The PCL (posterior cruciate ligament) is the strongest ligament, or band of tissue, in your knee. It stretches across the back of your knee. It connects your shinbone to your thigh bone and keeps your knee stable.
A sharp, violent blow to the knee can stretch or tear your PCL. That can make it hard for you to get around. It may heal on its own with some rehab. In rare cases, you may need surgery.
What Causes It?
Many knee injuries are sports-related. But a PCL injury is more likely to happen during trauma like a car accident.
There are a number of ways your PCL can be damaged:
- Something forces your knee backward very quickly -- a car crash, for example.
- Your shin slams very hard into something, like your car’s dashboard.
- Your knee twists or over-extends in a sudden movement.
- You fall down or get tackled, landing on your bent knee as your foot is pointing downward. This can happen while playing sports like football or soccer.
What Are the Symptoms?
You may have trouble walking.
If you only have mild damage to the PCL and no other parts of your knee, you may not notice pain, swelling, or other problems at first. These symptoms may appear over time.
How Is It Diagnosed?
Your doctor will ask how you got hurt. They may look at both of your knees to see if one looks different from the other.
One sign that the PCL is torn is that your knee may appear to droop backwards in a way that isn’t natural when your doctor straightens out your leg.
During the exam, they may press on your shin when your knee is bent at a 90-degree angle to find out whether or not your PCL has been hurt. If your shinbone moves more than is normal when your knee is at that angle, there’s a good chance your PCL is damaged.
What’s the Treatment?
It’ll depend on how badly your PCL is injured. Your doctor may recommend one of the following:
Self-care at home. For minor damage to the PCL, it may help if you put ice on it. Stay off your feet, elevate your knee while seated, and keep the hurt knee in a brace or elastic bandage.
Physical therapy. Your physical therapist (PT) will give you specific exercises to do. They’ll help strengthen the leg muscles around your knee and bring a full range of motion back to your knee joint.
You may go to physical therapy a few times a week and do some of the exercises at home on off days. You may need to stick with it for up to 6 months to heal completely.
Surgery. Most people don’t need surgery to fix a torn PCL. But you might if other ligaments in your knee have also been injured. Your doctor can let you know if surgery would be right for you. The people who choose it are more likely to be athletes, younger people, and those who are very active on their feet.
When PCL surgery is needed, your doctor won’t stitch up your torn PCL, because this doesn’t heal well and it may tear again. Instead, your doctor will remove the old, torn ligament and replace it with new tissue. It’s an arthroscopic procedure. That means the surgeon inserts tools and a camera through small cuts around your knee. It’s quicker to heal and results in less scarring than other knee surgery.
If your injury is severe, your doctor may recommend open surgery.