Your body has almost 1,000 ligaments that connect bones and joints together. Ligaments are strong bands of tissue that support the healthy movement of joints and stabilize muscles and bones. An injury to one or more ligaments in the body can cause pain, swelling, and instability in the area. A PCL injury refers to the posterior cruciate ligament (PCL), which is a ligament that runs along the back of your knee joint. The posterior cruciate ligament connects your femur, or thigh bone, to the tibia, or shinbone. Anyone can suffer from a PCL injury, though this type is especially common in athletes who participate in sports like baseball, football, soccer, and skiing. Here’s everything you need to know about the causes, symptoms, and treatment for PCL injuries.
Anatomy of the Knee Joint
Did you know that the knee is actually the largest joint in your body? The knee is a hinge joint that allows you to bend and straighten your leg. This joint does have some flexibility by allowing slight rotation to either side. In each knee, you have four main ligaments that strengthen the knee joint and prevent the bones from dislocating. These ligaments support the forward bending and straightening of the knee. Your knee joint also relies on these ligaments to prevent your knee from moving backward or side to side.
Tendons and ligaments help support and stabilize the knee, while muscles provide power and mobility. Cartilage covers the ends of the femur and tibia, which prevents the bones from rubbing against one another. Your kneecap, also known as the patella, is another bone that makes up the knee joint. A healthy knee absorbs everyday stress and allows for typical movements like standing, sitting, and walking without experiencing pain or discomfort.
PCL Sprains & Tears
The posterior cruciate ligament is the strongest ligament in your knee. You need the PCL to help keep your bones in place and allow for the knee to move smoothly. As the main stabilizer for your knee joint, the PCL also prevents your knee from rotating too far to either side or backward. The posterior cruciate ligament also helps ensure that your thigh bone and shinbone are properly aligned. A strain or tear to the PCL is known as a PCL injury.
When you suffer an injury to the PCL, the symptoms can range from moderate discomfort to severe pain and an inability to bear weight on the knee joint. An injury to the PCL and knee will make typical movements more painful or unbearable until you receive proper treatment and care. A sprain refers to the overstretching of a soft tissue like the posterior cruciate ligament. A sprained ligament may be overstretched or suffer a partial or complete tear. PCL strain symptoms can include pain and instability of the knee, ranging from mild to severe.
Types of PCL Injuries
PCL injuries are typically divided into three grades, depending on the severity of the ligament damage.
Grade 1: Mild PCL Sprain
- The PCL is overstretched but not torn.
- Symptoms include minor swelling and discomfort, but the knee remains relatively stable.
- Most common in athletes or people who experience minor knee trauma.
Grade 2: Partial PCL Tear
- The ligament is partially torn, leading to moderate pain, swelling, and instability.
- Patients may feel their knee “giving out” or feel discomfort during movement.
- Commonly occurs due to moderate impact injuries, like falling directly onto a bent knee.
Grade 3: Complete PCL Tear
- The ligament is fully torn, which can cause significant pain, swelling, and knee instability.
- You may struggle to bear weight on the affected leg.
- Often occurs from high-impact trauma, including car accidents or severe sports injuries.
- May be accompanied by other knee injuries, like ACL tears or damage to the meniscus.
- Surgical reconstruction may be required to restore full knee function.
Chronic vs. Acute PCL Injuries
These types of injuries can be classified as either acute or chronic, depending on how they occur and how long the PCL injury signs and symptoms persist. Acute PCL injuries occur suddenly due to trauma, while chronic PCL injuries develop over time, often because of untreated or repeated stress on the ligament. Understanding the difference between these two types of injuries is essential for determining the best treatment approach and long-term recovery outlook.
Acute PCL Injuries
Acute PCL injuries occur suddenly due to direct trauma or a forceful movement that overstretches or tears the ligament. These injuries often result from high-impact sports incidents, such as a football tackle or a basketball player landing awkwardly on a bent knee. Car accidents are another common cause, particularly when the knee forcefully strikes the dashboard in what is known as a “dashboard injury.” Additionally, falls or missteps, such as slipping on ice or tripping down the stairs, can lead to a sudden and forceful bending of the knee, putting excessive strain on the PCL and resulting in injury.
Chronic PCL Injuries
A chronic PCL injury develops over time, often because of untreated or improperly healed past injuries. When an acute PCL injury is not diagnosed or fully rehabilitated, the ligament may become progressively weaker, leading to long-term knee instability and degeneration. One of the most common causes of chronic PCL injuries is repeated stress or overuse, particularly in athletes or individuals who frequently engage in activities that put excessive strain on the knee, such as running, jumping, or squatting. Plus, if an acute PCL injury is left undiagnosed or improperly treated, the ligament can gradually deteriorate, becoming weaker over time. Another potential factor is knee osteoarthritis or cartilage damage, which can develop because of prolonged PCL instability. This degeneration can lead to chronic pain, stiffness, and difficulty with movement, impacting knee function and overall mobility.
Causes of PCL Injuries
Severe knee trauma is the most common cause of a PCL injury. Here are four examples of what might cause a PCL injury.
Car Accidents
Drivers and front-seat passengers are at greater risk of a knee injury during a car accident. The force from the collision could cause your knees to collide with a hard surface like your car’s dashboard. A hard blow to the front of your knee can put too much pressure on the ligaments and other tissues that support your knee, leading to an injury like a sprained or torn PCL. A car accident could also lead to a dislocation of your knee joint, which can put additional stress on nearby soft tissues like the PCL. If you suffer a PCL car accident injury, you may notice pain, redness, bruising, and swelling in the affected knee.
