Posterior Cruciate Ligament (PCL) Tears Symptoms & Treatment

Overview

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(ACL), 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.

What causes Posterior Cruciate Ligament (PCL) Tears?

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: This can force the tibia backward, stressing or tearing the PCL.
• Falling on the knee while it is bent: The impact can push the shinbone backward, damaging the ligament.
• Hyperflexion of the knee: Excessive bending beyond the normal range can strain or rupture the PCL.

How the Injury Occurs: PCL injuries occur when the knee experiences sudden force that pushes the tibia backward relative to the femur. This can happen during falls, collisions, or awkward landings, causing the ligament to stretch or tear.

Common Everyday Causes

• Slipping and falling onto a bent knee
• Car accidents where the shin hits the dashboard
• Sudden twists or turns while running or walking

Posterior ligament tears are common in these sports:

• Football: High-speed tackles and collisions increase the risk of knee injuries.
• Hockey: Sudden stops, hits, and falls can stress the PCL.
• Rugby: Direct impacts and twisting movements make PCL injuries more likely.
• Soccer: Quick changes in direction or accidental collisions can cause tears.

Symptoms

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 PCL injury symptoms:

• Pain – Discomfort may be felt at the back of the knee, especially during movement.
• Swelling – The knee may appear swollen shortly after the injury.
• Stiffness – Limited range of motion can make bending or straightening the knee difficult.
• Instability or a loose feeling of the knee – The knee may feel as if it could give way while walking or standing.
• A knee that appears to sag when bent – The tibia may drop backward, creating a noticeable sag.
• Pain in the kneecap (seen in chronic cases) – Ongoing stress on the knee can lead to anterior knee pain over time.

Non-operative treatment

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

• Resting the knee – Avoid activities that put stress on the injured ligament.
• Icing the knee to reduce swelling – Applying ice can help control inflammation and pain.
• Wearing a brace to stabilize the knee while it’s healing – Supports proper alignment and prevents further injury.
• Physical therapy with a trained professional to strengthen the knee and restore range of motion – Exercises improve stability, flexibility, and function over time.

Try these exercises to help address your condition:

Below is a PDF of the Exercise Program

Knee PCL Injury

Surgical Treatment

If you have a complete PCL tear or if your injury does not improve after a rehabilitation program for a high grade partial PCL tear, surgery may be necessary. The goal of PCL reconstruction surgery is to rebuild the ligament and restore stability, mobility, and strength to the knee. During surgery, your doctor will use a graft taken from another part of your body, such as the hamstring or patella, or a donor ligament (allograft) to reconstruct the torn PCL. Because the PCL is a large ligament, an allograft is often preferred.