Posterior Cruciate Ligament Injuries 

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 center 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 if 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).

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
• Bruising
• An unstable feeling, like the knee may give out

A doctor will examine you and ask questions about your past health. They will also ask how you injured your knee and about your symptoms at the time you injured it.

The doctor will carefully examine your knee and leg. They 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 will also look at the rest of your leg to make sure 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 MRI.

Your treatment will depend on how severe your injury is and whether other parts of your knee are injured. Most PCL injuries can be treated at home with:

• Rest and protecting your knee
• Ice or a cold pack
• Wrapping your knee with an elastic bandage (compression)
• Propping up (elevating) your knee
• Anti-inflammatory medicine
• Crutches, to limit how much weight you put on your leg

You may need to be less active for a while. But doing gentle stretching and range-of-motion exercises as advised by your doctor can help you heal.

Mild or moderate injuries 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 four to six months.

Severe injuries may require using crutches and wearing a hinged knee brace. In some cases, surgery may be needed. Many people are able to be active again after about nine months. A doctor may also suggest that you wear a brace that protects and supports the knee but allows for some movement.

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

A severe tear may need surgery. But this is not usually done unless you also injure other parts of your knee, such as the medial collateral ligament (MCL) or meniscus.

When you have a PCL injury, it is recommended that you:

• Put ice or a cold pack on your knee for 10 to 20 minutes at a time. Put a thin cloth between the ice and your skin. Try to do this every one to two hours (when you are awake) for the first three days after your injury or until the swelling goes down.
• Prop your leg up on a pillow when you ice it or anytime you sit or lie down. Do this for about three days after your injury. Try to elevate 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 and naproxen. 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.