Posterior Cruciate Ligament (PCL) Injury

Anatomy of the PCL

The posterior cruciate ligament (PCL) is one of 4 major ligaments in the knee and crosses over the anterior cruciate ligament (ACL) in the center of the knee joint. The PCL is about 2 inches long and is the strongest ligament in the knee and is therefore less prone to injury.

The PCL aids in stabilization of the front and back movements of the knee by joining the back of the tibia (shin bone) to the inside end of the femur (thigh bone).

PCL Injury Symptoms

If you have injured your PCL you will usually experience pain in your knee that increases when you run, kneel, squat, slow down or use ramps and stairs. Tenderness and swelling usually set in within 3 hours of the injury with bruising to follow within 1-2 days. Your knee may be stable enough to walk but you may also notice a small degree of instability or it giving way during certain activities when you are not careful.

PCL Injury Causes

Tearing of the posterior cruciate ligament usually occurs during a sports related activity or an acute trauma of some kind.

If the shinbone is hit hard just below the knee in situations such as a football or soccer player falling to the ground with the knee bent and it takes the force of the fall or your knees slamming into the dashboard in a car accident, PCL tears are often the result.

PCL Injury Diagnosis

To diagnose a PCL tear and the extent of damage that has occured, your doctor may perform a variety of assessments:

• Palpation and Observation is often the first step in diagnosing. The joint will be examined for swelling, bruising and deformities. Next the doctor pressing lightly in the ligament area to check for the degree of tenderness, swelling and warmth. Some tenderness usually indicates a mild, or grade 1, sprain and acute pain indicates a more serious injury such as a tear.
• The doctor will also assess the range of motion at the knee. You will be asked to bend and straighten your knee and then the doctor will bend it for you to check for limitations due to pain and swelling.
• The Posterior Drawer Test is used if a PCL tear is suspected. During this test, the doctor will push the shinbone back with the knee bent at 90 degrees. If the shinbone can move more than 5mm backward, a PCL tear is diagnosed.
• An MRI may also be recommended so the doctor can take a look at the actual ligament for a more accurate diagnosis.
• An arthroscopy may also be used to allow the doctor a look at the ligament. A tiny camera is inserted into the knee and the doctor can use a small surgical instrument to gently tug at the PCL to determine the extent of the damage. An arthroscopy can be performed on an outpatient basis.

PCL Injury Treatments - What You Can Do!

Treatment differs from case to case depending on the degree of instability in the knee and the patient's activity level. Treating a PCL injury with rest, Cold Compression, Ultrasound Therapy, and Blood Flow Stimulation Therapy will speed healing and improve the function of the knee so you can return to your normal activities. Once the PCL has improved and activities can be resumed, you will first want to build muscle strength around the knee under the guidance of a physical therapist.

If reconstruction of the PCL is required, using these therapies prior to surgery will reduce further damage and improve the health of the PCL and surrounding tissue so the surgery is less invasive.

Using these therapies after surgery will control pain and swelling, reduce tissue damage, speed healing and treat the scar tissue resulting from the healing process. You will have a healthier knee with a greater range of motion than if your recontructed PCL was left untreated.

Cold Compression Therapy

Using cold compression immediately following a PCL tear reduces pain and swelling and reduces the tissue damage that occurs with soft tissue injuries like ligament tears.

The Knee Freezie Wrap™ allows you to treat yourself in an effective and convenient way following a PCL tear and after any further re-injury (which is common due to the instability of the knee).

Cold Compression Therapy works by interrupting and slowing nerve and cell function in the damaged area. This is important because once blood vessels are damaged, they can no longer carry oxygenated blood to the damaged PCL and cells begin to break-down.

The deep cold provided by the Knee Freezie Wrap™ slows cell function thereby reducing cellular break-down. Furthermore, because the cold wraps serve to numb the nerves, the wraps also reduce pain! The Knee Freezie Wrap™ uses a deep cold gel pack with a medical-grade neoprene compression cover to keep the ice off the skin preventing cryoburn and to keep the cold in the area that you need it.

Ultrasound Therapy

Ultrasound Therapy increases tissue elasticity while promoting the flow of blood (filled with vital oxygen and nutrients) to your injured PCL. This cleans the injured area by getting rid of damaged tissue and reducing the inflammation surrounding the PCL and opening up the blood vessels to begin healing.

During the healing process, scar tissue builds on the ligament and can attach the ACL to the PCL or other surrounding tissue in the joint, limiting the flexibility in your knee. Fortunately, you can treat your PCL with therapeutic ultrasound to soften scar tissue and improve your range of motion.

Not only does ultrasound aid in the duration of healing, but it helps to prevent long term complications. Pain, scar tissue, lack of mobility and arthritis are some of the more common long term complications from a PCL injury. By treating your ligament with ultrasound, scar tissue is softened reducing the risk of chronic problems in the future.

For those who suffer from long term complications of existing posterior cruciate ligament injuries, ultrasound can help. Ultrasound therapy can help to break up scar and fibrous tissue in the affected area.

Ultrasound can also be used to administer therapeutic medicines into the body. This is a process known as phonophoresis. Ultrasound with phonophoresis is rapidly becoming more popular than ultrasound therapy alone.

Phonophoresis can be received using a MendMeShop Ultrasound Therapy System. The treatment is safe, easy, painless, and generally requires between 5 - 10 minutes. It is based on a form of deep tissue therapy, which is generated through high frequency sound waves (that we can not hear). These waves send vibrations deep into your body and slightly increase the temperature of your soft tissue cells. The waves are delivered through a hand held transducer and conductive gel that are used together in a slow, circular motion on your skin over the injured area.

Once the inflammation and swelling of a PCL tear has been alleviated, nourishing and strengthening the ligament tissue is recommended. Using Blood Flow Stimulation Therapy will speed your recovery and heal your ligament more completely preparing it for leg strengthening exercises. Talk to your doctor or physical therapist to find out which exercises are appropriate for your situation.

Blood Flow Stimulation Therapy™

After the inflammation and swelling is gone you can begin to treat your PCL tear with Blood Flow Stimulation Therapy, or BFST. BFST increases the amount of blood that flows naturally to your knee to nourish cartilage, tendons, ligaments and muscles to speed healing.

By treating yourself with Blood Flow Stimulation Therapy you can increase your body's blood supply to the knee and your body's natural healing power. In addition, the fresh blood flow whisks away dead cells and toxins that have built up from the injury leaving the area clean and able to heal faster. Our Knee Inferno Wrap™ provides effective, non-invasive, non-addictive pain relief and healing with no side effects.

During your recovery, you should modify and/or eliminate any activities that cause pain or discomfort in your knee area until your pain and inflammation settle.

With these 3 easy therapies you will notice incredible improvement in your knee. The more diligent you are with your treatment and rehabilitation, the faster you will see successful results!

We recommend that you consult your doctor or physiotherapist before using any of our products to be sure they're right for you and your condition.

I want to learn more about The Cold Compression Freezie Wrap™

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Prevention

To prevent knee injuries it is recommended that you gradually increase the intensity of any exercise or activity when you begin and to be aware of the movement of the knee during activity.

A knee that is supported by strong leg muscles is less prone to injury, therefore, regular exercise and maintaining good physical condition, particularly when participating in sports such as football and skiing are also excellent ways to avoid ligament injuries. If your knee is unstable or weak, wearing a brace during exercise and activity can reduce the risk of reinjury of the ligament while your knee is regaining strength.

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