Injury advice > Knee Injuries > Posterior Cruciate Ligament Injury

Posterior Cruciate Ligament Injury

What is the posterior cruciate ligament?

There are 4 main ligaments that stabilize the knee 2 collateral ligaments (medial and lateral) and 2 cruciate ligaments both anterior (front) and posterior (back). These are fixed to the femur (thigh bone) and travel within the knee joint to the upper surface of the tibia (shin bone). The ligaments pass each other in the middle of the joint forming a cross shape, hence the name 'cruciate'.
The main functions of the posterior cruciate ligament (PCL) is to prevent the tibia from traveling backwards on the femur, known as posterior drawer. It also has the function of preventing the tibia from twisting outwards. Injury to the ligament leads to knee instability with the shin bone having a tendency to 'sag' backwards when the knee is bent at 90 degrees.

Injury of the posterior cruciate ligament:

This ligament is less likely to be injured that the anterior cruciate ligament. The PCL is both thicker and stronger. Direct impact to the front of the tibia when the knee is bent is the most common way in which the PCL is injured. This may occur in a front-on tackle or collision or when falling with the knee bent. The injury is commonly associated with injuries to other structures in the rear compartment of the knee joint such as lateral meniscus tears. In addition the articular cartilage may also be damaged.

This injury (PCL tears) is graded I- III with III being the worst. These grading's are classified depending on the amount of backward tibial displacement observed when the knee is bent at 90 degrees. In extreme cases the ligament may become avulsed, or pulled off the bone completely.

Symptoms of a posterior cruciate ligament injury:

  • Obviously pain at the time of impact this may subsequently be felt in the calf region.
  • There may be swelling but this may be minimal.
  • Positive sign on the 'Posterior draw test'.
  • Pain and laxity when a 'reverse Lachman's test' is performed.
  • The joint may lose stability and may feel as though it is 'giving way'.

What are the treatments for Posterior Cruciate Ligament Sprain:

What can the athlete do after sustaining a PCL injury?

  • Cold therapy and rest. Apply RICE (Rest, Ice, Compression, Elevation) as soon after the injury as possible.
  • See a sports injury professional immediately.

Visiting a sports injury professional ?

  • They will be able to correctly diagnose the injury. They may employ the 'posterior drawer test' or 'reverse Lachman's'.
  • An MRI scan and/or X-ray can be used to assess the extent of the damage.

Once the injury has been correctly diagnosed, 2 modes of treatment may be recommended:

1. Conservative Treatment

This is used for most PCL injuries and may consist of:

  • Cold or heat therapy.
  • Electrotherapy e.g. TENS and Ultrasound
  • Sports massage, manipulation and mobilization treatments
  • Advise on a specific rehabilitative exercise program which may include: quadriceps and hamstring strengthening, gait reeducation and balance training using wobble boards.

2. Surgical Treatment

This is an option for more serious cases. Particularly those cases in which other structures within the knee joint have been injured, surgery may be necessary. If the conservative treatment has not been sufficiently successful then surgery may be indicated.

The recovery rates of people who have sustained a PCL injury are normally good. Most are able to return to their previous level of sporting activity. However, full recovery from cruciate ligament damage is highly dependant on the ability to adhere to a strict rehabilitation program.

Useful Products:

  • Cold Therapy - apply cold therapy to the site of injury as soon as possible to help ease pain and inflammation.

Please see the Virtual Sports Injury Clinic for more information on how to treat Posterior Cruciate Ligament Injury