Posterior Cruciate Ligament (PCL) Injury

A posterior cruciate ligament (PCL) injury happens when you sprain or tear the PCL in your knee. It’s the ligament that runs along the back of your knee and connects your thighbone to the top of your lower leg bone.

PCL injuries are much less common than ACL injuries. In fact, PCL tears usually happen along with other ligament injuries.

You may need surgery to reconstruct your PCL or build a new one. More mild injuries may heal by wearing a brace, using crutches and keeping weight off that knee.

Types of PCL injuries

You might see or hear “PCL sprain” and “PCL tear” used interchangeably. They’re different names for the same injury. A sprain is the medical term for a damaged ligament that’s stretched far enough to damage it. So, technically, even a mild sprain is a type of tear.

Healthcare providers grade PCL injuries as one of four types:

• Grade 1: Your PCL is partially torn.
• Grade 2: Your PCL is partially torn and feels loose.
• Grade 3: This is a complete tear. Your knee feels unstable.

PCL injury symptoms

Symptoms of an injured posterior cruciate ligament can include:

• Pain that gets worse over time
• Swelling and inflammation
• Feeling like your knee is unstable or weaker than usual
• Stiffness
• Trouble walking or moving, especially going down stairs

Symptoms can vary. Some people feel severe pain, but others only have minor discomfort. Similarly, you might be able to stand and walk with a torn PCL. But more severe tears may make it hard (or impossible) to move normally.

PCL injury complications

Untreated PCL injuries can become worse over time. Especially if you have a complete tear with knee instability and don’t get it diagnosed quickly. You may continue to have symptoms, such as pain and swelling. Eventually, your knee may give out. This can damage your knee’s cartilage, other ligaments or meniscus. If the cartilage damage is severe enough, you may need a knee replacement.

Seeing a provider as soon as you think you have a knee injury is the best way to avoid these complications.

PCL injury causes

Anything that stretches your posterior cruciate ligament too far can cause a PCL injury, including:

• Falling on your knee while it’s bent
• Getting hit hard in the front of your knee
• Something forcing your knee to bend too far backward
• Twisting your knee

Some of the most common causes include:

• Car accidents, especially if your knees bang into the dashboard
• Sports injuries
• Knee dislocations
• Landing incorrectly after a jump

Injured posterior cruciate ligament risk factors

Anyone can injure their PCL. Athletes are more likely to. You may have a higher risk of a PCL injury if you play sports like:

• Basketball
• Baseball
• Football
• Soccer
• Skiing or snowboarding

How doctors diagnose posterior cruciate ligament injuries

A healthcare provider will diagnose a PCL injury with a physical exam and tests. Your provider will examine your knee and check your range of motion. Tell them if you know you experienced an injury, or what you were doing before you noticed pain and other symptoms. Also, tell them if your knee feels different or if it’s hard to move or stand.

Your provider might use some imaging tests to take pictures of your knee, including:

• X-rays
• MRI
• CT scan

PCL injury treatments

Your healthcare provider will suggest treatments based on the severity of the PCL injury. Common treatments include:

• The RICE or MEAT methods: These are at-home ways to manage injuries. Your provider will suggest the one that’s best for you.
• Pain relievers: Over-the-counter medications like NSAIDs can relieve pain and reduce inflammation. Your provider will tell you which medicines you should take and how often it’s safe to use them.
• Crutches: Using crutches can reduce how much weight you put on your knee.
• A knee brace: Bracing your knee can support it and keep it from moving too much.
• Physical therapy (PT): PT can help you regain your strength and flexibility. Strengthening the muscles around your leg may help you prevent future injuries.
• Surgery: You may need surgery if you have a severe PCL tear. A surgeon will use a knee arthroscopy to reconstruct your ligament and any damage inside your knee.

Recovery time

Recovery time varies. It depends on how damaged your PCL is and if you have any other injuries.

If the injury is mild, it may only take about 10 days to heal. If you need surgery, it could take anywhere from six to nine months to recover completely. Your healthcare provider or surgeon will tell you what to expect based on your unique situation.

When should I see my healthcare provider?

Visit a healthcare provider if you think you might have a knee injury, or if you experience any of these symptoms:

• You have severe pain or swelling.
• Your knee is unstable or you can’t use it normally.
• Your foot feels numb.
• Your leg or foot changes color or feels cold.

What can I expect if I have a PCL injury?

Minor PCL injuries usually heal with no long-term effects. More severe grades may make your knee weak and increase your risk of re-injury unless you have surgery.

If you need PCL surgery, you should expect to make a full recovery. In fact, people who have surgery usually notice improved stability and mobility after they recover. Your surgeon may still recommend that you wear a knee brace during physical activities in the future. The extra support can help reduce your risk of another injury.