Definition

The posterior cruciate ligament (PCL) is connective tissue located within the knee. The PCL connects the thighbone to the shinbone. This connection keeps the shinbone from moving too far backward, stabilizing the knee.

Posterior Cruciate Ligament

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Causes

The PCL ligament can become strained or torn when a strong force is applied to it. This force can occur during sports or other high-stress activity.

Risk Factors

Factors that may increase your chance of injuring the PCL include:

    
  • Sports injury
  • Motor vehicle accident
  • Fall on a bent knee
  • Strong force to the leg immediately below the kneecap
  • Knee dislocation
  • Symptoms

    A PCL tear may cause:

        
  • Pain and swelling in the knee
  • Soreness in the area behind the knee
  • Weakness or instability in the knee
  • Difficulty walking
  • Pain when moving the knee
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.

    Images may need to be taken of the internal structure of your knee. This can be done with:

        
  • X-ray
  • MRI scan
  • Ligament sprains are graded according to their severity:

        
  • Grade 1—Mild ligament damage.
  • Grade 2—Partial tearing of the ligament.
  • Grade 3—Complete tearing of the ligament.
  • Treatment

    Talk with your doctor about the best treatment plan for you. Recovery time ranges depending on the grade of your injury. Treatment steps may include:

    Acute Care

    Rest

    Your ligament will need time to heal. Avoid activities that place extra stress on the knee:

        
  • Do not do activities that cause pain. This includes running, jumping, and weight lifting using the legs.
  • Do not play sports until your doctor has said it is safe to do so.
  • Your doctor may recommend a knee brace to stabilize the knee, and crutches to keep extra weight off your leg.

    Cold

    To reduce pain and swelling, apply an ice pack to the area for 15-20 minutes, four times a day, for several days after the injury. Do not apply the ice directly to your skin. Wrap the ice pack in a towel.

    Pain Relief Medications

    To manage pain, your doctor may advise:

        
  • Over-the-counter medication, such as ibuprofen and naproxen
  • Topical pain medication—creams or patches that are applied to the skin
  • Prescription pain relievers
  • Compression

    Compression can help prevent more swelling. Your doctor may recommend an elastic compression bandage around your knee. Be careful not to wrap the bandage too tight.

    Elevation

    Elevation can also help keep swelling down. Keep your knee higher than your heart as much as possible for the first 24 hours or so. A couple of days of elevation might be recommended for severe sprains.

    Recovery Steps

    Physical Therapy

    Your doctor may refer you to a physical therapist. Therapy can help control discomfort and promote recovery.

    Heat

    Use heat only when you are returning to physical activity. Heat may then be used before stretching or getting ready to play sports to help loosen the ligament.

    Stretching

    When the acute pain is gone, start gentle stretching as recommended. Stay within pain limits. Hold each stretch for about 10 seconds and repeat six times. Stretch several times a day.

    Strengthening

    Begin strengthening exercises for your ligaments as recommended.

    Surgery

    Surgery may be needed to fully restore function of the knee. The decision to have surgery should be made after discussion with your doctor about your athletic needs, age, and associated factors.

    Prevention

    Some steps that may help decrease your chance of getting a PCL injury include:

        
  • Protect your knees by doing regular strengthening exercises for your thighs.
  • Maintain proper technique when exercising or playing sports.