Dr. Adolph Lombardi Jr.
Hip, Knee
PCL Tear Symptoms
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A posterior cruciate ligament (PCL) tear is a painful and sometimes overlooked knee injury that can significantly affect mobility and athletic performance. In this article, we’ll explain what a PCL tear is, explore how and why these injuries occur, and guide you through diagnosis, treatment options, and prevention strategies.
At JIS Orthopedics, located in New Albany and St. Clairsville, OH, our expert orthopedic surgeons specialize in treating knee ligament injuries. If you’re experiencing pain, swelling, or instability in your knee, don’t wait. Contact our knee specialists today for an expert evaluation.
What is a PCL Tear?
The posterior cruciate ligament (PCL) is one of the four major knee ligaments that stabilize the knee joint. It runs from the back of the thigh bone (femur) to the back of the shin bone (tibia) and works with the anterior cruciate ligament (ACL) to control the motion of the tibia. The PCL prevents the tibia from sliding too far backward under the femur.
A PCL tear occurs when the ligament is stretched beyond its capacity or is torn completely. This can range from a partial tear to a complete tear. These injuries can severely limit your ability to walk, run, or engage in sports medicine activities.
Although less common than ACL injuries, PCL injuries occur in many traumatic situations and can be just as serious.
Causes of a PCL Tear
A PCL tear typically results from a sudden injury to the knee, such as:
- A dashboard injury where the shin forcefully strikes the dashboard during a car crash
- Falling on a bent knee
- Severe impact during playing sports, especially contact sports
- Hyperextension or direct trauma to the lower leg
Signs and Symptoms of a PCL Tear
Common signs and symptoms include:
- Immediate and steady knee swelling
- Pain in the injured knee, especially when walking or going down stairs
- A sense of knee instability
- Difficulty bending or straightening the knee gently
- The knee “giving out” during movement
Unlike ACL injuries, PCL tears may present milder initial symptoms, leading people to mistake them for a minor knee problem.
Categories of the Tear
Doctors classify PCL injuries by grades, which helps determine the appropriate treatment path:
- Grade I – A mild stretch or partial tear of the PCL
- Grade II – A more significant stretch or partial rupture
- Grade III – A completely torn ligament, often leading to significant knee instability
- Grade IV – A severe injury that includes damage to other ligaments
Grade III PCL tears and above often require surgical treatment, especially if accompanied by other ligament injuries.
Diagnostic Exams and Tests
Proper diagnosis begins with a thorough medical history and a comprehensive physical examination. One common test is the posterior drawer test, where the doctor gently pushes the tibia backward while the knee is bent to evaluate the PCL’s integrity.
Additional diagnostics may include:
- X-rays: To rule out bone damage
- MRI scans: Essential to visualize soft tissue injuries, including damage to the posterior cruciate ligament.
- Knee arthroscopy: A minimally invasive procedure sometimes used to diagnose and treat ligament injuries
These tests help distinguish acute PCL problems from chronic PCL problems, which may have different treatment plans.
PCL Tear Treatment
Treatment for a posterior cruciate ligament injury depends on the injury grade:
Initial Treatment
In minor PCL injury cases, initial treatment may include:
- Rest and injury resting
- Knee icing several times a day
- Compression using an elastic bandage
- Elevation of the affected upper leg
For partial tears or low-grade injuries, conservative management may be an effective approach.
Conservative Management
Conservative treatment for low-grade PCL injuries includes the following:
- Wearing a knee brace to protect the injured knee
- Supervised physical therapy to strengthen thigh muscles and restore joint mobility
- Monitoring to prevent further injury
Surgical Treatment
In more serious cases or chronic PCL injuries, PCL surgery or PCL reconstruction may be necessary. This typically involves a tissue graft to replace the damaged ligament.
Post-surgical recovery involves ongoing physical medicine and rehabilitation, guided by a physical therapist, to ensure optimal healing and a smooth return to function.
Preventing a Tear
While not all injuries are avoidable, you can reduce your risk with a few precautions:
- Strengthen leg muscles and thigh muscles
- Wear appropriate gear while playing sports
- Warm up before intense activities
- Improve flexibility and joint control
- Address other ligament injuries before returning to play
These practices help keep the knee stable and reduce the risk of injury.
Recovery
Recovery time depends on injury severity and treatment method:
- Non-surgical cases: Return to activity in 6 to 12 weeks with guided rehabilitation
- Surgical recovery: May take 6 to 9 months or more
Chronic PCL problems involve long-term discomfort and knee instability if untreated, so timely care is crucial.
Most patients can regain full function with the right care and guidance.
Expert Care for Knee Ligament Injuries at JIS Orthopedics
If you’ve suffered a torn PCL or have ongoing pain from a previous injury posterior cruciate ligament, our team at JIS Orthopedics is here to help. Our orthopedic surgeons and sports medicine experts offer leading care in knee ligament repair, recovery, and prevention.
Take control of your recovery by scheduling an appointment with our knee specialists in New Albany or St. Clairsville today. We’ll create a personalized plan to help you get back on your feet and back to the activities you love.
Medically reviewed by Dr. Alexander G. Athey
JIS Orthopedics can diagnose and treat your injury, and help you recover
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