Posterior Cruciate Ligament Injury
DefinitionThe posterior cruciate ligament (PCL) is connective tissue located within the knee. The PCL connects the thighbone to the shinbone. This connection keeps the shinbone from moving too far backward, stabilizing the knee.
|Posterior Cruciate Ligament|
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CausesThe PCL ligament can become strained or torn when a strong force is applied to it. This force can occur during sports or other high-stress activity.
Risk FactorsFactors that may increase your chance of injuring the PCL include:
- Sports injury
- Motor vehicle accident
- Fall on a bent knee
- Strong force to the leg immediately below the kneecap
- Knee dislocation
SymptomsA PCL tear may cause:
- Pain and swelling in the knee
- Soreness in the area behind the knee
- Weakness or instability in the knee
- Difficulty walking
- Pain when moving the knee
DiagnosisYou will be asked about your symptoms and medical history. A physical exam will be done. Images may need to be taken of the internal structure of your knee. This can be done with:
- Grade 1—Mild ligament damage.
- Grade 2—Partial tearing of the ligament.
- Grade 3—Complete tearing of the ligament.
TreatmentTalk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:
Acute CareRestYour ligament will need time to heal. Avoid activities that place extra stress on the knee:
- Do not do activities that cause pain. This includes running, jumping, and weight lifting using the legs.
- Do not play sports until your doctor has said it is safe to do so.
- Over-the-counter medication, such as ibuprofen and naproxen
- Topical pain medication—creams or patches that are applied to the skin
- Prescription pain relievers
Recovery StepsPhysical TherapyYour doctor may refer you to a physical therapist. Therapy can help control discomfort and promote recovery. HeatUse heat only when you are returning to physical activity. Heat may then be used before stretching or getting ready to play sports to help loosen the ligament.StretchingWhen the acute pain is gone, start gentle stretching as recommended. Stay within pain limits. Hold each stretch for about 10 seconds and repeat six times. Stretch several times a day.StrengtheningBegin strengthening exercises for your ligaments as recommended.
SurgerySurgery may be needed to fully restore function of the knee. The decision to have surgery should be made after discussion with your doctor about your athletic needs, age, and associated factors.
PreventionSome steps that may help decrease your chance of getting a PCL injury include:
- Protect your knees by doing regular strengthening exercises for your thighs.
- Maintain proper technique when exercising or playing sports.
American Academy of Orthopaedic Surgeons
American Orthopaedic Society for Sports Medicine
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Knee sprains and meniscal injuries. Merck Manual for Health Care Professionals. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/fractures%5Fdislocations%5Fand%5Fsprains/knee%5Fsprains%5Fand%5Fmeniscal%5Finjuries.html. Updated August 2013. Accessed February 28, 2014.
Ligament injuries to the knee. John Hopkins Medicine website. Available at. http://www.hopkinsmedicine.org/healthlibrary/conditions/adult/orthopaedic%5Fdisorders/ligament%5Finjuries%5Fto%5Fthe%5Fknee%5F85,P00926/. Accessed February 28, 2014.
Posterior cruciate ligament injuries. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00420.Updated February 2009. Accessed February 28, 2014.
Posterior cruciate ligament (PCL) injury. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated February 13, 2014. Accessed February 28, 2014.
10/26/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Massey T, Derry S, Moore R, McQuay H. Topical NSAIDs for acute pain in adults. Cochrane Database Syst Rev. 2010;(6):CD007402.
- Reviewer: Teresa Briedwell, PT, DPT
- Review Date: 02/2014
- Update Date: 02/28/2014