Sports Collisions
High-contact sports can also put you at greater risk for a PCL injury. Athletes who play sports like football or soccer could tear the posterior cruciate ligament if they collide with another player and take a hard hit to the knee. Baseball and basketball players could also suffer a PCL injury if they land incorrectly from a jump or fall onto a bent knee. A sudden hit to the front of the knee can cause the knee to bend too far backward, which can overstretch or tear the posterior cruciate ligament.
Slip & Fall
Accidents happen, and a sudden slip or trip could lead to a painful injury that affects the ligaments in your knee. When you do not have enough time to brace yourself for a fall, you could land hard on bent knees, which can send a jolt of pressure into the knee. You might trip while walking up some stairs and hit your knee on a hard surface. A fall down the stairs or tripping on an uneven surface could cause you to twist your knee outside of its typical forward motion and sprain or tear the PCL and other tissues that support the joint.
Symptoms of a PCL Injury
Symptoms of posterior cruciate ligament injuries can vary depending on the location and severity of the injury. The most common symptoms of a PCL injury include pain, swelling, and instability in the knee. Pain can range from mild to severe, depending on whether you have suffered a mild sprain or a full tear of the PCL. A PCL injury can also occur along with injuries to other ligaments that support the knee, making your pain and discomfort worse.
A sudden blow to the knee will typically result in bruising in the area, and you may notice redness and that the skin around your knee becomes warm to the touch. Swelling and inflammation of the knee can cause more pain and make it difficult for you to bend or straighten your knee. A moderate to severe PCL injury can cause difficulty walking or going down a flight of stairs. When your knee feels unstable, you might worry about putting too much weight on the knee.
Because a PCL injury can restrict the movement of your knee, you may notice an increase in stiffness and soreness in and around the knee.
Here’s a breakdown of acute vs. chronic PCL injury symptoms:
Symptoms of Acute PCL Injuries:
- Immediate pain and swelling in the knee joint.
- Stiffness and limited range of motion, especially when trying to bend or extend the knee.
- A feeling of instability or the knee “giving out” when trying to bear weight.
- In severe cases, bruising behind the knee due to internal bleeding from the ligament tear.
Symptoms of Chronic PCL Injuries:
- Recurrent knee instability, especially when walking on uneven surfaces, climbing stairs, or squatting.
- Intermittent swelling that comes and goes after activity.
- Mild to moderate pain in the back of the knee or deep inside the joint.
- Poor athletic performance as your knee becomes less stable and more prone to discomfort with certain movements.
- In severe cases, degenerative changes in the area, such as arthritis, may develop due to prolonged instability.
PCL Injury Treatments
Visit your Atlanta doctor for a proper diagnosis of your PCL injury and learn more about the extent of the damage. Your doctor will likely perform a physical examination of the knee and test your range of motion. They will want to hear about what symptoms you have been experiencing and what movements or activities have made your PCL tear symptoms better or worse. Diagnostic imaging tests like X-rays or CT scans can also help to confirm a PCL injury and rule out other potential injuries with similar symptoms. Once your doctor has confirmed a PCL injury, they will talk to you about your options for treatment. These are three examples of PCL injury treatments you may experience.
Self-Care
For mild PCL injuries, you may be able to manage your pain and other symptoms with home remedies and self-care. Resting the area will help remove pressure from the knee so the healing can begin. Icing your affected knee will help bring down any swelling and inflammation in the area. Your doctor may recommend an elastic bandage or knee brace to provide gentle compression and support for any instability while you heal. Elevating your knee above your heart can also help reduce blood flow to the area, reducing swelling. Over-the-counter pain relievers like non-steroidal anti-inflammatory drugs may help address inflammation, swelling, and pain.
Non-Invasive Options
Depending on the severity of your PCL injury, your doctor may suggest non-invasive treatment options to help you heal. You may need to use crutches for a certain period of time, which can help you take the weight off the affected knee. A knee brace can also help with swelling and addressing instability so you do not risk further spraining or tearing the ligament. A physical therapist can also work with you to help strengthen and stabilize your knee. If necessary, physical therapy stretches and exercises can help you regain mobility after surgery.
Surgical Options
A severe PCL injury may require surgery for a full recovery. The most common surgery for a PCL injury is called a knee arthroscopy, where a surgeon will reconstruct the ligament. This is a less invasive surgical option where the surgeon makes small incisions around the knee and uses tiny surgical tools to repair or remove any damaged tissue. On average, recovery from knee surgery can take 6 to 9 months, so you want to talk with your doctor about all your treatment options.
Treatment for PCL Injuries at AICA Atlanta
Early diagnosis and proper rehabilitation are crucial to preventing long-term knee instability, pain, and complications like arthritis. Whether the injury is acute or chronic, addressing it with proper treatment and care is essential for maintaining knee function and preventing further damage. Visit AICA Orthopedics in Atlanta and meet with a knee doctor to find out what type of treatment for your PCL injury is right for you. Our team of doctors has access to state-of-the-art diagnostic equipment in the office, and you can meet with your doctor and a physical therapist all in one convenient location. We will also work with you to help reduce your risk and prevent posterior cruciate ligament injuries in the future.