PCL Injury | Causes and Symptoms | Diagnosis and Treatment

Healthy PCL Vs. Complete PCL Tear

PCL Injury | Causes and Symptoms | Diagnosis and Treatment

• Overview
• Causes of PCL Injury
• Symptoms
• Diagnosis
• Treatment

Best 2 ways to treat a PCL Injury

Overview

Quite similar to the ACL, the posterior cruciate ligament (PCL) is a tough fibrous band that connects the femur (Thigh bone) to the tibia (Shin bone).

The PCL controls the backward motion of the tibia in relation to the femur; it doesn’t let the tibia slip far back in relation to the femur.

It also limits some rotation of the knee joint just like the ACL does.

The posterior cruciate ligament is essential to keep the knee stable, providing the strength needed to execute moves within the normal range of motion of the knee.

The PCL is broader and even stronger than the ACL and it stretches across the back of the knee.

However, in case of a hard blow to the knee when it’s bent, say falling and landing on bent knees during sports or hitting the dashboard in an accident, can injure the PCL.

PCL injury can range from strains or overstretching to partially torn to completely ruptured or separated from the bone it attaches to.

Treatment of an injured PCL is dependent on how severe the condition is. In most cases, rehab would do well although it takes time for a total recovery.

Nevertheless, if the PCL is completely torn, surgical solutions are opted to.

Causes of PCL Injury

Injuries to the posterior cruciate ligament can occur due to a direct and abrupt blow to the area of the tibia (Shin bone) just below the knee.

This kind of blow can have a force against the Ligament in question as the shin bone moves backward in relation the femur, causing the PCL to either overstretch or tear.

Injuries are most likely to happen if the knee is bent when it receives the strike.

Instances that may cause PCL injuries include:

Traffic Collision

The sharp sudden blow to the knee hitting the dashboard while it’s bent is very likely to tear the PCL.

Falling

Another common cause of PCL injury is falling by stumbling while running. If the person is lucky enough, they can get only a strain.

However, if the blow is hard due to some reason (Falling from a high platform, or if the person has extra pounds on themselves) tears can happen.

Sports

In sports like football, soccer and rugby athletes can have severe injuries that include complete tears of the PCL.

This happens following their most common falls that involve hitting the ground with their knees bent.

Symptoms

People can know if they had injured their PCL by noticing the following:

Pain

Instantly after the injury, People can experience different levels of pain with the feeling of a flabby knee and difficulty to walk.

However, after a week or more, two other different pains may pop up.

At the back of the knee the mild pain can worsen when kneeling.

Also, when altering pace (Running or slowing down) it can be painful in the front of the knee.

Swelling

During the very first hours of injury, swelling becomes prevalent all around the knee.

Instability

The knee feels like it is lacking support, firmness and strength.

Diagnosis

To diagnose PCL injury, your doctor may well go through the following steps:

Accident History

Patients are asked about the activities they were doing prior to the injury and how the injury happened. 

The doctor will also emphasize on asking about the position of the knee during the accident, how it felt and what the symptoms were, following the injury.

Physical Examination

The doctors will perform some examinations on the injured knee like:

• Pressing it to see if there is any flabbiness or fluids due to bleeding.
• Moving the shin bone and feet in different directions to see where the patient feels pain.
• Comparing the injured knee with the healthy one.
• Asking the patient to walk to check for any abnormal walking motions or movement of the shin bone.

Physical Examination to Detect PCL Injury

X-ray

Although X-ray doesn’t show ligament damage, doctors still order it because it shows bones fractures.

In severe PCL injuries the bone where the ligament attaches may break, and this type of imaging shows it.

MRI

This scan is very common with ligaments injuries as it can show exactly where the tear is.

Treatment

Treating PCL injury depends on how bad the condition is and if the injury has just occurred or it happened a while ago, but in most cases no surgery is required.

• Self-care and Physical Therapy

1. Self Care At Home

Patients with minor injuries (Strains and partial tears) can stop pain and reduce swelling with over the counter pain killers and applying the RICE technique (Rest, Icing, Compressing and Elevation)

2. Physical Therapy

If needed, patients should go through a rehabilitation program with a physical therapist. 

Generally, your physical therapist with give you certain exercises to strengthen the muscles around your knee (Mainly quadriceps and hamstrings)

But these ones are only simple moves with light weights (or even body weight) for rehabilitation, not crazy heavy weight squats at the gym. 

So patients should make sure to ask a specialist in order not to hurt themselves even further.

Patients will have to perform the strengthening exercises a few times a week for up to six months in order to heal completely.

• Surgery

Surgery is advised by the doctor only if the condition is severe with an overall knee damage that includes a complete tear of the PCL and damage to the other ligaments or cartilage.

Reconstructing a torn PCL isn’t done by stitching it up, because this way it will be torn again.

The surgeon will rather replace the damaged ligament with a new tissue (Usually taken from the patella tendon)

This type of surgery is arthroscopic; it works by inserting a fiber-optic camera and other surgical tools through small cuts around the knee.