Sports Medicine: Posterior Cruciate Ligament (PCL) Injury

What is the PCL?

The Posterior Cruciate Ligament (PCL) is the ligament in the knee that joins the back part of the femur (thigh bone) to the back part of the tibia (shin bone). The PCL provides support to prevent the shin bone from sliding backward while walking and running. It can be found in the back of the knee.

What causes a PCL injury?

The PCL is most vulnerable when the knee is bent. PCL injuries commonly result from a fall on the front of a bent knee or a direct blow to the front of a bent knee. This can happen in many sports activities, most often in football.

What are the symptoms of a PCL injury?

For many who suffer PCL injuries, the initial injury is accompanied by a "pop" which is often felt and sometimes heard by the patient. Often the knee will swell within 24 hours. This swelling causes the knee to become stiff and painful. The swelling, stiffness and pain may last for several days, and it may be several weeks before the knee is completely stable again. Athletes who are tempted to test the knee too early risk re-injury, with more swelling, pain and stiffness that could prolong the healing process.

How is a PCL injury diagnosed?

Physicians usually diagnose a PCL tear with a thorough history and physical examination. Physicians may order an MRI (magnetic resonance imaging) of the knee to confirm the diagnosis and to look for damage to the knee cartilage or other ligaments which may have occurred along with the PCL tear.

What is the treatment for a PCL injury?

Conservative treatment for a PCL injury is usually recommended. Unlike an injury to the ACL, the knee will be stable for activities in most individuals. In some cases, the athlete will be fitted for a knee brace that allows the knee to straighten and bend, but prevents the knee from shifting backwards. Rehab will consist of anti-inflammatory treatments and quadriceps strengthening exercises then progressing to sport-specific exercises.

What is the long-term outlook for a PCL injury?

With proper treatment and rehabilitation, athletes usually recover well from a PCL injury. In some cases, the athlete will be required to wear a lightweight brace during activity to keep the knee from shifting.