Massage therapy · Kitchener–WaterlooPosterior Cruciate Ligament Tear (PCL)

If a PCL tear is suspected, a clinical examination and special tests to determine the stability of the PCL can be done. However, an MRI scan may need to be performed to look at the ligament and rule out any other damage to the knee joint (American Academy of Orthopaedic Surgeons, n.d.).

Even though a posterior cruciate ligament tear causes less pain, instability and disability than an ACL tear does, it can still take you out for several weeks, if not months. The time really depends on the nature and size of the tear, and the rehabilitation following the injury. Many PCL tears are partial tears that can heal on their own (American Academy of Orthopaedic Surgeons, n.d.). Milder (grade I and II) tears are usually treated without surgery, while complete (grade III) tears are more severe and may need surgery (Vaquero-Picado and Rodríguez-Merchán, 2017). Even without surgery, getting back to sport often takes at least 3 months, and after reconstruction surgery it usually takes 6 to 9 months (Vaquero-Picado and Rodríguez-Merchán, 2017).

The anterior cruciate ligament stops the shin bone (tibia) sliding too far forward under the thigh bone (femur). The medial and lateral collateral ligaments control side-to-side movement of the knee. The posterior cruciate ligament stops the shin bone moving too far backward in relation to the thigh bone. It is stronger than the ACL and is injured far less often (American Academy of Orthopaedic Surgeons, n.d.).

1. Medication

For knee pain, the NHS suggests painkillers such as paracetamol, or ibuprofen gel or tablets (NHS, 2023). (This medicine information comes from the NHS, not from me. Always check with a pharmacist or your family doctor or nurse practitioner before taking any medicine.) In the short term this may help, but therapy, rehab and strengthening exercises will offer a better long-term solution.

2. Therapy

Physical therapists can teach you the proper exercises to help make the knee stronger and improve how it works. Strengthening the muscles at the front of the thigh (quadriceps) has been shown to be a key factor in a successful recovery (American Academy of Orthopaedic Surgeons, n.d.).

Options outside my scope

• Knee brace and crutches: your doctor may recommend a special brace that stops the shinbone sagging backwards, and crutches to keep weight off the leg (American Academy of Orthopaedic Surgeons, n.d.).
• Surgery: if the injury is severe, especially when other knee ligaments or cartilage are also damaged, or if the knee stays unstable or painful despite non-surgical treatment, the ligament may be reconstructed using a tissue graft. This is usually done by arthroscopy (keyhole surgery), using a camera and long surgical tools inserted through small cuts around the knee (American Academy of Orthopaedic Surgeons, n.d.).

How I can help (see the My Approach tab)

I start by assessing how your knee moves and how stable it feels, the strength of your thigh, hip and calf, and how you walk. If your knee is badly swollen, won't take your weight or gives way and hasn't been checked, I'll ask you to see a doctor first.

If your knee locks, gives way or swells badly, get medical advice promptly (see When to get help).