Following a posterior cruciate ligament (PCL) rupture, surgery is uncommon due to difficulties surrounding the procedure, as well as the success of conservative treatment and rehabilitation in providing enough stability for the knee. A rehabilitation programme should look to regain full range of motion as soon as possible, followed by strengthening the muscles surrounding the joint. A knee support may be used during the rehab process and beyond to add further support to the joint.

Mobility exercises

Mobility exercises can usually begin pretty soon after injury, provided they do not cause pain. The aim is to regain full motion as early as possible.

Assisted heel slides

Lie on the floor with the leg outstretched and a towel or cord etc wrapped around the ankle. Bend the knee by pulling the towel to pull the ankle in, sliding the heel along the ground towards the buttocks, as far as is comfortable. Hold for a few seconds, return to the start and repeat.

Hamstring stretch

Sit on the floor with both legs straight out in front. Sit upright and lean forwards from the hips until you feel a pull in the back of the thigh. Hold for 20-30 seconds, rest and repeat 3-5 times.

Quad stretch

Lay on the floor on your front and bend the knee as far as possible. Pull the ankle in further towards the buttocks either with your hand or a towel until you feel a stretch at the front of the thigh. Hold for 20-30 seconds, rest and repeat 3-5 times.

Forward lunge

Stand with a bench or chair in front of you and the foot of the injured leg up on the chair, knee bent slightly. Lunge forwards, further bending the front knee as far as is comfortable. Hold for a few seconds, rest and repeat.

Strengthening exercises

Gentle strengthening exercises to avoid muscle wasting should begin as soon as possible, provided they are pain free.

Quad contractions

The easiest exercise is to sit on the floor with the legs outstretched and to practice contracting the quad muscles. This places on strain on the knee joint and injured ligament, but helps to prevent muscle wasting and also acts as a pump to reduce excess swelling. Hold contractions for 5 seconds, rest and repeat 10-20 times, several times a day.

Hamstring holds

In a standing position (making sure there is something to hold on to close by!), bend the knee up to 90 degrees (a right angle) and hold for 5 seconds. Rest and repeat. This starts to work the hamstring muscles. An ankle weight can be used to make this more difficult.

Mini squats

Once full weight bearing is comfortable, small squats can be performed. Stand with the feet shoulder width apart and toes facing straight forwards. Sit into a squat, by bending your knees and sitting back, as if going to sit in a chair. Start with just a shallow squat, and progress to a full squat where the knees reach 90 degrees. A progression from here is a single leg squat.

Useful Products:

• Cold Therapy - apply cold therapy to the site of injury as soon as possible to help ease pain and inflammation.
• Knee supports - a knee support can be used to help stabilise the knee during and after rehabilitation.
• Wobble boards - these are great for lower limb rehabilitation

Please see the Virtual Sports Injury Clinic for more information on how to treat Posterior Cruciate Ligament Injury and other causes of knee pain.