hinder the healing process, it could lead to further damage to the ligament and surrounding tissue. Applying ice to the area is also an important aspect of recovery for any soft tissue injury as it will minimize any swelling and inflammation of the area. Following the RICE method (Rest, Ice, Compression, Elevation) when the injury first occurs and within the following 72 hours will ensure no further damage is caused to the area and prevent any further swelling of the injury which may come from resuming activity. Anti-Inflammatory medications may be taken to relive the pain of the injury and also to minimize any swelling. Braces and supports are often recommended to patients with a PCL tear as they will provide the knee with stability and support to allow effective healing. Many patients also continue to use supports as well as taping and strapping techniques once they return to sport to prevent the injury reoccurring in the future. A strengthening program may also be advised by a physiotherapist to keep the area strong and ensure flexibility once the injury had healed. This should not be done without professional advice as a patient can run the risk of aggravating the area and increase the healing process. In the final stages of recovery and in the first few months of returning to training, stretching exercises may be performed to keep the area stable and strong and can also help prevent the injury reoccurring. In more severe cases where the PCL has ruptured surgery may be required to correct the injury. This then requires a lengthy recovery and rehabilitation period from 6-12 months and there are no guarantees that the injury will not re-surface in the future.