The posterior cruciate ligament is considerably thicker and stronger than the ACL and is also made up of two bundles of fibres. These pass forwards from the back (posterior) to the front (anterior) of the knee. It is attached at its lower end to quite a broad area of the back of the upper tibia. This is its posterior attachment. From there it leads upwards and forwards ending up attached to the inner part of the medial femoral condyle which forms its anterior attachment. The two bundles of fibres are also aligned so that one band becomes tight in rather more flexion and the other band becomes tight in more extended positions of the knee. Like the ACL the PCL contributes to stabilisation of knee movements so that the joint surfaces of the tibia remain properly aligned to the femur in all stages of knee bend. Without it the tibia becomes unstable in relation to the femur and tends to slide backwards under load.
Lesions to the Posterior Cruciate Ligament (PCL) are rarer than those to the ACL, and are seen more often following a traffic accident. Symptoms are also less severe, with pain and swelling in the knee presenting sometime after the injury was sustained, making diagnosis more difficult.
Again, we have a great deal of experience dealing with these kinds of knee injuries, without resorting to surgery, through physiotherapy and effective rehabilitation exercises.
Posterior Cruciate Ligament (PCL) reconstruction
Although the PCL is rarely operated on in isolation, surgeries here are more common where there are lesions to other cruciate ligaments as well. Grafts taken from gracilis tissues are common here, as with ACL Reconstructions. Braces are used to immobilise the knee following surgery, to maximise natural recovery and healing.
Recovery from this type of knee surgery will typically take around five months, with acquatherapy, physiotherapy and on-field rehab all playing a key role.
Posterior Cruciate Ligament (PCL) rehabilitation
The new guidelines after injury of the posterior cruciate ligament, favor a conservative treatment, without resorting to surgery; this because the rear knee ligament is the one that less participates in the stabilization of the same during movement (it has an active role only during knee hyperextension).
In the initial stages, the rehabilitation treatment is similar to that of the most common knee sprains with the aim to reduce swelling and recover joint movement, with care to avoid knee extension movements ceiling.
Once you reach the goal you can move on to the stage of muscle recovery, primarily the muscles that limit the hyperextension, such as knee flexors in both concentric and eccentric mode, triceps, especially the twins; will be simultaneously reinforced the quadriceps, especially with eccentric exercises, the muscles of the core (important for overall body stabilization) which will be linked to proprioceptive and coordinative exercises.
After passing the isokinetic testing (no difference in strength between the two limbs) you will advance to the stage of recovery of the sport specific gesture with functional strength exercises and exercises on the sports field and implemented movement education and prevention program through running the Movement Analysis Test (MAT) in the Green room.