While less common than ACL injuries, a Posterior Cruciate Ligament (PCL) injury is often referred to as a dashboard injury because it frequently occurs when the knee is struck while bent.
PCL Sprain: You might experience a dull ache or soreness in the back of the knee. Swelling is often minimal, and the joint may feel stiff but relatively stable.
PCL Rupture: A complete tear often causes a feeling of instability when walking or descending stairs. You may notice swelling that fills the back of the knee (the popliteal fossa) and a visible sag of the shinbone when lying down with your knees bent.
Physical Exam
Imaging: While X-rays help rule out bone fractures, an MRI is the gold standard for visualizing soft tissue. This allows us to see if the PCL is stretched (sprain) or disconnected (rupture).
Many PCL injuries heal well with conservative management because the ligament has a better blood supply than the ACL.
Most Grade I and Grade II PCL injuries do not require surgery.
Dynamic Bracing: A specialized PCL brace applies constant forward pressure on the tibia to keep it in the correct position while the ligament heals.
Physical Therapy: Focus is placed heavily on the quadriceps. Strong quads can effectively take over the job of the PCL by pulling the tibia forward.
Surgery is rarely utilized for isolated injuries of the PCL and is generally reserved for specific cases.
Combined Injuries: If the PCL is torn along with other ligaments, surgery is usually necessary to restore stability.