PCL: Symptoms, Causes, Treatment & Exercises

Key Takeaways

• PCL injuries primarily occur from direct impact to the front of the knee, such as dashboard injuries in car accidents or falls onto bent knees.

• Recognise symptoms including knee pain, swelling, instability, and difficulty bearing weight.

• Treatment options range from conservative RICE protocol for minor injuries to surgical reconstruction for complete tears or persistent instability.

• Rehabilitation exercises focusing on strengthening, flexibility, and balance are necessary components of recovery regardless of treatment approach.

• MSK Doctors offers specialist PCL treatment with no GP referral required, combining the experience of orthopaedic consultants and personalised rehabilitation plans for optimal knee health.

What is PCL?

The PCL is one of the four major ligaments in the knee. It is located at the back of the knee and works in tandem with the anterior cruciate ligament (ACL) to control the backward and forward motion of the knee (image courtesy of Cleveland Clinic). 

The PCL has two main functional components:

1. The anterolateral component - larger and tighter when the knee is flexed

2. The posteromedial component  - tighter when the knee is extended

The primary function of the PCL is to prevent posterior translation - it stops the tibia from sliding too far backward relative to the femur. It acts as a central stabiliser of the knee, providing about 95% of the restraining force that prevents this backward movement. This is particularly important when walking downhill or descending stairs, when forces push the tibia backward.

The PCL is generally stronger and thicker than the ACL, making it less prone to injury, but it can still be damaged under significant stress or trauma. 

Identifying PCL Injury Symptoms

Pain and Swelling

Pain and swelling are the body's natural responses to injury. After a PCL injury, these symptoms often appear quickly. Applying ice and elevating the leg can help reduce swelling and manage pain. However, if these symptoms persist, seek medical advice to rule out more severe damage.

Knee Instability

Instability in the knee is a common symptom of PCL injuries that occurs because the PCL is responsible for keeping the knee stable and aligned. When damaged, the knee may feel loose or unstable, like when you are walking or changing direction. Making every day activities challenging and increasing the risk of further injury.

Movement Difficulty

Difficulty moving the knee is another sign of a PCL injury that can manifest as stiffness, reduced range of motion, or an inability to fully straighten or bend the knee. Movement difficulty often follows pain and swelling. 

Understanding PCL Injury Causes

Injury from Impact

Direct impact injuries occur when a significant force is applied to the knee. This can happen during a football tackle or a car accident, where the knee hits the dashboard. Such impacts can stretch or tear the PCL - leading to instability and pain.

Sports-Related Issues

Sports are a common cause for PCL injuries, particularly those that involve high-impact or contact. Football, soccer, and skiing are just a few examples where athletes are at risk. These activities often involve sudden changes in direction, jumping, and physical contact, all of which can put excessive stress on the knee. 

For instance, a football player might experience a PCL injury when tackled from the front, causing the knee to bend backward awkwardly.

Accidental Falls

Imagine slipping on a wet surface or tripping over an object, leading to a fall where your knee bends sharply. This sudden, forceful motion can easily strain or tear the PCL. The risk is higher in environments where falls are more likely, such as icy sidewalks or cluttered areas.

In addition, these falls can occur in everyday settings, not just in sports or high-risk environments. For example, a simple misstep on a staircase can result in a knee injury if you land awkwardly on a bent knee. 

Be mindful of your surroundings and take precautions to prevent such accidents:

• Ensure adequate lighting in your home to avoid tripping over unseen objects.

• Use handrails when going up or down stairs to provide additional support.

• Wear appropriate footwear with good traction to prevent slips.

Treatment Options

Non-Surgical Methods

• Rest: Allowing the knee to rest and avoiding activities that could worsen the injury is essential for healing.

• Ice: Applying ice packs to the affected area can help reduce swelling and numb the pain.

• Compression: Using a compression bandage can provide support and limit swelling.

• Elevation: Keeping the knee elevated above heart level can also help minimise swelling.

