Posterior Cruciate Ligament (PCL) Tears Symptoms & Treatment

The posterior cruciate ligament (PCL) is a strong ligament that runs through the center of the knee joint and connects the femur (thigh bone) to the tibia (shin bone). The PCL keeps the shinbone from moving backward after the leg has been straightened.

Because the posterior cruciate ligament is stronger than the anterior cruciate ligament, it is injured less often. A PCL tear often occurs alongside other knee injuries, like an ACL, MCL, or LCL tear. Generally, when a PCL tear occurs, it is partial, meaning that the tear does not go all the way through the ligament. Occasionally, the tear will go completely through the ligament. Partial tears are able to heal on their own, while complete tears may need surgical repair.

PCL tears are most commonly seen in contact sports. They typically occur as the result of:

• A direct blow to the front of the knee
• Falling on the knee while it is bent
• Hyperflexion of the knee

Posterior ligament tears are common in these sports:

• Football
• Hockey
• Rugby
• Soccer

Most often, PCL tears are partial tears and can be difficult to identify. You may have a tear in your posterior cruciate ligament if you experience one or more of the following symptoms:

• Pain
• Swelling
• Stiffness
• Instability or a loose feeling of the knee
• A knee that appears to sag when bent
• Pain in the kneecap (seen in chronic cases)

If you have had trauma or impact to the knee, like falling on the knee when its bent, and experience symptoms of a PCL tear, make an appointment with an orthopedic specialist. During your appointment, your doctor will ask you to describe your symptoms.

Your doctor will also examine your knee for swelling and will perform a posterior drawer test to assess the integrity of the posterior cruciate ligament. If your doctor feels that the ligament seems loose, this may indicate a PCL tear.

In order to make a diagnosis, your doctor may prescribe the following imaging tests:

• X-ray
• MRI

If you have a partial PCL tear, your doctor will likely recommend beginning with conservative, non-operative treatments. Non-operative treatments for a partial PCL tear may include:

• Resting the knee
• Icing the knee to reduce swelling
• Wearing a brace to stabilize the knee while it’s healing
• Physical therapy with a trained professional to strengthen the knee and restore range of motion

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Knee PCL Injury

If you have a complete PCL tear, or if your injury does not heal after completing a rehabilitation program for a partial PCL tear, you may require surgery. The goal of PCL reconstruction surgery is to rebuild the PCL ligament and restore stability, mobility, and strength to the knee. During PCL reconstruction surgery, your doctor will use a graft made from tissue taken from another place in your body (like the hamstring or the patella) or from a donor ligament (called an allograft) to reconstruct the torn PCL. As the PCL is a large ligament, oftentimes an allograft is needed.

The time it takes you to recover from a PCL tear will depend on the severity of your injury and if you require surgery. Non-operative treatments can take three to six months for full recovery, while surgical treatment can take six to 12 months to return to normal activities.

It’s important to follow all instructions given to you by your orthopedic specialist. You will be allowed to return to sports and normal activities when you have recovered full strength and range of motion and have no pain.