Posterior Cruciate Ligament (PCL) Injury

Condition Basics

What is a posterior cruciate ligament (PCL) injury?

A PCL injury is a sprain or tear of the posterior cruciate ligament (PCL). The PCL is a band of tissue that crosses inside the centre of the knee joint. It connects your thigh bone to the bone of your lower leg. The PCL keeps your knee stable when it moves forward or backward.

A direct blow to the knee can injure your PCL. For example, the PCL can be injured in a car crash when your bent knee hits the dashboard. You can also hurt your PCL during sports, such as football, soccer, or skiing. Or you can hurt it while doing other activities if you fall on your bent knee with your foot or toes bent downward or if the front of your knee is hit.

A PCL injury can also happen if you stretch or straighten your knee beyond its normal limits (hyperextend the knee).

What are the symptoms?

An injury to your PCL may cause swelling, pain, tenderness, and stiffness around the knee. Several hours after the injury, your pain may get worse. And it might be harder to move your knee. You may also have bruising and an unstable feeling, like the knee may give out.

How is it diagnosed?

The doctor will examine you and ask questions about your past health. You'll also be asked how you injured your knee and about your symptoms at the time you injured it.

Your doctor will carefully examine your knee and leg. The doctor will look and feel to see if there is swelling and may gently push on certain places to find spots that are most tender. Then your doctor will move your knee and leg in certain ways to help check for stability. They'll also look at the rest of your leg to make sure that blood is flowing, the leg works well, and there are no other injuries above or below the knee.

You may have some tests, such as an X-ray or an MRI.

How is a PCL injury treated?

Your treatment will depend on how severe your injury is and whether other parts of your knee are injured.

• Mild or grade 1 and moderate or grade 2 injuries. These may only need home treatment along with using crutches for a short time and wearing a hinged knee brace. Many people are able to be active again after about 4 to 6 months.
• Severe or grade 3 injuries. These may require using crutches and wearing a hinged knee brace. Many people are able to be active again after about 9 months.

  A severe tear may need surgery. But this usually isn't done unless you also injure other parts of your knee, such as the MCL or meniscus.

Your doctor may recommend physiotherapy to increase range of motion and strengthen your muscles.

How can you care for yourself?

• Put ice or a cold pack on your knee for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours (when you're awake) for the first 3 days after your injury or until the swelling goes down. Put a thin cloth between the ice and your skin.
• Prop up your leg on a pillow when you ice it or anytime you sit or lie down. Do this for about 3 days after your injury. Try to keep your knee above the level of your heart. This will help reduce swelling.
• Take anti-inflammatory medicines to reduce pain and swelling. These include ibuprofen (Advil, Motrin) and naproxen (Aleve). Be safe with medicines. Read and follow all instructions on the label.
• Follow instructions about how much weight you can put on your leg and how to walk with crutches, if your doctor recommends them.
• Wear a brace, if your doctor recommends it, to protect and support your knee while it heals. Wear it as directed.
• Do stretches or strength exercises as your doctor suggests.