Surgical Interventions

Surgical interventions typically involve reconstructing the damaged ligament using tissue grafts. This procedure aims to restore the knee's stability and function, allowing you to return to your normal activities.

Home Care Tips

Managing a PCL injury at home involves several important steps: 

• Get adequate rest. 

• Avoid activities that strain the knee. 

• Apply ice packs to reduce swelling and alleviate pain. 

• Keep the knee elevated whenever possible to minimise fluid buildup.

• Compression bandages or knee braces can provide additional support and stability as they help limit unnecessary movement and protect the knee during recovery. 

Stay consistent with these home care practices and you will significantly impact the recovery timeline and effectiveness. The goal is to maintain a balance between rest and gradual activity to promote healing. 

Rehabilitation Exercises

Strengthening Exercises

Strengthening exercises focus on building the muscles that support the knee joint, such as the quadriceps, hamstrings, and calves. These exercises improve the knee's stability and reduce strain on the PCL.

Effective strengthening exercises include:

• Leg Press: Using a leg press machine to strengthen the quadriceps and hamstrings.

• Hamstring Curls: Performing hamstring curls with resistance bands or weights.

• Calf Raises: Standing on your toes to strengthen the calf muscles.

Flexibility Drills

Stretching exercises such as hamstring stretch and wall slides can improve flexibility and reduce the risk of injury by keeping the muscles and ligaments supple (image courtesy of Sports Injury Clinic).

Flexibility drills like heel slides, quad sets and straight leg raises help maintain the knee's range of motion and prevent stiffness.

Balance Training

Balance training enhances proprioception, which is the body's ability to sense its position in space. Improving balance can help prevent falls and reduce the risk of future knee injuries.

Examples of balance training exercises include:

Single-Leg Stands: Standing on one leg to improve balance and stability.

Bosu Ball Exercises: Using a Bosu ball to challenge your balance and coordination.

Long-Term Management

Focus on low-impact activities like swimming or cycling, which can strengthen the muscles around the knee without putting undue stress on the joint. 

Precise PCL Care: Why Choose MSK Doctors

At MSK Doctors, we understand the significant impact a PCL injury can have on your mobility and quality of life. Our approach to PCL injuries combines advanced diagnostic technology with personalised treatment plans delivered by leading orthopaedic specialists. 

Our state-of-the-art MAI-Motion AI platform provides unparalleled insights into your unique movement patterns, allowing us to personalise rehabilitation programmes that address your musculoskeletal needs and goals. 

Even if you require conservative management or surgical intervention, our comprehensive care extends beyond treatment to include detailed recovery guidance and preventative strategies.

What differentiates us from traditional healthcare pathways, is our immediate access to expert care without GP referrals - ensuring your recovery begins promptly.

Trust us to restore your knee stability and function with precision care and expertise. Book your consultation with MSK Doctors today and begin your journey to optimal knee health! 

Frequently Asked Questions (FAQ)

How can I tell if my PCL is injured?

Identifying a PCL injury often involves recognising key symptoms such as knee pain, swelling, and a feeling of instability. 

Should I see a doctor for PCL pain?

Yes, it's advisable to see a doctor if you experience persistent knee pain or suspect a PCL injury. Early diagnosis and treatment can prevent further damage and promote faster recovery. 

Which exercises are best after PCL surgery?

Initially, gentle range-of-motion exercises are recommended to prevent stiffness. As you progress, strengthening exercises like leg presses and hamstring curls can be introduced as well as balance and proprioception exercises. 

How long is the recovery from a PCL injury?

Recovery time varies based on the injury's severity and the treatment approach. Minor PCL injuries might heal within a few weeks with non-surgical treatment, while more severe injuries requiring surgery could take several months to a year for full recovery.

Why is MSK Doctors the optimal choice for PCL treatment?

At MSK Doctors, we offer direct access to specialist care - eliminating waiting times. Our combination of AI-assisted movement analysis delivers comprehensive care that optimises recovery outcomes and long-term knee health.