Posterior Cruciate Ligament Injury

What is the Posterior Cruciate Ligament (PCL)?

There are 4 main ligaments that stabilize the knee - 2 collateral ligaments (medial and lateral) and 2 cruciate ligaments (anterior and posterior). The cruciate's 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 function of the PCL is to prevent the tibia from moving backwards on the femur. It also prevents 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. The injury is commonly associated with injuries to other structures in the back of the knee joint such as lateral meniscus tears.

This injury is graded I- III with III being the worst. In extreme cases the ligament may rupture or become avulsed - pulled off the bone completely.

Symptoms of a posterior cruciate ligament injury:

• Pain at the time of impact which 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:

• Stop playing immediately if a PCL injury is suspected.
• Cold therapy and rest. Apply RICE (Rest, Ice, Compression, Elevation) as soon after the injury as possible.
• See a sports injury professional immediately for diagnosis.
• An MRI scan and/or X-ray can be used to assess the extent of the damage.
• Conservative treatment such as physiotherapy and strengthening is usually the first step.
• If this fails, PCL reconstruction surgery may be undertaken.

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 knee injuries