What Does a PCL Tear Feel Like? Treatment, Recovery, Evidence
Although a posterior cruciate ligament injury (PCL) is less common than an ACL or LCL tear, it can still limit or prevent you from doing things you enjoy. Symptoms are likely to overlap with those of other causes, such as a hamstring strain or a Baker’s cyst.
The PCL is the strongest ligament in the human body, preventing the femur from sliding horizontally across the tibia and limiting knee abduction and adduction. Like all ligaments, the PCL has a poor blood supply, making PCL lesions more difficult to heal.
PCL tear causes
Trauma to the knee joint, particularly an impact to the shin bone, is the most common cause of PCL tears (13.1%) among all sports, and non-contact injuries may increase the risk of such a tear.
PCL tear symptoms
PCL tears can cause swelling, achiness, and instability in the back of the knee, and they can occur in conjunction with other knee injuries such as torn knee meniscus or osteoarthritis. Symptoms vary from person to person due to a variety of factors.
PCL tear diagnosis
Acute and chronic pain from a PCL tear or injury would necessitate different tests, and they can be difficult for clinicians to diagnose because there could be one or more causes of pain in addition to the PCL injury, necessitating multiple physical examinations.
Posterior drawer test
While the femur is stabilized, a clinician will push hard on the tibia near your knee joint, the amount of movement depending on the grade of the tear, which ranges from 0-5 millimeters to 11-plus millimeters.
The Clancy sign, named after Dr. William Clancy, Jr. of the University of Wisconsin, was developed in the early 1980s and indicates that the clinician cannot feel the bony projections to either side of the tibial plateau beneath the femur’s condyles.
The dial test compares the external rotation of the tibia to that of the opposite, uninjured knee. If there is more than 10 degrees of external rotation compared to the opposite, uninjured knee, there may be a PCL injury. However, a cadaver study from South Korea found that it may not be able to detect injury to posterior knee structures.
Reverse pivot-shift test
The reverse pivot-shift test, which has a low sensitivity rate of 26% and a high specificity rate of 95%, can be used to check for a PCL tear. The tibia plateau is partially “out” of the knee joint as knee flexion is reduced between 20 and 30 degrees.
Posterior sag test
Clinicians check for excessive concaveness of the upper tibia near the tibial plateau during the posterior sag test, which is likely a sign of a PCL tear if performed with your hip and knee flexed at about 90 degrees.
PCL tear treatments
The type of treatment you receive is determined by whether the PCL or other parts of the knee are torn acutely or chronically.
According to a 2018 review by Pache et al. of the Steadman Philippon Research Institute in Vail, Colorado, the type of treatment patients receive depends on the severity of the torn PCL, with the majority of the scientific literature favoring operative interventions over non-operative ones. A Belgian study finds that delaying PCL reconstruction surgery causes more cartilage damage.
Massage therapy and PCL tear
There is no panacea for different types of pain, according to Robert Haddow, because two patients with the same injury will not experience pain and movement in the same way. Massage therapists should use “a solid assessments strategy” rather than assumptions.
How do you know if you tore your PCL?
Posterior Cruciate Ligament ( PCL ) Tears Symptoms
- Sharp or dull pain around the back of the knee
- Difficulty bearing weight.
- Knee instability.
- The back of the knee may be warm to the touch.
- Tenderness around the knee joint.
- Knee tingling or numbness.
Can a torn PCL heal on its own?
PCL injuries are usually partial ligament tears that heal on their own without causing instability as long as the knee is protected during healing and no other knee joint injuries are present.
Is a PCL tear serious?
The PCL can be damaged in a variety of ways, from mild to severe.
Can a torn PCL heal without surgery?
PCL injuries can be successfully treated without surgery, according to a recent study published in the prestigious American Journal of Sports Medicine.
How do you check for a torn PCL?
Increased external rotation at 30 degrees only indicates an isolated PCL injury; noticeable differences at both 30 and 90 degrees indicate a combined PCL and PLC injury. Dial test or tibial external rotation test: to determine if there is a combined PCL and posterolateral corner (PLC) injury.
Can you tear your PCL and not know it?
Make an appointment to see your doctor if you develop pain in the front of your knee several weeks after you’ve injured it; many PCL sprains are overlooked at the time of injury, so you could have sprained your PCL without realizing it.
Can you walk with torn PCL?
If you only have mild damage to the PCL and no other parts of your knee, you may not notice any pain, swelling, or other problems right away.
Do you need surgery if you tear your PCL?
Many people can live and function normally with just a torn PCL. However, if you are younger, having a torn PCL and instability of your knee may lead to arthritis as you age. Talk to your doctor about the best treatment for you.
What should you avoid with a PCL injury?
Weight shifting and proprioception exercises are progressed from two to one limb (Fig. 3au2013c), with double-limb strengthening exercises like squats and leg press limited to no more than 70 degrees of flexion to avoid stressing the healing PCL .
Can you play sports with a torn PCL?
However, due to the instability or lack of confidence in the joint, a PCL injury can slightly impair performance, and about 20% of athletes are unable to continue playing their sport.
What’s worse ACL or PCL tear?
An ACL tear causes more pain than a PCL tear, and there may be a significant (or complete) loss of range of motion in the knee. Swelling from an ACL tear usually develops slowly over the course of 24 hours.
How do you strengthen your PCL?
Sets of four
- Place a small, rolled-up towel under your affected leg’s knee and sit with it straight and supported on the floor or a firm bed.
- Tighten the thigh muscles of your affected leg by pressing the back of your knee down into the towel.
- Hold for about 6 seconds, then rest for up to 10 seconds.
- Repeat 8 to 12 times.
Can you squat with a torn PCL?
Precautions you can take at home for minor PCL injuries include reducing activity during the acute phase and using crutches and a knee brace. Exercises like squats and leg presses are used because they put less stress on the knee.
How much does PCL surgery cost?
How Much Does Posterior Cruciate Ligament (PCL) Repair or Reconstruction Cost? Posterior Cruciate Ligament (PCL) Repair or Reconstruction costs $10,488 to $21,265, according to MDsave.